Arlet B Urrutia USDOT 1349620

Total Number of Inspections for the measurement period (24 months)	2
Total Number of Driver Inspections for the measurment period	2
Total Number of Driver Inspections containing at least one Driver Out-of-Service Violation	0
Total Number of Vehicle Inspections for the measurement period	2
Total Number of Vehicle Inspections containing at least one Vehicle Out-of-Service violation	1
Arlet B Urrutia Unsafe Truck Driving Data
Number of inspections with at least one Unsafe Driving BASIC violation	0
Unsafe Driving BASIC Roadside Performance Measure Value	0
Unsafe Driving BASIC Acute/Critical Indicator (Yes = Acute/Critical from investigation within previous 12 months)	No

Arlet B Urrutia Hours-of-Service (HOS) Data
Number of inspections with at least one Hours-of-Service BASIC violation	0
Hours-of-Service (HOS) Compliance BASIC Roadside Performance measure value	0
Hours-of-Service (HOS) Compliance BASIC Acute/Critical Indicator (Yes = Acute/Critical from investigation within previous 12 months)	No
Arlet B Urrutia Truck Driver Fitness Data
Number of inspections with at least one Truck Driver Fitness BASIC violation	0
Truck Driver Fitness BASIC Roadside Performance measure value	0
Truck Driver Fitness BASIC Serious Violation Indicator (Yes = Acute/Critical from investigation within previous 12 months)	No

Arlet B Urrutia Controlled Substances and Alcohol Data
Number of inspections with at least one Controlled Substances and Alcohol BASIC violation	0
Number of inspections with at least one Controlled Substances and Alcohol BASIC violation	0
Controlled Substances and Alcohol BASIC Acute/Critical Indicator (Yes = Acute/Critical from investigation within previous 12 months)	No
Arlet B Urrutia Vehicle Maintenance Data
Number of inspections with at least one Vehicle Maintenance BASIC violation	1
Vehicle Maintenance BASIC Roadside Performance measure value	6.66
Vehicle Maintenance BASIC Acute/Critical Indicator (Yes = Acute/Critical from investigation within previous 12 months)	No

Insurance Form	Insurance Type	Insurance Carrier	Policy/Surety	Coverage Amount From	Coverage Amount To	Effective Date From	Effective Date To
91X	BIPD/Primary	Northland Insurance Company	WN187271	$0	$750,000	03/19/2016	?
91X	BIPD/Primary	National Indemnity Company	70TRS046105-01	$0	$750,000	05/14/2015	03/19/2016 Cancelled
91X	BIPD/Primary	National Indemnity Company	70TRS046105-01	$0	$750,000	03/20/2015	05/26/2015 Cancelled
91X	BIPD/Primary	National Indemnity Company	70TRS046105-01	$0	$750,000	03/20/2015	05/14/2015 Replaced
91X	BIPD/Primary	Carolina Casualty Insurance Co.	361922	$0	$1,000,000	03/19/2014	03/19/2015 Cancelled
91X	BIPD/Primary	Carolina Casualty Insurance Co.	360820	$0	$750,000	03/19/2013	03/19/2014 Cancelled
91X	BIPD/Primary	Carolina Casualty Insurance Co.	358046	$0	$750,000	03/19/2012	03/19/2013 Cancelled
91X	BIPD/Primary	Carolina Casualty Insurance Co.	CBP356227	$0	$750,000	03/19/2011	03/19/2012 Cancelled
91X	BIPD/Primary	Carolina Casualty Insurance Co.	348428	$0	$750,000	07/08/2010	03/19/2011 Cancelled
91X	BIPD/Primary	Carolina Casualty Insurance Co.	348428	$0	$750,000	05/17/2010	07/08/2010 Cancelled
91X	BIPD/Primary	Carolina Casualty Insurance Co.	348428	$0	$750,000	03/19/2010	05/17/2010 Cancelled
91X	BIPD/Primary	Carolina Casualty Insurance Co.	353076	$0	$750,000	01/22/2010	03/19/2010 Cancelled
91X	BIPD/Primary	Carolina Casualty Insurance Co.	353076	$0	$750,000	12/11/2009	01/22/2010 Cancelled
91X	BIPD/Primary	Carolina Casualty Insurance Co.	353076	$0	$750,000	03/19/2009	12/11/2009 Cancelled
91X	BIPD/Primary	Empire Fire & Marine Insurance Co.	CL272816	$0	$750,000	05/10/2008	03/19/2009 Cancelled
91X	BIPD/Primary	Empire Fire & Marine Insurance Co.	CL272816	$0	$750,000	03/19/2008	05/10/2008 Cancelled
91X	BIPD/Primary	Empire Fire & Marine Insurance Co.	CL272353	$0	$750,000	11/21/2007	03/19/2008 Cancelled
34	CARGO	Carolina Casualty Insurance Co.	CBP356227	$0	$5,000*	03/19/2011	03/19/2012 Cancelled
34	CARGO	Carolina Casualty Insurance Co.	348428	$0	$5,000*	07/08/2010	03/19/2011 Cancelled
34	CARGO	Carolina Casualty Insurance Co.	348428	$0	$5,000*	05/17/2010	07/08/2010 Cancelled
34	CARGO	Carolina Casualty Insurance Co.	348428	$0	$5,000*	03/19/2010	05/17/2010 Cancelled
34	CARGO	Carolina Casualty Insurance Co.	353076	$0	$5,000*	01/22/2010	03/19/2010 Cancelled
34	CARGO	Carolina Casualty Insurance Co.	353076	$0	$5,000*	12/11/2009	01/22/2010 Cancelled
34	CARGO	Carolina Casualty Insurance Co.	353076	$0	$5,000*	03/19/2009	12/11/2009 Cancelled
34	CARGO	Empire Fire & Marine Insurance Co.	CL272816	$0	$5,000*	05/10/2008	03/19/2009 Cancelled
34	CARGO	Empire Fire & Marine Insurance Co.	CL272816	$0	$5,000*	03/19/2008	05/10/2008 Cancelled
34	CARGO	Carolina Casualty Insurance Co.	475766	$0	$5,000*	11/21/2007	03/19/2008 Cancelled

* If a carrier is in compliance, the amount of coverage will always be shown as the required Federal minimum ($5,000 per vehicle, $10,000 per occurrence for cargo insurance and $75,000 for bond/trust fund). The carrier may actually have higher levels of coverage.';

Northland Insurance Company 385 WASHINGTON STREET MAIL CODE 103 ST. PAUL, MN Fax:(651)310 - 4949	Carolina Casualty Insurance Co. P O BOX 2575 JACKSONVILLLE, FL Fax:(900)363 - 8088	Empire Fire & Marine Insurance Co. 13810 FNB PKWY. OMAHA, NE
National Indemnity Company 3024 HARNEY STREET OMAHA, NE Fax:(402)916 - 3018