Forth Trucking USDOT 1111625

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	2
Forth Trucking Unsafe Truck Driving Data
Number of inspections with at least one Unsafe Driving BASIC violation	1
Unsafe Driving BASIC Roadside Performance Measure Value	.8
Unsafe Driving BASIC Acute/Critical Indicator (Yes = Acute/Critical from investigation within previous 12 months)	No

Forth Trucking 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
Forth Trucking 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

Forth Trucking 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
Forth Trucking Vehicle Maintenance Data
Number of inspections with at least one Vehicle Maintenance BASIC violation	2
Vehicle Maintenance BASIC Roadside Performance measure value	20.66
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	Acuity, A Mutual Insurance Company	CA-X66823	$0	$750,000	08/14/2015	?
91X	BIPD/Primary	Acuity, A Mutual Insurance Company	CA-X66823	$0	$750,000	04/20/2015	09/21/2015 Name Changed
91X	BIPD/Primary	Acuity, A Mutual Insurance Company	CA-X66823	$0	$750,000	04/20/2015	08/14/2015 Replaced
91X	BIPD/Primary	Acuity, A Mutual Insurance Company	CA-X66823	$0	$750,000	04/11/2013	05/04/2015 Cancelled
91X	BIPD/Primary	Acuity, A Mutual Insurance Company	CA-X66823	$0	$750,000	04/11/2013	04/20/2015 Replaced
91X	BIPD/Primary	Northland Insurance Company	WN066021	$0	$750,000	04/11/2011	04/11/2013 Replaced
91X	BIPD/Primary	Great West Casualty Co.	GWP13378B	$0	$1,000,000	04/11/2004	05/13/2011 Cancelled
91X	BIPD/Primary	Great West Casualty Co.	GWP13378B	$0	$1,000,000	04/11/2004	04/11/2011 Replaced
91X	BIPD/Primary	Northland Insurance Company	TN375187	$0	$1,000,000	04/11/2003	05/13/2004 Cancelled
91X	BIPD/Primary	Northland Insurance Company	TN375187	$0	$1,000,000	04/11/2003	04/11/2004 Replaced
34	CARGO	Great West Casualty Co.	GWP13378A	$0	$5,000*	04/05/2003	05/13/2011 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.';

Great West Casualty Co. 1100 WEST 29TH ST., P.O. BOX 277 SOUTH SIOUX CITY, NE Fax:(402)494 - 7400

Northland Insurance Company 385 WASHINGTON STREET MAIL CODE 103 ST. PAUL, MN Fax:(651)310 - 4949

Acuity, A Mutual Insurance Company 2800 SOUTH TAYLOR DR. SHEBOYGAN, WI Fax:(920)458 - 1618