John Black USDOT 2004059

Total Number of Inspections for the measurement period (24 months)	0
Total Number of Driver Inspections for the measurment period	0
Total Number of Driver Inspections containing at least one Driver Out-of-Service Violation	0
Total Number of Vehicle Inspections for the measurement period	0
Total Number of Vehicle Inspections containing at least one Vehicle Out-of-Service violation	0
John Black 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

John Black 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
John Black 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

John Black 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
John Black Vehicle Maintenance Data
Number of inspections with at least one Vehicle Maintenance BASIC violation	0
Vehicle Maintenance BASIC Roadside Performance measure value	0
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
91	BIPD	Motorists Mutual Insurance Co.	33.301690	$0	$750,000	02/15/2016	?
34	CARGO	United Ohio Insurance Company	BP 0010073	$0	$5,000*	02/15/2010	?
91X	BIPD/Primary	Plaza Insurance Company	PTOWK005341-01	$0	$1,000,000	02/15/2015	02/15/2016 Cancelled
91X	BIPD/Primary	Plaza Insurance Company	PTOWK005341-00	$0	$1,000,000	02/15/2014	02/15/2015 Cancelled
91X	BIPD/Primary	United Ohio Insurance Company	CPP0009494	$0	$1,000,000	02/15/2010	02/15/2014 Replaced

* 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.';

Plaza Insurance Company 700 WEST 47TH ST., STE: 350 KANSAS CITY, MO Fax:(816)412 - 7550

Motorists Mutual Insurance Co. 471 EAST BROAD STREET COLUMBUS, OH Fax:(866)831 - 3605

United Ohio Insurance Company P.O. BOX 111 BUCYRUS, OH Fax:(888)895 - 7726