De La Rosa F USDOT 1814639

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
De La Rosa F Unsafe Truck Driving Data
Number of inspections with at least one Unsafe Driving BASIC violation	1
Unsafe Driving BASIC Roadside Performance Measure Value	14
Unsafe Driving BASIC Acute/Critical Indicator (Yes = Acute/Critical from investigation within previous 12 months)	No

De La Rosa F 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
De La Rosa F 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

De La Rosa F 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
De La Rosa F Vehicle Maintenance Data
Number of inspections with at least one Vehicle Maintenance BASIC violation	2
Vehicle Maintenance BASIC Roadside Performance measure value	22
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	WN137382	$0	$750,000	01/23/2015
91X	BIPD/Primary	Northland Insurance Company	WN104034	$0	$750,000	03/29/2013	03/02/2015 Name Changed
91X	BIPD/Primary	Northland Insurance Company	WN104034	$0	$750,000	03/29/2013	01/23/2015 Replaced
91X	BIPD/Primary	Northland Insurance Company	WN033134	$0	$750,000	06/29/2011	03/29/2013 Cancelled
91X	BIPD/Primary	Northland Insurance Company	WN033134	$0	$750,000	08/11/2010	06/29/2011 Cancelled
34	CARGO	Northland Insurance Company	WN033134	$0	$5,000*	08/11/2010	05/17/2011 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.';

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