Jacobsen Trucking USDOT 942584

Total Number of Inspections for the measurement period (24 months)	3
Total Number of Driver Inspections for the measurment period	3
Total Number of Driver Inspections containing at least one Driver Out-of-Service Violation	0
Total Number of Vehicle Inspections for the measurement period	1
Total Number of Vehicle Inspections containing at least one Vehicle Out-of-Service violation	0
Jacobsen Trucking 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

Jacobsen 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
Jacobsen 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

Jacobsen 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
Jacobsen Trucking Vehicle Maintenance Data
Number of inspections with at least one Vehicle Maintenance BASIC violation	1
Vehicle Maintenance BASIC Roadside Performance measure value	9
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	Carolina Casualty Insurance Co.	353665	$0	$750,000	12/22/2009	02/10/2010 Cancelled
91X	BIPD/Primary	Carolina Casualty Insurance Co.	345730	$0	$750,000	12/22/2008	02/25/2009 Cancelled
91X	BIPD/Primary	Carolina Casualty Insurance Co.	345694	$0	$750,000	12/22/2007	12/22/2008 Cancelled
91X	BIPD/Primary	Carolina Casualty Insurance Co.	345652	$0	$750,000	12/22/2006	12/22/2007 Cancelled
91X	BIPD/Primary	Empire Fire & Marine Insurance Co.	CL410675	$0	$1,000,000	12/22/2005	12/22/2006 Cancelled
91X	CARGO	Empire Fire & Marine Insurance Co.	CL410675	$0	$5,000*	12/22/2005	12/22/2006 Cancelled
91X	BIPD/Primary	Empire Fire & Marine Insurance Co.	CL410555	$0	$1,000,000	12/22/2004	12/22/2005 Cancelled
91X	BIPD/Primary	Progressive Northern Insurance Company	CA 4675460-1	$0	$1,000,000	11/26/2002	11/26/2002 Replaced
91X	BIPD/Primary	Progressive Northern Insurance Company	CA 4675460-1	$0	$1,000,000	11/26/2002	04/23/2003 Cancelled
91X	BIPD/Primary	Progressive Northern Insurance Company	CA 4675460-1	$0	$1,000,000	10/23/2002	11/26/2002 Cancelled
91X	BIPD/Primary	Carolina Casualty Insurance Co.	353726	$0	$1,000,000	10/12/2012	09/08/2013 Cancelled
91X	BIPD/Primary	Carolina Casualty Insurance Co.	CSP442842	$0	$750,000	10/01/2010	09/08/2011 Cancelled
91X	BIPD/Primary	Progressive Northern Insurance Company	CA 4675460-1	$0	$1,000,000	09/25/2002	10/23/2002 Cancelled
91X	BIPD/Primary	Carolina Casualty Insurance Co.	353726	$0	$1,000,000	09/08/2012	10/12/2012 Cancelled
91X	BIPD/Primary	Carolina Casualty Insurance Co.	353704	$0	$750,000	09/08/2011	11/09/2011 Cancelled
91X	BIPD/Primary	Carolina Casualty Insurance Co.	442842	$0	$750,000	09/08/2010	10/01/2010 Replaced
91X	BIPD/Primary	Carolina Casualty Insurance Co.	442842	$0	$750,000	09/08/2010	09/07/2011 Cancelled
91X	BIPD/Primary	Carolina Casualty Insurance Co.	442840	$0	$750,000	09/08/2010	09/08/2010 Replaced
91X	BIPD/Primary	Carolina Casualty Insurance Co.	442840	$0	$750,000	09/08/2010	11/06/2010 Cancelled
91X	BIPD/Primary	Progressive Northern Insurance Company	CA 4675460-1	$0	$1,000,000	07/22/2002	09/25/2002 Cancelled
91X	BIPD/Primary	Progressive Northern Insurance Company	CA 4675460-0	$0	$1,000,000	05/11/2001	04/23/2002 Cancelled
91X	BIPD/Primary	Progressive Northern Insurance Company	CA 4675460-2	$0	$1,000,000	04/23/2003	08/04/2003 Cancelled
91X	BIPD/Primary	Progressive Northern Insurance Company	CA 4675460-1	$0	$1,000,000	04/23/2002	07/22/2002 Cancelled
91X	BIPD/Primary	Carolina Casualty Insurance Co.	345730	$0	$750,000	02/25/2009	12/22/2009 Cancelled
91X	BIPD/Primary	Carolina Casualty Insurance Co.	353665	$0	$750,000	02/10/2010	09/08/2010 Replaced
91X	BIPD/Primary	Canal Insurance Co.	444610	$0	$1,000,000	01/27/2004	12/22/2004 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.';

Canal Insurance Co. P O BOX 7 GREENVILLE, SC Fax:(864)679 - 2557	Progressive Northern Insurance Company P.O. BOX 94739 CLEVELAND, OH Fax:(440)603 - 4555	Carolina Casualty Insurance Co. P O BOX 2575 JACKSONVILLLE, FL Fax:(900)363 - 8088
Empire Fire & Marine Insurance Co. 13810 FNB PKWY. OMAHA, NE