Jerry Black USDOT 915095

Total Number of Inspections for the measurement period (24 months)	8
Total Number of Driver Inspections for the measurment period	8
Total Number of Driver Inspections containing at least one Driver Out-of-Service Violation	0
Total Number of Vehicle Inspections for the measurement period	5
Total Number of Vehicle Inspections containing at least one Vehicle Out-of-Service violation	0
Jerry Black Unsafe Truck Driving Data
Number of inspections with at least one Unsafe Driving BASIC violation	1
Unsafe Driving BASIC Roadside Performance Measure Value	1.45
Unsafe Driving BASIC Acute/Critical Indicator (Yes = Acute/Critical from investigation within previous 12 months)	No

Jerry 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
Jerry 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

Jerry 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
Jerry Black Vehicle Maintenance Data
Number of inspections with at least one Vehicle Maintenance BASIC violation	1
Vehicle Maintenance BASIC Roadside Performance measure value	1.71
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	Canal Insurance Co.	352078	$0	$750,000	12/18/2000	09/23/2001 Cancelled
91X	CARGO	Canal Insurance Co.	PIA02869702	$0	$5,000*	12/15/2008	12/15/2009 Cancelled
91X	CARGO	Canal Insurance Co.	PIA02869701	$0	$5,000*	12/15/2007	12/15/2008 Cancelled
91X	CARGO	Canal Insurance Co.	C345684	$0	$5,000*	12/15/2006	12/15/2007 Cancelled
91X	CARGO	Canal Insurance Co.	C325463	$0	$5,000*	12/15/2005	12/15/2006 Cancelled
91X	CARGO	Canal Insurance Co.	C325172	$0	$5,000*	12/15/2004	12/15/2005 Cancelled
91X	CARGO	Canal Insurance Co.	C305521	$0	$5,000*	12/15/2003	12/15/2004 Cancelled
91X	CARGO	Canal Insurance Co.	C090852	$0	$5,000*	12/15/2002	02/09/2003Transferred
91X	CARGO	Canal Insurance Co.	MTC064569	$0	$5,000*	12/15/2001	12/15/2002 Cancelled
91X	CARGO	Canal Insurance Co.	MTC051925	$0	$5,000*	12/15/2000	12/15/2001 Cancelled
91X	BIPD/Primary	Canal Insurance Co.	448946	$0	$750,000	11/23/2004	09/23/2005 Cancelled
91X	BIPD/Primary	Occidental Fire And Casualty Co. Of N.c.	BA 069 09 67	$0	$750,000	09/23/2008	02/12/2010 Cancelled
91X	BIPD/Primary	Canal Insurance Co.	PIA02200701	$0	$750,000	09/23/2007	09/23/2008 Cancelled
91X	BIPD/Primary	Canal Insurance Co.	499444	$0	$750,000	09/23/2006	09/23/2007 Cancelled
91X	BIPD/Primary	Canal Insurance Co.	479615	$0	$750,000	09/23/2005	09/23/2006 Cancelled
91X	BIPD/Primary	Canal Insurance Co.	448946	$0	$750,000	09/23/2004	11/23/2004 Replaced
91X	BIPD/Primary	Canal Insurance Co.	448946	$0	$750,000	09/23/2004	12/09/2004 Cancelled
91X	BIPD/Primary	Canal Insurance Co.	396367	$0	$750,000	09/23/2003	09/23/2004 Cancelled
91X	BIPD/Primary	Canal Insurance Co.	375270	$0	$750,000	09/23/2002	01/16/2003 Replaced
91X	BIPD/Primary	Canal Insurance Co.	375270	$0	$750,000	09/23/2002	02/09/2003Transferred
91X	BIPD/Primary	Canal Insurance Co.	374929	$0	$750,000	09/23/2001	09/23/2002 Cancelled
91X	CARGO	Canal Insurance Co.	C090852	$0	$5,000*	03/14/2003	12/15/2003 Cancelled
91X	BIPD/Primary	Great West Casualty Co.	MCP08181A	$0	$750,000	01/26/2014
91X	CARGO	North River Insurance Co.	506-8678653	$0	$5,000*	01/26/2011	01/26/2014 Cancelled
91X	BIPD/Primary	North River Insurance Co.	506-8678653	$0	$750,000	01/26/2011	01/26/2014 Cancelled
91X	BIPD/Primary	Canal Insurance Co.	375270	$0	$750,000	01/16/2003	09/23/2003 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	Occidental Fire And Casualty Co. Of N.c. P.O. BOX 3328 OMAHA, , N Fax:(402)342 - 0095	Canal Insurance Co. P O BOX 7 GREENVILLE, SC Fax:(864)679 - 2557
North River Insurance Co. 305 MADISON AVE. P.O. BOX 1973 MORRISTOWN, NJ