Sams Water Truck Service USDOT 913336

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	TN322713	$0	$1,000,000	11/15/2001	08/02/2002 Cancelled
91X	BIPD/Primary	Northland Insurance Company	TN322713	$0	$1,000,000	08/28/2001	11/15/2001 Cancelled
91X	BIPD/Primary	Northland Insurance Company	TN324279	$0	$1,000,000	08/02/2002	04/01/2004 Cancelled
91X	BIPD/Primary	Northland Insurance Company	TN322713	$0	$1,000,000	06/26/2001	08/28/2001 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