Triple S Vacuum Services USDOT 2095036

Insurance Form	Insurance Type	Insurance Carrier	Policy/Surety	Coverage Amount From	Coverage Amount To	Effective Date From	Effective Date To
91X	BIPD/Primary	Rockwood Casualty Insurance Company	TP 16308	$0	$1,000,000	10/18/2014
91X	BIPD/Primary	Rockwood Casualty Insurance Company	TP 16201	$0	$1,000,000	10/18/2013	10/18/2014 Replaced
91X	BIPD/Primary	Northland Insurance Company	WN052601	$0	$750,000	11/17/2010	10/18/2013 Replaced
34	CARGO	Northland Insurance Company	WN052601	$0	$5,000*	12/30/2010	11/18/2011 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

Rockwood Casualty Insurance Company 654 MAIN STREET ROCKWOOD, PA Fax:(814)926 - 3249