Forzack Trucking USDOT 2021671

Total Number of Inspections for the measurement period (24 months)	11
Total Number of Driver Inspections for the measurment period	11
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
Forzack Trucking Unsafe Truck Driving Data
Number of inspections with at least one Unsafe Driving BASIC violation	4
Unsafe Driving BASIC Roadside Performance Measure Value	2.78
Unsafe Driving BASIC Acute/Critical Indicator (Yes = Acute/Critical from investigation within previous 12 months)	No

Forzack 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
Forzack 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

Forzack 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
Forzack Trucking Vehicle Maintenance Data
Number of inspections with at least one Vehicle Maintenance BASIC violation	2
Vehicle Maintenance BASIC Roadside Performance measure value	11
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	Crum & Forster Indemnity Company	506-8808298	$0	$750,000	05/01/2015	?
91X	BIPD/Primary	Great West Casualty Co.	GWP78520A	$0	$1,000,000	07/05/2012	05/29/2015 Cancelled
91X	BIPD/Primary	Great West Casualty Co.	GWP78520A	$0	$1,000,000	07/05/2012	05/01/2015 Replaced
91X	BIPD/Primary	Great West Casualty Co.	GWP78520A	$0	$1,000,000	05/01/2010	07/05/2012 Replaced
34	CARGO	Great West Casualty Co.	GWP78520A	$0	$5,000*	05/01/2010	05/29/2015 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

Crum & Forster Indemnity Company 305 MADISON AVE. MORRISTOWN, NJ Fax:(201)490 - 6612