Kozak LLC USDOT 2585237

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

Kozak Llc 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
Kozak LLC 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

Kozak Llc 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
Kozak LLC Vehicle Maintenance Data
Number of inspections with at least one Vehicle Maintenance BASIC violation	0
Vehicle Maintenance BASIC Roadside Performance measure value	0
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	Wilshire Insurance Company	BA2602021	$0	$750,000	05/06/2015

* 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.';

Wilshire Insurance Company 1206 WEST AVENJE J., STE: 100 LANCASTER, CA Fax:(661)940 - 7105