Henry Clifton Adcock USDOT 661339

Total Number of Inspections for the measurement period (24 months)	0
Total Number of Driver Inspections for the measurment period	0
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
Henry Clifton Adcock 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

Henry Clifton Adcock 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
Henry Clifton Adcock 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

Henry Clifton Adcock 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
Henry Clifton Adcock 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	Ooida Risk Retention Group, Inc.	PL199520432	$0	$1,000,000	04/30/2014
91X	BIPD/Primary	Progressive County Mutual	CA 1588870	$0	$1,000,000	05/04/2012	06/18/2013 Cancelled
91X	BIPD/Primary	Great American Assurance Company	TRP9064201 01	$0	$750,000	02/07/2009	05/04/2012 Replaced
91X	BIPD/Primary	Great American Assurance Company	CAP9064201 00	$0	$750,000	02/07/2008	02/07/2009 Replaced
91X	BIPD/Primary	Northland Insurance Company	TN493643	$0	$750,000	02/07/2006	02/07/2008 Replaced
91X	BIPD/Primary	Northland Insurance Company	TN479145	$0	$750,000	11/10/2005	01/24/2006 Cancelled
91X	BIPD/Primary	Northland Insurance Company	TN248354	$0	$1,000,000	09/07/1998	10/14/2003 Cancelled
91X	BIPD/Primary	Northland Insurance Company	TN248354	$0	$750,000	06/26/1998	09/07/1998 Replaced
91X	BIPD/Primary	Northland Insurance Company	TN248354	$0	$750,000	09/07/1997	06/26/1998 Cancelled
91X	BIPD/Primary	Occidental Fire And Casualty Co. Of N.c.	BA 63 73 82	$0	$750,000	10/10/1996	10/17/1997 Cancelled
91X	BIPD/Primary	Occidental Fire And Casualty Co. Of N.c.	BA 63 73 82	$0	$750,000	10/10/1996	09/07/1997 Replaced
91X	BIPD/Primary	Occidental Fire And Casualty Co. Of N.c.	BA637382	$0	$750,000	10/10/1996	10/10/1996 Replaced
91X	BIPD/Primary	Occidental Fire And Casualty Co. Of N.c.	BA 637382	$0	$750,000	10/10/1996	10/10/1996 Replaced
34	CARGO	Occidental Fire And Casualty Co. Of N.c.	BA 637382	$0	$5,000*	10/10/1996	10/17/1997 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	Occidental Fire And Casualty Co. Of N.c. P.O. BOX 3328 OMAHA, , N Fax:(402)342 - 0095	Ooida Risk Retention Group, Inc. P.O. BOX L, 311 MIZE ROAD GRAIN VALLEY, MO Fax:(816)229 - 0518
Great American Assurance Company 49 E 4TH STREET, SUITE 300N CINCINATI, OH	Progressive County Mutual P.O. BOX 94739 CLEVELAND, OH Fax:(440)603 - 4555