Ray J Forney, Inc. USDOT 142923

Safety Rating	Satisfactory
Total Number of Inspections for the measurement period (24 months)	2
Total Number of Driver Inspections for the measurment period	2
Total Number of Driver Inspections containing at least one Driver Out-of-Service Violation	0
Total Number of Vehicle Inspections for the measurement period	1
Total Number of Vehicle Inspections containing at least one Vehicle Out-of-Service violation	0
Ray J Forney, Inc. 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

Ray J Forney, Inc. Hours-of-Service (HOS) Data
Number of inspections with at least one Hours-of-Service BASIC violation	1
Hours-of-Service (HOS) Compliance BASIC Roadside Performance measure value	1.5
Hours-of-Service (HOS) Compliance BASIC Acute/Critical Indicator (Yes = Acute/Critical from investigation within previous 12 months)	No
Ray J Forney, Inc. 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

Ray J Forney, Inc. 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
Ray J Forney, Inc. Vehicle Maintenance Data
Number of inspections with at least one Vehicle Maintenance BASIC violation	1
Vehicle Maintenance BASIC Roadside Performance measure value	14
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	Acuity, A Mutual Insurance Company	CA-X90025	$0	$750,000	03/01/2014
91X	BIPD/Primary	General Casualty Company Of Wisconsin	CTP1018697	$0	$750,000	03/01/2012	03/29/2014 Cancelled
91X	BIPD/Primary	General Casualty Company Of Wisconsin	CTP1018697	$0	$750,000	03/01/2012	03/01/2014 Replaced
91X	BIPD/Primary	Northland Insurance Company	TN374817	$0	$1,000,000	03/01/2003	03/01/2012 Replaced
91X	BIPD/Primary	Acuity, A Mutual Insurance Company	CA-F63918	$0	$1,000,000	03/01/2000	03/01/2003 Replaced
91X	BIPD/Primary	Great West Casualty Co.	CLP19814A	$0	$1,000,000	02/15/1991	04/03/2000 Cancelled
91X	BIPD/Primary	Great West Casualty Co.	CLP19814A	$0	$1,000,000	02/15/1991	03/01/2000 Replaced
34	CARGO	Northland Insurance Company	TN374817	$0	$5,000*	03/28/2011	04/25/2011 Cancelled
34	CARGO	Northland Insurance Company	TN374817	$0	$5,000*	03/01/2003	03/28/2011 Cancelled
34	CARGO	Acuity, A Mutual Insurance Company	IM-F63918	$0	$5,000*	03/01/2000	03/01/2003 Replaced
34	CARGO	Great West Casualty Co.	CLP19814A	$0	$5,000*	02/15/1991	04/03/2000 Cancelled
84	SURETY	American Alternative Insurance Corporation	20110711246	$0	$10,000*	07/12/2011	08/19/2012 Cancelled
34	CARGO	Great West Casualty Co.	CLP19814A	$0	$5,000*	02/15/1991	03/01/2000 Replaced
84	SURETY	United States Fidelity & Guaranty Co.	22013010896879	$0	$10,000*	08/31/1987	07/12/2011 Replaced

* 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.';

General Casualty Company Of Wisconsin ONE GENERAL DRIVE SUN PRAIRIE, WI Fax:(608)825 - 5100	Great West Casualty Co. 1100 WEST 29TH ST., P.O. BOX 277 SOUTH SIOUX CITY, NE Fax:(402)494 - 7400	Northland Insurance Company 385 WASHINGTON STREET MAIL CODE 103 ST. PAUL, MN Fax:(651)310 - 4949
United States Fidelity & Guaranty Co. ONE TOWER SQUARE, -5GS HARTFORD, CT	Acuity, A Mutual Insurance Company 2800 SOUTH TAYLOR DR. SHEBOYGAN, WI Fax:(920)458 - 1618	American Alternative Insurance Corporation 555 COLLEGE RD. EAST PLAZA II PRINCETON, NJ Fax:(609)951 - 8310