Raymond Joseph Kozlowski Jr USDOT 457048

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	1
Total Number of Vehicle Inspections containing at least one Vehicle Out-of-Service violation	0
Raymond Joseph Kozlowski Jr 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

Raymond Joseph Kozlowski Jr 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
Raymond Joseph Kozlowski Jr 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

Raymond Joseph Kozlowski Jr 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
Raymond Joseph Kozlowski Jr Vehicle Maintenance Data
Number of inspections with at least one Vehicle Maintenance BASIC violation	1
Vehicle Maintenance BASIC Roadside Performance measure value	4
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	Northland Insurance Company	TN518582	$0	$750,000	10/16/2006
91X	BIPD/Primary	Westport Insurance Corporation	WCP1030028760	$0	$1,000,000	10/16/2004	10/16/2006 Cancelled
91X	BIPD/Primary	Northland Insurance Company	TN366828	$0	$1,000,000	10/16/2002	11/24/2004 Cancelled
91X	BIPD/Primary	Northland Insurance Company	TN366828	$0	$1,000,000	10/16/2002	10/16/2004 Replaced
91X	BIPD/Primary	Westport Insurance Corporation	TK3201211	$0	$1,000,000	10/16/2001	10/16/2002 Replaced
91X	BIPD/Primary	Gulf Insurance Co.	GA0678984-00	$0	$1,000,000	10/16/2000	10/16/2001 Replaced
91X	BIPD/Primary	Empire Fire & Marine Insurance Co.	CL757907	$0	$1,000,000	10/16/1999	10/16/2000 Cancelled
91X	BIPD/Primary	Empire Fire & Marine Insurance Co.	CL537646	$0	$1,000,000	10/16/1998	10/16/1999 Cancelled
91X	BIPD/Primary	Empire Fire & Marine Insurance Co.	CL533989	$0	$1,000,000	10/16/1997	10/16/1998 Cancelled
91X	BIPD/Primary	Empire Fire & Marine Insurance Co.	CL533989	$0	$1,000,000	10/16/1997	10/16/1997 Replaced
91X	BIPD/Primary	Empire Fire & Marine Insurance Co.	CL 532470	$0	$1,000,000	10/16/1996	10/16/1997 Cancelled
91X	BIPD/Primary	Empire Fire & Marine Insurance Co.	CL 527665	$0	$1,000,000	10/16/1995	10/16/1996 Cancelled
91X	BIPD/Primary	Empire Fire & Marine Insurance Co.	CL 525142	$0	$750,000	03/28/1995	10/16/1995 Cancelled
91X	BIPD/Primary	Empire Fire & Marine Insurance Co.	CL 52 51 42	$0	$750,000	10/16/1994	03/28/1995 Cancelled
34	CARGO	Gulf Insurance Co.	GA0678984-00	$0	$5,000*	10/16/2000	06/13/2004 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	Westport Insurance Corporation 5200 METCALF AVE. P.O. BOX 2979 OVERLAND PARK, KS Fax:(913)676 - 6916	Empire Fire & Marine Insurance Co. 13810 FNB PKWY. OMAHA, NE
Gulf Insurance Co. P O BOX 1771 DALLAS, TX