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Last modified
9/24/2021 2:44:29 PM
Creation date
9/24/2021 2:42:59 PM
Metadata
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Template:
Contracts
Company Name
TRUSTAR ENERGY LLC
Contract #
A-2021-147
Agency
Public Works
Council Approval Date
8/17/2021
Expiration Date
8/16/2022
Insurance Exp Date
6/2/2022
Destruction Year
2027
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AGENCY CUSTOMER ID: CNIO1642634 <br />LOC #: New York <br />'4CC)tR O? ADDITIONAL REMARKS SCHEDULE Page 2 of 2 <br />AGENCY NAMED NSURED <br />Marsh USA, Inc. TruStar Energy, LLC <br />1 Rancho <br />Philadelphia CL <br />POLICY NUMBER Rancho Cucampnge, CA 91730 <br />CARRIER I NAIC CODE <br />EFFECTIVE DATE: <br />ADDITIONAL REMARKS <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 26 FORM TITLE: Certificate of Liability Insurance <br />TmStaf Energy LLC Workers' Compensation coverage forAn CtherSrares (excluding CA & NH) <br />TruStar Energy LLC Workars' Compensation coverage for CA & NH (excluding All Other SIaftli Me policy 9718334-98 with Federal Insurance Company <br />2006l01 RWe M�AgmadDMsbn <br />ACORD <br />( ) ©20013 ACORn CnRp A' � CRsAEwmAAPPROv1EBY: <br />Rex Management Analyst <br />The ACORD name and logo are registered marks of ACORD <br />
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