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AGENCY CUSTOMER ID: CNIO1642634 <br />_ LOC n: New York <br />4CiOR EX� ADDITIONAL REMARKS SCHEDULE Page 2 of 2 <br />AGENCY NAMED WSURED <br />Marsh USA, Inc. TmSla Energy, LLC <br />10225 Fi ladelphia 01. <br />POLICYNUMI ER Rancho Cucamonga, CA 91730 <br />CARRIER i NAIC CODE <br />EFPECTNE DATE: <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE: Certificate Of Liability Insur <br />TruSlar Energy LLC Workers Compensalicn coverage for All Other Stales (excluding CA & NH) <br />TnuStar Energy LLC Workers' Compensation coverage for CA & NH (excluding All Other Stales), see polcy 57183349E with Federal Insurance Company <br />auemvu8mwulmaamr <br />©2008 ACORD CORP + Ao^• f�'- REMRDm& APPRCA1®8r <br />The ACORD name and logo are registered marks of ACORD ' fa eskMan Management <br />An pt <br />r�. Risk Management Analyst <br />