Text

Updated 2015 Nuclear Liability Certificate of Insurance
	ML15181A250
Person / Time
Site:	Susquehanna
Issue date:	06/16/2015
From:	Baldys S; Marsh USA
To:	; Document Control Desk, Office of Nuclear Reactor Regulation
References
	Download: ML15181A250 (8)
	v • d • e

Sarah Baldys Marsh USA Inc.

MMARSH Three Logan Square 1717 Arch Street, Suite 1100 Philadelphia, PA 19103

+1 215 246 1023 Sarah.Baldys@marsh.com www.marsh.com U.S. Nuclear Regulatory Commission ATTN: Document Control Desk Washington, DC 20555-0001 June 16, 2015

Subject:

Updated 2015 Nuclear Liability Certificate of Insurance Enclosed, please find an updated 2015 Nuclear Liability Certificate of Insurance for the named insured listed in Table 1. The Certificate of Insurance provides evidence of financial protection in accordance with 10CFR140.15 and other NRC Regulatory Compliance requirements.

If you have any questions, please do not hesitate to contact me.

Best regards, Sarah Baldys U.S. Nuclear Energy Practice Enclosure Copy:

J. Oehler, M. Kolodner, J. Loesner, T. Farward, C. Hardie, N. Cayabyab

&400 SOLUTIONS...DEFINED, DESIGNED, AND DELIVERED.

r4 MARSH &McLENNAN COMPANIES

DATE (MMIDD/YYYY)

A~cRD CERTIFICATE OF LIABILITY INSURANCE 06/116/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.

IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).

PRODUCER CONTACT Marsh USA Inc. NAME:

PHONE IFAX 1717 Arch Street IAIC.No. Extf: (A/C, No):

Philadelphia, PA 19103-2797 E-MAIL ADDRESS:

Attn: Philadelphia.Certs@marshcom/ fax - 212-948-0360 INSURER(S) AFFORDING COVERAGE NAIC #

S27324-NUC-ENR-15-16 INSURER A: American Nuclear Insurers INS URED I S R RBB Susquehanna Nuclear, LLC INSURER 835 Hamilton Street INSURER C:

Suite 150 GENPL7N, Plaza 7 INSURER D:

Allentown, PA 18101 INSURER E:

INSURER F:

COVERAGES CERTIFICATE NUMBER: CLE-004721348-07 REVISION NUMBER:7 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCI I ICONlNIT IONS

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('11 r IIITc CU.iA/tKi nAAv wA\c DcIrI Drl: in'C:r-l IV DAIIfl(I RAll INSR ADDLSUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER (MM/DD/YYYY) (MMIDD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S CLAIMS-MADE M

LJ OCCUR DAMAGE TO RENTED PREMISES lEa occurrence) $

MED EXP (Any one person) $

PERSONAL & ADV INJURY $

GEN'L AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $

POLICYF JECT P [ LOC PRODUCTS - COMP/OP AGG $

_ OTHER: $

AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT accident)$

AUTOMBILELIABLITY(Ea ANY AUTO BODILY INJURY (Per person) $

ALL OWNED SCHEDULED BODILY INJURY (Per accident) $

AUTOS AUTOS NON-OWNED PROPERTY DAMAGE HIREDAUTOS AUTOS (Per accident) $

UMBRELLA LIAB OCCUR EACH OCCURRENCE $

EXCESS LIAB !CLAIMS-MADE AGGREGATE s DED I RETENTION $ $

WORKERS COMPENSATION PER I OTH-AND EMPLOYERS' LIABILITY YIN I I ER ER ANY PROPRIETOR/PARTNER/EXECUTIVE []IA E.L. EACH ACCIDENT $

OFFICER/MEMBER EXCLUDED? L N/A (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $

Ifyes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $

A Nuclear Energy Liability See Attached 01/01/2015 01/01/2016 See Attached Acord 101 Insurance Acord 101 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)

CERTIFICATE HOLDER CANCELLATION State of Tennessee Department SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE of Environment and Conservation THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Division of Radiological Health ACCORDANCE WITH THE POLICY PROVISIONS.

3rd Floor, L and C Annex 401 Church Street AUTHORIZED REPRESENTATIVE Nashville, TN 37243-1532 of Marsh USA Inc.

Manashi Mukherjee _..SVtwC.&e, k;, ,

ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD

AGENCY CUSTOMER ID: S27324 LOC #: Philadelphia ACR?- '-ADDITIONAL REMARKS SCHEDULE - Page.'

. 2`'- f -2 AGENCY NAMEVDNISURED - :.

Marsh USA Inc: SusquehennaNuclear, LLC .

_______________________________________________________________ 835 Hamiliton Street

.POLICY NUMBER .... .Suite'150GENPL.N, Plaza 7 Allento~wn, PA 18101 CARRIER NAIC CODE.

ý 'EFFECTIVE DATE:

ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance CERTIFICATE OF NUCLEAR ENERGY LIABILITY INSURANCE This is to certify that there is inforce as of the effective dateof this Certificate a Nuclear Energy Liability Insurance Policy Issued by:membersofAmerican Nuclear Insurers as indicated (Companies), tothe Insured named.

herein, with respect to the NuclearFacility at the Location shown rand/or with respect to the Insured's operations described herein. Ifsuch policy is cancelled or otherwise terminated priorto the end of December 31st of the caiendhr year inwhich thd;Effectied Date of thisCertificate occurs, notice willbe-dIeliveredlin accordance with thepolicy provisions. Otherwise this Certificate shall terminate as of the end of such December 31st." A Cer[Ificate willNOT be issued for any subequ6et calendar year unless requested.in writing. . . . .. , .

Types of Insurance: NF -[Fa6ility Form], NW- [Master WorkerCertificaiel NS-[US Domestic Suppliers &Transpo'rters]L"FS - [Foreign Suppliers &Transporters]

COVERAGE FOR NUCLEAR FACILITIES:

1. SITE #1 -SUSQUEHANNA...

LOCATION OF NUCLEAR FACILITY: Susquehanna Nuclear Power Plant in Salem Township, Luzerne County, Pennsylvania NAMED INSURED [LISTED ON POLICY]: Susquehanna.Nuclear, LLC &Allegheny Electric Cooperative, Inc.

POLICY NUMBER: POLICY EFFECTIVE: LIMITOF LIABILITY:

NF-0262 01/01/1981. $375 Million..

NW-0622 01101/1981 $375 Million" COVERAGE FOR SUPPLIER'S &TRANSPORTER'S:

2. US DOMESTIC S&T DESCRIPTION OF OPERATIONS: Furnishing of services, Materials, parts or equipment Inconnection with the planning, construction, maintenance, involving the handling, storage, shipment, use or disposal of specified types of nuclear materials:-.

NAMED INSURED [LISTED ONPOLICY]: Susquehanna Nuclear, LLC, PPL Corporation, PPL Energy Funding Corporation, PPL Energy Supply, LLC, PPL Generation, LLC,Allegheny Electric Cooperative, Inc., Talen Energy Corporation [NOTE 1]

POLICY NUMBER: POLICY EFFECTIVE: LIMITOF LIABILITY:

NS-0422 . 07/27/1982 - $375 Million THIS CERTIFICATE IS ISSUED AS AMATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.

The insurance afforded by the policy(les) is subject to the exclusions, conditions and other provisions of the policy(ies). Neither this Certificaie'nor any contradt or otherdocumentwith respect to which itis issued shall amend, extend or alter the coverage afforded by the policy. The Limit of Liability shown above may have been reduced by payment of claims or claims expenses.

COMMENTS/NOTES:

"*Master Worker Certificate - This limit is shared by allCertificates to the Master Worker Policy of which each Certificate is a part and is subject to allof the provisions of such Policy and Certificate having reference thereto, Such limit may have been reduced by payment of claims or claims expenses.

NOTE 1.- NS-0422: Suppliers &Transporters Coverage - Additional Named Insured - Restricted Coverage Such insurance as Isafforded by the policy shall also apply to Allegheny Electric Cooperative, Inc. and Talen Energy Corporation, but solely with respect to liability for bodily injury, property damage or environmental damage which arises out of nuclder material which has been used or is to be used, or hasebeen irradiated in the course of the operation of a reactor inwhich it has an ownership interest, located at the Susquehanna Steam Electric Station:

The ACORD name and logo are registered marks of ACORD

-mmli, DATE (MMIDDIYYYY)

ACGDRD CERTIFICATE 'OF LIABILITY INSURANCE 06/16/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE .HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY,"AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOTCONSTITUTE'A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.

IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).

PRODUCER CONTACT NAME:

Marsh USA Inc. PHONE (FAX 1717 Arch Street C, , Ext) A/C, No):

Philadelphia, PA 19103-2797 . .. .. E-MAIL ADDRESS: -. ..

Attn: Philadelphia.Cers@.arsh.com/ fax - 212-948-0360 INSURER(S) AFFORDING COVERAGE NAIC# "

S27324-NUC-ENR-15-16 INSURER A: American Nuclear Insurers..

INSURED INSURER S:

Susquehanna Nuclear, LLC 835 Hamilton Street INSURER C:

Suite 150 GENPL7N, Plaza 7 INSURER D:

Allentown, PA 18101 INSURER E:

INSURER F:

COVERAGES CERTIFICATE NUMBER: . CLE-004963523-01 REVISION NUMBER:2, THIS.IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED-ABOVE FORTHE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, ,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL..THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.

FDDLSUB3R POLICY EFF POLICY EXP TYPE OF INSURANCE INSD WViv POLICY NUMBER IMM/DD/YYYY1 (MM/DD/YYYYI LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $

Z CLAIMS-MADE 1' OCCUR DAMAGE TO RENTED PREMISES (Ea occu.enc.) $

MED EXP (Any one person) $

PERSONAL&ADVINJURY $

GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $

POIYD PRO- II POLICY JECT -] LOC PRODUCTS - COMP/OP AGG $

OTHER:

I UUIVID5NCU cIIN,.,Cc LIIVI~ I$

AUTOMOBILE LIABILITY COBOIYINEDR SINGE LIMIT)

ANY AUTO ALL OWNED AUTOS H SCHEDULED AUTOS BODILY INJURY (Per person)

BODILY INJURY (Per accident) $

NON-OWNED PROPERTY DAMAGE $

HIRED AUTOS AUTOS (per .,cdenlt $___________

UMBRELLA LIAB OCCUR EACH OCCURRENCE $

EXCESS LIAB CLAIMS-MADE AGGREGATE $

DED RETENTIONS$"_". .".. .

ýKERS COMPENSATION SPER "TH-EMPLOYERS' LIABILITY " YIN .ER. ST UTE PROPRIETOR/PARTNER/EXECUTIVEDN-N E.L. EACH ACCIDENT $ ..

CER/MEMBER EXCLUDED? jJNINA cdatory in NH) E.L. DISEASE - EA EMPLOYE $

, describe under CRIPTION OF OPERATIONS below I I E.L.DISEASE- POLICY LIMIT $

A Nuclear Energy Uability 3ee Attached 01/01/2015 01/01/2016 See Attached Acord 101 Insurance kcord 101 -

DESCRIPTION OF OPERATIONS I LOCATIONS./VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)

CERTIFICATE HOLDER CANCELLATION South Carolina Department of SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Health & Environmental Control THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Bureau of Solid and Hazardous Waste Management ACCORDANCE WITH THE POLICY PROVISIONS.

Division of Radioactive Waste Management 2600 Bull Street AUTHORIZED REPRESENTATIVE Columbia, SC 29201 of Marsh USA Inc.

Manashi Mukherjee ._ s.-L I

ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD

. , ,,AGENCY

- CUSTOMER ID: $27324 L_ c#- Philadelphia' ACRD '"ADDITIONAL REMARKS, SCHEDULE Page- 2: of" 2 AGENCY NAMEýDiNSUJRED Marsh USA Inc . . Susgueha16na'Nflear, LLC

_835 Hamilto'n Street POLICYNUMBER Suite150GENPLYN, Plaza?7

-. Allentown,.PA.181-01 CARRIER NI OE EFFECTIVE DATE:

ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance I.... I CERTIFICATE OF NUCLEAR ENERGY LIABILITY INSURANCE This is to e. fythat there.. Isin f.ore as.of the effective date of this Certificate a Nuclear E..ergy Lability Insurance Policy issued by members of Americarn Nuclear Insurers as indicated (Companies),to.th.e Insured named herein, with respcttto the:tiluclea'Facility at the Location shown and/orwith respectio the:insured's operations described herein. Ifsuch policy is cancelled or otherwise terminated priorto the end of December 31st of the calerndaryear in which theeEfftectisvd Date of this Certificate occurs, notice willbe delivered in accordance with the policy provisibrs. Otherwise this Certificate shall terminate as of the end ot such December 31st.. A:

Certificate willNOT be issued for anysubsequent calendar year unless requested in wdting, Types of Insurance: NF- *Facility Form], NW- [Master Worker Certificate], NS -[US Domestic Suppliers &Transportei;,] ES-[Foreign Suppliers &Transporters]

COVERAGE FOR NUCLEAR FACILITIES:

1. SITE #1 -SUSQUEHANNA.

LOCATION OF NUCLEAR FACILITY: Susquehanna Nuclear Power Plant inSalem Township, Luzerne County, Pennsylvania NAMED INSURED [LISTED ON POLICY]: Susquehanna Nuclear, LLC&Allegheny Electric Cooperative, Inc.

POLICY NUMBER: POLICY EFFECTIVE: LIMITOF LIABILITY:

NF-0262 01/01/1981 $375 Million NW-0622 I1/01'/1981 $375 Million-COVERAGE FOR SUPPLIER'S &TRANSPORTER'S:

2. US DOMESTIC S&T DESCRIPTION OF OPERATIONS: Furnishing of services, matedals, parts or equipment in connection with the planning, construction, maintenance, involving the handling, storage, shipment, use or disposal of specified types of nuclear materials:.

NAMED INSURED [LISTED ON*POLICY]: Susquehanna Nuclear, LLC,PPL Corporation, PPL Energy Funding Corporation, PPL Energy Supply, LLC, PPL Generation, LLC, Allegheny Electric Cooperative, Inc., Talen Energy Corporation [NOTE 1]

POLICY NUMBER: POLICY EFFECTIVE: LIMITOF LIABILITY:

NS-0422 . . 07127/1982 $375 Million THIS CERTIFICATE ISISSUED AS AMATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.

The insurance afforded by the policy(ies) is subject to the exclusions, conditions and other provisions of the policy(ies). Neither this Certficate no? any contract or other doicument with respect to which itis issued shall amend, extend or alter the coverage afforded by the policy. The Limit of Liability shown above may have been reduced by payment of claims or claims expenses.

COMMENTS/NOTES:

- Master Worker Certificate - This limit is shared by all Certificates to the Master Worker Policy of which each Certificate is a part and is subject to allof the provisions of such Policy and Certificate having reference thereto. Such limit may have been reduced by payment of claims or claims expenses.

NOTE 1 - NS-0422: Suppliers &Transporters Coverage - Additional Named Insured - Restricted Coverage Such insurance as is afforded by the policy shall also apply to Allegheny Electric Cooperative, Inc. and Talen Energy Corporation, but solely with respect to liability for bodily injury, property damage or environmental damage which arises out of nuclear material which has been used or is to be used; or has been irradiated in the course ofithe operation of a reactor inwhich ithas an ownership interest, located at the Susqueahanna Steam Electric Station.

The ACORD name and logo are registered marks of ACORD

AWORD DATE (MMIDD/YYYY)

CERTIFICATE OF LIABILITY INSURANCE 06/16/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR, NEGATIVELY ;AMEND, -EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE'ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE: HOLDER. .

IMPORTANT: If the certificate holder is an ADDITIONAL INSUREDi. the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). . ...

PRODUCER CONTACT Marsh USA Inc. NAME:

PHONE FAX C 1717 Arch Street " " " E-MAI No:

Philadelphia, PA 19103-2797 .. E-MAIL ADDRESS: .

INSURER(S) AFFORDING COVERAGE - NAIC #

S27324-NUC-NUC-15-16 INSURER A :,American Nuclear Insurers INSURED u ,INSURERB:

Susquehanna Nuclear, LLG ."

835 Hamilton Street INSURER C:

Suite 150 GENPL7N, Plaza 7 INSURER D:

Allentown, PA 18101 INSURER E:

INSURER F:

COVERAGES . CERTIFICATE NUMBER: . CLE-004443748-02 REVISION NUMBER:4, THIS IS.TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE" TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. "_"_""__"

INSR LTR T TYPE OPF INSURANCE RADDLSUBRI I *.,n I ^tl,,r PA!3ii.V NI]iMRFP IiMMIfiV'/VVI POLICY EXP ! I POLICY EFF IfIM*i,fIViVVVY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $

DAMAGE TO RENTED CLAIMS-MADE LJ OCCUR PREMISES (Ea occurrence) $

._MED EXP (Any one person) $

PERSONAL & ADV INJURY $

m PRO- m-q...

GEN'L AGGREGATE LIMITAPPLIES PER:

POLICY [ JE LOC GENERAL AGGREGATE $

[PRODUCTS --COMP/OP AGG $

OTHER: $

AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $

(Ea accident)

ANY AUTO BODILY INJURY (Per person) $

ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $

NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS (Per accident) $

I$,

UMBRELLA LIAB OCCUR EACH OCCURRENCE $

EXCESS LIAB CLAIMS-MADE AGGREGATE $

I DED RETENTIONS .......... .$I . 7 -.

WORKERS COMPENSATION PER ETHR AND EMPLOYERS'-LIABILITY N Y'/N ' STATUTE'ER .

ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $

OFFICER/MEMBER EXCLUDED? [ Nj IA (Mandatory in NH) E.L: DISEASE - EA EMPLOYEE $

If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $

A Nuclear Energy Liability See Attached 01/01/2015 01/01/2016 See Attached Insurance Acord 101 -. . ,Acord101 ... ..

DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

CERTIFICATE HOLDER CANCELLATION Document Control Desk . SHOULD, ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE U.S. Nuclear Regulatory Commission THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Washington, DC 20555-0001 ACCORDANCE WITH THE POLICY PROVISIONS.

AUTHORIZED REPRESENTATIVE of Marsh USA Inc.

Manashl Mukherjee _, .. ,,-.

ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD

AGENCY CUSTOMER ID: S27324 LOC#' Philadelphia

- m,

ACORD, ADDITIONAL REMARKS SCHEDULE Page. 2 of 2 AGENCY NAMED INSURED . ' -

Marsh USA Inc...

___________________________________________________ SusuehannaNuclear, 835, LLC Hainrilto Street........... ... , . -,.- ..

POLICY NUMBER Suite 150 GENPL7N, Plaza-7

-, - ., Allentown, PA..<18101, CARRIER NAICCODE EFFECTIVE DATE: "

ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance CERTIFICATE OF NUCLEAR ENERGY LIABILITY INSURANCE This is to certify that there is inforce as of the effective date of this Certificate a Nuclear Energy Uability Insurance Policy issued by members of American Nuclear Insurers as indicated (Companies), to the Insured named herein, with respect to the Nuclear Facility at the Location shown and/or with respect to the Insured's operations described herein. If such policy is cancelled or otherwise terminated prior to the end of December 31st of the calendar year in which the Effective Date of this Certificate occurs, notice willbe delivered in accordance with the policy provisions. Otherwise this Certificate shall terminate as of the end of such December 31st. A Certificate willNOT be issued for any subsequent calendar year unless requested inwriting.

Types of Insurance: NF -[Facility Form], NW- [Master Worker Certificate], NS -[US Domestic Supplier's &Transporters], FS - [Foreign Suppliers &Transporters], N- [Secondary Financial Protection Certificate]

COVERAGE FOR NUCLEAR FACILITIES:

1. SITE #1 - SUSQUEHANNA LOCATION OF NUCLEAR FACILITY: Susquehanna Nuclear Power Plant in Salem Township, Luzerne County, Pennsylvania NAMED INSURED [LISTED ON POLICY]: Susquehanna Nuclear, LLC&Allegheny Electric Cooperative, Inc.

POLICY NUMBER: POLICY EFFECTIVE: LIMITOF LIABILITY:

NF-0262 01/01/1981 $375 Million NW-0622 01/01/1981 $375 Million-N-0084 07/17/1982

N-0096 03/23/1984 THIS CERTIFICATE ISISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.

The insurance afforded by the policy(ies) is subject to the exclusions, conditions and other provisions of the policy(ies). Neither this Certificate nor any contract or other document with respect to which itis issued shall amend, extend or alter the coverage afforded by the policy. The Limit of Liability shown above may have been reduced by payment of claims or claims expenses.

COMMENTS/NOTES:

- Master Worker Certificate -This limit is shared by all Certificates to the Master Worker Policy of which each Certificate is a part and is subject to allof the provisions of such Policy and Certificate having reference thereto. Such limit may have been reduced by payment of claims or claims expenses.

"* Secondary Financial Protection Certificate -Financial protection available under an industry retrospective rating plan.

The ACORD name and logo are registered marks of ACORD

TABLE 1 NF-0262 Susquehanna Nuclear, LLC and Allegheny Eledt~ic Cooperative, Inc.

NF-0262 Susquehanna Nuclear, LLC and Allegheny Elbetric Cooperative, Inc.

N-0062 Susquehanna Nuclear, LLC and Allegheny Electric Cooperative, Inc.

IN-0096 - ISusquehanna Nuclear, LLC and-Allegheny Electric-Cooper .ative, Inc,-...

ML15181A250

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