ML16048A249

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Certification of Liability Insurance
ML16048A249
Person / Time
Site: Salem, Hope Creek  PSEG icon.png
Issue date: 01/22/2016
From: Mukherjee M
Marsh USA
To:
Document Control Desk, Office of Nuclear Reactor Regulation
References
Download: ML16048A249 (3)
v • d • e


Text

0 0 0 2459 SP 0039 DOCUMENT CONTROL DESK

-C01-P02460-I Jo-- z-l*

U.S. NUCLEAR REGULATORY COMMISSION WASHINGTON, DC 20555-0001 3(1

'51)

ACO~RD CERTIFICATE OF LIABILITY INSURANCE S DATE (MM/DDIYYYY) 01/22/2016 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 FAX 445 SOUTH STREET Ac. No. xt (A/C No):

MORRISTOWN, NJ 07960-6454 E-MAIL Attn: Morristown.CertRequest~marsh.com ADDRESS:

INSURER(S) AFFORDING COVERAGE NAIC #

074725-OTU-NUCLE-16-17 INSURER A : American Nuclear Insurers INSUREDINUEB PSEG NUCLEAR LLC ISRRB ATTN: ROBERT GREEN INSURER C :

ROBERT.GREEN2@PSEG.COM INSURER D :

80 PARK PLAZA, MAIL CODE T-6B NEWARK, NJ 07101 INSURER E :

___________________________________________________________ INSURER F: ______

COVERAGES CERTIFICATE NUMBER: NYC-007087875-03 REVISION NUMBER:11 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.

TYPE OF INSUIRANCE ADDLj 5UBR Dt'tl IPV *11 IMI*I=D POLICY EFF POLICY EXP LIMITS

~U~5'4NY~5~+/- ~' J'~~'"' J.~OO'L~'+/--~-+/-+/-L L ---

COMM**E RCIA L GEN ERAL LIABILITY EACH OCCURRENCE $

CLAIMS-MADE OCCUR PREMISES (Ea occurrence) -$

MED EXP (Any one person) -$

PERSONAL & ADV INJURY $

GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $

POLICY I OTHER:

DPRO- JECT --

LJLOC PRODUCTS - COMPIOP AGG AUTOMOBILE LIABILITY 1 ~I- ~-,-.,.,.,,-.,.-. - r uivii~aa~gntu IIN3CLIi $

ANY AUTO BODILY INJURY (Per person) $

ALL OWNED

__AUTOS AUTOS BODILY INJURY (Per accidenl) $

HIRED AUTOS

-- NON-OWNED SCHEDULED PROPERTY DAMAGE

__AUTOS (Per accidenl) _______________________

K A-H

-I -1 ~-

UMBRELLA LIAB

  • JOCCUR $

AGREACHOTRENCE EXCESS LIAB I CLAIMS-MADE AGGREGATE $

SI RETENTION $

RKERS COMPENSATION DEMPLOYERS' LIABILITY Y/IN I *TATIiT PER ITF I I°TH I:S (PROPRIETOR/PARTNER/EXECUTIVE flF ICER/MEMBER EXCLUDED? E.L. EACH ACCIDENT $

NIA ndatory in NH)

EL. DISEASE- EA EMPLOYEE~ $

s, describe under 3CRIPTION OF OPERATIONS below O:H fIQOrQ1 -ffl D('IIV I MITI

-I 4____________ ~"'-"-'-"~ -, ,-,.-.'-,, .- ,,.,,, I--'-

ENERGY LIABILITY 3EE ATTACHED ACORD 101 01/01/2016 01/01/2017 SEE ATTACHED ACORD 101 DESCRIPTION OF OPERATIONS I LOCATIONS I(VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

CERTIFICATE HOLDER CANCELLATION DOCUENTCONTOL ESKSHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE U.S. NUCLE-AR 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.

IManashi Mukherjee 2 c,,,i.,.k.

.. * ~.4L

  • A-tL*

© 1988-2014 ACORD CORPORATION. All rights reserved.

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

AGENCY CUSTOMER ID:. 074725 LOC #: Morristown ACORD ADDITIONAL REMARKS SCHEDULE Page 2 of2 AGENCY NAMED INSURED MARSH USA, INC. PSEG NUCLEAR LLC

_______________________________________________ATTN: ROBERT GREEN POLICY NUMBER ROBERT.GREEN2@PSEG.COM 80 PARK PLAZA, MAIL CODE T-6B CARRIER /NAIC CODE NWRN 70 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 Iisinforce as of the effective date of this Certificate a Nuclear Energy Liability 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 snaured'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 Certificnte shall terminate as of the end of such December 31st. ACertificate willNOT be issued for sany subsequent calendar year unless requested in writing.

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- SALEM NUCLEAR POWER STATIONS AND HOPE CREEK NUCLEAR POWER STATION LOCATION OF NUCLEAR FACILITY: Salem Nuclear Power Plant and Hope Creek Nuclear Power Plant inLower Alloways Creek Township, Salem County, New Jersey NAMED INSURED [LISTED ON POLICY]: PSEG Nuclear LLC and Exelon Generation Company, LLC POLICY NUMBER: POLICY EFFECTIVE: LIMITOF LIABILITY:

NF-0230 10/1511974 $375 Million NW-0606 10/1511974 $375 Million**

N-0060 08/01/1977**

N-0072 04118/1980**

N-0104 04/14/1986

  • THIS CERTIFICATE IS ISSUED 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, conditlons anedother provisions of the policyjies). Neither this Certificate nor any contract or other document with respect to which it is issued shall amend, extend or alter thu coverage afforded by the policy. The Limit of Liability shown above may have bees reduced by payment of claims or claims expenses.

COMMENTS/NOTES:

    • Master Worker Certificate - This limit is shared by altCertificates to the Master Worker Policy of which each Certificate is a part and is subject to allof the provisions of such Policy and Certificate basing reference thereto. Such limit way have been reduced by payment of claims or claims expenses.
    • SecondaryFinancial Protection Certificate - Financial protection available under an industry retrospective rating plan.

ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORD

0 0 0 2459 SP 0039 DOCUMENT CONTROL DESK

-C01-P02460-I Jo-- z-l*

U.S. NUCLEAR REGULATORY COMMISSION WASHINGTON, DC 20555-0001 3(1

'51)

ACO~RD CERTIFICATE OF LIABILITY INSURANCE S DATE (MM/DDIYYYY) 01/22/2016 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 FAX 445 SOUTH STREET Ac. No. xt (A/C No):

MORRISTOWN, NJ 07960-6454 E-MAIL Attn: Morristown.CertRequest~marsh.com ADDRESS:

INSURER(S) AFFORDING COVERAGE NAIC #

074725-OTU-NUCLE-16-17 INSURER A : American Nuclear Insurers INSUREDINUEB PSEG NUCLEAR LLC ISRRB ATTN: ROBERT GREEN INSURER C :

ROBERT.GREEN2@PSEG.COM INSURER D :

80 PARK PLAZA, MAIL CODE T-6B NEWARK, NJ 07101 INSURER E :

___________________________________________________________ INSURER F: ______

COVERAGES CERTIFICATE NUMBER: NYC-007087875-03 REVISION NUMBER:11 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.

TYPE OF INSUIRANCE ADDLj 5UBR Dt'tl IPV *11 IMI*I=D POLICY EFF POLICY EXP LIMITS

~U~5'4NY~5~+/- ~' J'~~'"' J.~OO'L~'+/--~-+/-+/-L L ---

COMM**E RCIA L GEN ERAL LIABILITY EACH OCCURRENCE $

CLAIMS-MADE OCCUR PREMISES (Ea occurrence) -$

MED EXP (Any one person) -$

PERSONAL & ADV INJURY $

GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $

POLICY I OTHER:

DPRO- JECT --

LJLOC PRODUCTS - COMPIOP AGG AUTOMOBILE LIABILITY 1 ~I- ~-,-.,.,.,,-.,.-. - r uivii~aa~gntu IIN3CLIi $

ANY AUTO BODILY INJURY (Per person) $

ALL OWNED

__AUTOS AUTOS BODILY INJURY (Per accidenl) $

HIRED AUTOS

-- NON-OWNED SCHEDULED PROPERTY DAMAGE

__AUTOS (Per accidenl) _______________________

K A-H

-I -1 ~-

UMBRELLA LIAB

  • JOCCUR $

AGREACHOTRENCE EXCESS LIAB I CLAIMS-MADE AGGREGATE $

SI RETENTION $

RKERS COMPENSATION DEMPLOYERS' LIABILITY Y/IN I *TATIiT PER ITF I I°TH I:S (PROPRIETOR/PARTNER/EXECUTIVE flF ICER/MEMBER EXCLUDED? E.L. EACH ACCIDENT $

NIA ndatory in NH)

EL. DISEASE- EA EMPLOYEE~ $

s, describe under 3CRIPTION OF OPERATIONS below O:H fIQOrQ1 -ffl D('IIV I MITI

-I 4____________ ~"'-"-'-"~ -, ,-,.-.'-,, .- ,,.,,, I--'-

ENERGY LIABILITY 3EE ATTACHED ACORD 101 01/01/2016 01/01/2017 SEE ATTACHED ACORD 101 DESCRIPTION OF OPERATIONS I LOCATIONS I(VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

CERTIFICATE HOLDER CANCELLATION DOCUENTCONTOL ESKSHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE U.S. NUCLE-AR 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.

IManashi Mukherjee 2 c,,,i.,.k.

.. * ~.4L

  • A-tL*

© 1988-2014 ACORD CORPORATION. All rights reserved.

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

AGENCY CUSTOMER ID:. 074725 LOC #: Morristown ACORD ADDITIONAL REMARKS SCHEDULE Page 2 of2 AGENCY NAMED INSURED MARSH USA, INC. PSEG NUCLEAR LLC

_______________________________________________ATTN: ROBERT GREEN POLICY NUMBER ROBERT.GREEN2@PSEG.COM 80 PARK PLAZA, MAIL CODE T-6B CARRIER /NAIC CODE NWRN 70 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 Iisinforce as of the effective date of this Certificate a Nuclear Energy Liability 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 snaured'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 Certificnte shall terminate as of the end of such December 31st. ACertificate willNOT be issued for sany subsequent calendar year unless requested in writing.

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- SALEM NUCLEAR POWER STATIONS AND HOPE CREEK NUCLEAR POWER STATION LOCATION OF NUCLEAR FACILITY: Salem Nuclear Power Plant and Hope Creek Nuclear Power Plant inLower Alloways Creek Township, Salem County, New Jersey NAMED INSURED [LISTED ON POLICY]: PSEG Nuclear LLC and Exelon Generation Company, LLC POLICY NUMBER: POLICY EFFECTIVE: LIMITOF LIABILITY:

NF-0230 10/1511974 $375 Million NW-0606 10/1511974 $375 Million**

N-0060 08/01/1977**

N-0072 04118/1980**

N-0104 04/14/1986

  • THIS CERTIFICATE IS ISSUED 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, conditlons anedother provisions of the policyjies). Neither this Certificate nor any contract or other document with respect to which it is issued shall amend, extend or alter thu coverage afforded by the policy. The Limit of Liability shown above may have bees reduced by payment of claims or claims expenses.

COMMENTS/NOTES:

    • Master Worker Certificate - This limit is shared by altCertificates to the Master Worker Policy of which each Certificate is a part and is subject to allof the provisions of such Policy and Certificate basing reference thereto. Such limit way have been reduced by payment of claims or claims expenses.
    • SecondaryFinancial Protection Certificate - Financial protection available under an industry retrospective rating plan.

ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORD

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