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Certificate of Liability Insurance for Susquehanna, Units 1 and 2
	ML16074A136
Person / Time
Site:	Susquehanna
Issue date:	02/09/2016
From:	Mukherjee M; Marsh USA
To:	; Document Control Desk, Office of Nuclear Reactor Regulation
References
	Download: ML16074A136 (3)
	v • d • e

00 0 0909 SP 0062 -C01-P00909-1 Document Control Desk U.S. Nuclear Regulatory Commission Washington, DC 20555-0001 3o)

ACO RD CERTIFICATE OF LIABILITY INSURANCE DAE(MDIYY 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 NAME:

Marsh USA Inc. PHONE FAX 1717 Arch Street AC. No Ex) A/C. No:

Philadelphia, PA 19103-2797 E-MAIL Attn: Philadelphia.Certs~marsh~com/ fax - 212-948-0360 ADDRESS:_______

INSURER(S) AFFORDING COVERAGE NAIC #

S27324-NUC-ENR-16-17 INSURER A : American Nuclear Insurers INSURED INSURER B :

Susquehanna Nuclear, LLC and Allegheny Electiic Cooperative, Inc. INSURER C :

Corporate Risk & Insurance INSURER D :

835 Hamilton streat, Suite 150, GENPL7N_______

Allentown, PA 18101 INSURER E :

_____________________________________________________INSURER F :

COVERAGES CERTIFICATE NUMBER: CLE-004443748-05 REVISION NUMBER:9 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, I::YrI I I*:fl.Ikl Akifl rr~klrnTIr'tMlC I'tZ C11II-U D(*I It'ItO: I lIKAITC*C rI-tlA/INl IRAV I.A\II= D kI::1Ol;;I 11'. ~

IC l- l V DAIrl ('I AISAJC:

INSR MDDLISUBR POLICY EFF POLICY EXP LTR __ TYPE OF INSURANCE INDJ V POLICY NUMBER (MMIDD/YYYY) (MMIDD/YYYYI LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $

m""-- DAMAGE TO RENTED jCLAIMS-MADE KJOCCUR PREMISES (Ea occurrence) $

__ _________________MED EXP (Any one person) $ ,-"

_______________PERSONAL &ADV INJURY $

GEN'L AGGREGATE LIMIT APPLIES PER; GENERAL AGGREGATE $

E7-- PRO- Efl POLICY LiJECT LiLOC PRODUCTS - COMP/OP AGG $

OTHER: ___________$

AUTOMOILE UBIUTYCOMBINED SINGLE LIMIT $

AUTOMBILEUABIITY Ea accident)$

ANY AUTO BODILY INJURY (Per person) $

ALL OWNED SCHEDULED BODILY INJURY (Per accident) $

__AUTOS __AUTOS NON-OWNED PROPERTY DAMAGE $

__HIRED AUTOS __AUTOS (Per accidentl

__UMBRELLA LIAB R OCCUR EACH OCCURRENCE $

EXCESS LIABR ICLAIMS-MADE AGGREGATE ;$

050I RETENTIONS $

WORKERS COMPENSATION PE AND EMPLOYERS' LIABILITY Y /NI ER _________

ANY PROPRIETOR/PARTNER/EXECUTIVE r1 EL. EACH ACCIDENT $

OFFICER/MEMBER EXCLUDED? L* NI 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 01/01/2016 01/01/2017 See Attached Acord 101 Insurance Acord 101 DESCRIPTION OF OPERATIONS / LOCATIONS I 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.

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

AGENCY CUSTOMER ID: S27324 LOC #: Philadelphia ACORD ADDITIONAL REMARKS SCHEDULE Page 2 of2 AGENCY NAMED INSURED Marsh USA Inc. Susquehanna Nuclear, LLC and Allegheny

_______________________________________________________________Electric___ CEoecercaCopereiveIInc POLICY NUMBER Corporate Risk &Insurance 835 Hamilton Street, Suite 150, GENPL7N

-Allentown, PA 18101 CARRIER NAIC coDE

[THIS J EFFECTIVE DATE:

ADDITIONAL REMARKS 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 in force as of the effective date of this Certiticate 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 Insured's operations described herein. If such policy is cancelled Orotherwise terminated prior to the end of December 31 st 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 in writing.

Types of Insurance: NF - [Facility Form), NW- [Master Worker Certiticate], NS - [US Domestic Supplier's &Transporters], FS - [Foreign Suppliers &Transporters)

COVERAGE FOR NUCLEAR FACILITIES:

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

POLICY NUMBER: POLICY EFFECTIVE: LIMITOF LIABtLITY:

NF-0262 01/01/1981 $375 Million NW-0622 01/01/1981 $375 Mi~lion**

N-0084 07/1 7/1982

N-0096 03/23/1984**

THIS CERTIFICATE IS ISSUED AS AMATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.

The insurance afforded by the policyjies) is subject to the exclusions, conditions and other provisions of the policyjies). 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 Limitof Liability shown above may have been reduced bypayment 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 hy the policy shall al~soapply to Allegheny Electric Cooperative, Inc. and Talen Energy Cor"poration, 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 of the operation of a reactor in which it has an ownership interest, located at the Susquehanna Steam Electric Station.

The ACORD name and logo are registered marks of ACORD

00 0 0909 SP 0062 -C01-P00909-1 Document Control Desk U.S. Nuclear Regulatory Commission Washington, DC 20555-0001 3o)

ACO RD CERTIFICATE OF LIABILITY INSURANCE DAE(MDIYY 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 NAME:

Marsh USA Inc. PHONE FAX 1717 Arch Street AC. No Ex) A/C. No:

Philadelphia, PA 19103-2797 E-MAIL Attn: Philadelphia.Certs~marsh~com/ fax - 212-948-0360 ADDRESS:_______

INSURER(S) AFFORDING COVERAGE NAIC #

S27324-NUC-ENR-16-17 INSURER A : American Nuclear Insurers INSURED INSURER B :

Susquehanna Nuclear, LLC and Allegheny Electiic Cooperative, Inc. INSURER C :

Corporate Risk & Insurance INSURER D :

835 Hamilton streat, Suite 150, GENPL7N_______

Allentown, PA 18101 INSURER E :

_____________________________________________________INSURER F :

COVERAGES CERTIFICATE NUMBER: CLE-004443748-05 REVISION NUMBER:9 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, I::YrI I I*:fl.Ikl Akifl rr~klrnTIr'tMlC I'tZ C11II-U D(*I It'ItO: I lIKAITC*C rI-tlA/INl IRAV I.A\II= D kI::1Ol;;I 11'. ~

IC l- l V DAIrl ('I AISAJC:

INSR MDDLISUBR POLICY EFF POLICY EXP LTR __ TYPE OF INSURANCE INDJ V POLICY NUMBER (MMIDD/YYYY) (MMIDD/YYYYI LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $

m""-- DAMAGE TO RENTED jCLAIMS-MADE KJOCCUR PREMISES (Ea occurrence) $

__ _________________MED EXP (Any one person) $ ,-"

_______________PERSONAL &ADV INJURY $

GEN'L AGGREGATE LIMIT APPLIES PER; GENERAL AGGREGATE $

E7-- PRO- Efl POLICY LiJECT LiLOC PRODUCTS - COMP/OP AGG $

OTHER: ___________$

AUTOMOILE UBIUTYCOMBINED SINGLE LIMIT $

AUTOMBILEUABIITY Ea accident)$

ANY AUTO BODILY INJURY (Per person) $

ALL OWNED SCHEDULED BODILY INJURY (Per accident) $

__AUTOS __AUTOS NON-OWNED PROPERTY DAMAGE $

__HIRED AUTOS __AUTOS (Per accidentl

__UMBRELLA LIAB R OCCUR EACH OCCURRENCE $

EXCESS LIABR ICLAIMS-MADE AGGREGATE ;$

050I RETENTIONS $

WORKERS COMPENSATION PE AND EMPLOYERS' LIABILITY Y /NI ER _________

ANY PROPRIETOR/PARTNER/EXECUTIVE r1 EL. EACH ACCIDENT $

OFFICER/MEMBER EXCLUDED? L* NI 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 01/01/2016 01/01/2017 See Attached Acord 101 Insurance Acord 101 DESCRIPTION OF OPERATIONS / LOCATIONS I 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.

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

AGENCY CUSTOMER ID: S27324 LOC #: Philadelphia ACORD ADDITIONAL REMARKS SCHEDULE Page 2 of2 AGENCY NAMED INSURED Marsh USA Inc. Susquehanna Nuclear, LLC and Allegheny

_______________________________________________________________Electric___ CEoecercaCopereiveIInc POLICY NUMBER Corporate Risk &Insurance 835 Hamilton Street, Suite 150, GENPL7N

-Allentown, PA 18101 CARRIER NAIC coDE

[THIS J EFFECTIVE DATE:

ADDITIONAL REMARKS 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 in force as of the effective date of this Certiticate 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 Insured's operations described herein. If such policy is cancelled Orotherwise terminated prior to the end of December 31 st 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 in writing.

Types of Insurance: NF - [Facility Form), NW- [Master Worker Certiticate], NS - [US Domestic Supplier's &Transporters], FS - [Foreign Suppliers &Transporters)

COVERAGE FOR NUCLEAR FACILITIES:

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

POLICY NUMBER: POLICY EFFECTIVE: LIMITOF LIABtLITY:

NF-0262 01/01/1981 $375 Million NW-0622 01/01/1981 $375 Mi~lion**

N-0084 07/1 7/1982

N-0096 03/23/1984**

THIS CERTIFICATE IS ISSUED AS AMATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.

The insurance afforded by the policyjies) is subject to the exclusions, conditions and other provisions of the policyjies). 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 Limitof Liability shown above may have been reduced bypayment 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 hy the policy shall al~soapply to Allegheny Electric Cooperative, Inc. and Talen Energy Cor"poration, 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 of the operation of a reactor in which it has an ownership interest, located at the Susquehanna Steam Electric Station.

The ACORD name and logo are registered marks of ACORD

ML16074A136

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