ML16252A328

Certificate of Liability Insurance

ML16252A328
Person / Time
Site:	Oconee, Mcguire, Catawba, Harris, Brunswick, Framatome, Crystal River, Robinson, McGuire, Levy County, Lee
Issue date:	08/31/2016
From:	Marsh USA
To:	Document Control Desk, Office of New Reactors, Office of Nuclear Reactor Regulation
References
Download: ML16252A328 (5)

Text

0001566 SP 0505

-C01-P01566-I Document Control Desk U S Nuclear Regulatory Comm1ss1on Wa~hington, DC 20555--0001

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ACORD CERTIFICATE OF LIABILITY INSURANCE I

DATE (MM/DD/YYYY)

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08/31/2016 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:

~n~~N~o Fvtl*

I FAX 100 North T~on Street, Suite 3600 IAJC Nol:

Charlotte, N 28202 E-MAIL ADDRESS:

INSURERISl AFFORDING COVERAGE NAIC#

22830-0NE-1/1-16-17 INSURER A : American Nuclear Insurers INSURED INSURER B:

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Duke Energy Corporation ATIN: Ed Adams INSURERC:

ed.adams@duke-energy.com INSURERD:

550 S. Tryon Street DEC40-C INSURER E:

Charlotte, NC 28202 INSURER F:

COVERAGES CERTIFICATE NUMBER:

ATL-003526555-10 REVISION NUMBER:23 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 THI!:)~

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.

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INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLlCYEXP LTR

,.,.,n nnln POLICY NUMBER fMM/DD/YYYYI IMM/DD/YYYYI LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE I CLAIMS-MAOE D OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence I

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MED EXP (Any one person)

PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER:

GENERALAGGREGATE Fl DPRO-OLoc PRODUCTS - COMP/OP AGG POLICY JECT OTHER:

AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT IEa accident) f--

ANY AUTO BODILY INJURY (Per person) f--

ALL OWNED

~SCHEDULED BODILY INJURY (Per accident) $

f--

AUTOS f-- AUTOS NON-OWNEO PROPERTY DAMAGE HIRED AUTOS AUTOS (Per accident\\

f--

UMBRELLA LIAB H OCCUR EACH OCCURRENCE f--

EXCESSLIAB CLAIMS-MAOE AGGREGATE DED I I RETENTION $

WORKERS COMPENSATION I PER I I OTH-AND EMPLOYERS' LIABILITY STATUTE ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE ~

E.L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED?

N/A (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 SEEATIACHED 01/01/2016 01/01/2017 SEEATIACHED DESCRIPTION OF OPERATIONS I 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.

I Karen A. Burke I<~ (A.. ~

© 1988-2014 ACORD CORPORATION. All rights reserved.

ACORD 25 (2014/01)

The ACORD name and logo are registered marks of ACORD

AGENCYCUSTOMERID:_2_2_8_3_0~~~~~~~~~~~~~~~

LOC #: Charlotte ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED Marsh USA Inc.

Duke Energy Corporation ATIN: Ed Adams POLICY NUMBER ed.adams@duke-energy.com 550 S. Tryon Street DEC40-C CARRIER Charlotte, NC 28202 I 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 in force 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 lnsured's operations described herein. If such policy is cancelled or otheiwise terminated prior to the end of December 31st of the calendar year in which the Effective Date of this Certificate occurs, notice will be delivered in accordance with the policy provisions. Otheiwise this Certificate shall terminate as of the end of such December 31st. A Certificate will NOT be issued for any 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-CATAWBA LOCATION OF NUCLEAR FACILITY: Catawba Nuclear Power Plant in the NE portion of York County, SC NAMED INSURED [LISTED ON POLICY]: Duke Energy Carolinas, LLC POLICY NUMBER:

POLICY EFFECTIVE:

NF-0281 12/01/1983 NW-0637 N-0097 N-0106

2. SITE #2 - MCGUIRE 12/01/1983 07/1811984 12/01/1983 LIMIT OF LIABILITY:

$375 Million

$375 Million**

LOCATION OF NUCLEAR FACILITY: McGuire Nuclear Power Plant located 17 mi N/NW of Charlotte, NC NAMED INSURED [LISTED ON POLICY]: Duke Energy Carolinas, LLC POLICY NUMBER:

POLICY EFFECTIVE:

LIMIT OF LIABILITY:

NF-0248 NW-0615 N-0069 N-0092

3. SITE #3 - OCONEE 05/01/1977 05/01/1977 01123/1981 03/03/1983

$375 Million

$375 Million*'

LOCATION OF NUCLEAR FACILITY: Oconee Nuclear Power Plant in Oconee County, South Carolina NAMED INSURED [LISTED ON POLICY]: Duke Energy Carolinas, LLC POLICY NUMBER:

POLICY EFFECTIVE:

LIMIT OF LIABILITY:

NF-0182 03/0111970

$375 Million NW-0569 03/01/1970

$375 Million" N-0022 08/01/1977 N-0023 08/01/1977 N-0024 08/01/1977

4. SITE #4-BRUNSWICK LOCATION OF NUCLEAR FACILITY: Brunswick Nuclear Power Plant 2.5 Ml N of Southport, NC NAMED INSURED [LISTED ON POLICY]: Duke Energy Progress, LLC POLICY NUMBER:

POLICY EFFECTIVE:

LIMIT OF LIABILITY:

NF-0218 10/25/1973

$375 Million NW-0597 10/25/1973

$375 Million" N-0054 N-0055 08/01/1977 08/01/1977 Page 2

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ACORD 101 (2008/01)

© 2008 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORD

AGENCYCUSTOMERID:_2_2_8_3_0~~~~~~~~~~~~~~~

LOC #: Charlotte ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED Marsh USA Inc.

Duke Energy Corporation ATTN: Ed Adams POLICY NUMBER ed.adams@duke-energy.com 550 S. Tryon Street DEC40-C CARRIER Charlotte, NC 28202 I NAICCODE EFFECTIVE DATE:

ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:

25 FORM TITLE: Certificate of Liability Insurance

5. SITE #5-CRYSTAL RIVER LOCATION OF NUCLEAR FACILITY: Crystal River Nuclear Power Plant 7.5 Ml NW of Crystal River, Citrus County, FL NAMED INSURED [LISTED ON POLICY]: Duke Energy Florida, Inc.; Seminole Electric Cooperative, Inc.

POLICY NUMBER:

POLICY EFFECTIVE:

LIMIT OF LIABILITY:

NF-0195 NW-0579

6. SITE #6-SHEARON HARRIS 07/01/1971 07/01/1971

$375 Million

$375 Million" LOCATION OF NUCLEAR FACILITY: Shearon Harris Nuclear Power Plant 20 Ml SW of Raleigh, NC NAMED INSURED [LISTED ON POLICY]: Duke Energy Progress, Inc.

POLICY NUMBER:

POLICY EFFECTIVE:

NF-0288 NW-0642 N-0112

7. SITE #7 - H. B. ROBINSON 06/01/1984 06/01/1984 10/24/1986 LIMIT OF LIABILITY:

$375 Million

$375 Million

LOCATION OF NUCLEAR FACILITY: H.B. Robinson Nuclear Power Plant 5 Ml WNW from Hartsville, SC NAMED INSURED [LISTED ON POLICY]: Duke Energy Progress, Inc.

POLICY NUMBER:

POLICY EFFECTIVE:

NF-0180 NW-0567 N-0021

8. SITE #8 - LEVY 10115/1969 10/15/1969 08/01/1977 LOCATION OF NUCLEAR FACILITY: Levy Nuclear Plant 39 Ml SW of Gainsville, FL NAMED INSURED [LISTED ON POLICY]: Duke Energy Florida, Inc.

POLICY NUMBER:

POLICY EFFECTIVE:

NF-0354 01/01/2015

9. SITE #9 - LEE LOCATION OF NUCLEAR FACILITY: Lee Nuclear Site 6 Ml S of Blacksburg, SC NAMED INSURED [LISTED ON POLICY]: Duke Energy Carolinas, LLC LIMIT OF LIABILITY:

$375 Million

$375 Million" LIMIT OF LIABILITY:

$1 Million POLICY NUMBER:

POLICY EFFECTIVE:

LIMIT OF LIABILITY:

NF-0355 1/1/2016

$1 Million 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, conditions and other provisions of the policy(ies). Neither this Certificate nor any contract or other document with respect to which it is 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 all of the provisions of such Policy Page 3

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ACORD 101 (2008/01)

© 2008 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORD

AGENCYCUSTOMERID:_2_2_8_3_0~~~~~~~~~~~~~~~

LOC #: Charlotte

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ACORD ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED Marsh USA Inc.

Duke Energy Corporation ATIN: Ed Adams POLICY NUMBER ed.adams@duke-energy.com 550 S. Tryon Street DEC40-C CARRIER I NAICCODE Charlotte, NC 28202 EFFECTIVE DATE:

ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:

25 FORM TITLE: Certificate of Liability Insurance 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.

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ACORD 101 (2008/01)

© 2008 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORD