ML16252A329
| ML16252A329 | |
| Person / Time | |
|---|---|
| Site: | Oconee, Mcguire, Catawba, Harris, Brunswick, Crystal River, McGuire  |
| Issue date: | 08/31/2016 |
| From: | Duke Energy Corp |
| To: | Document Control Desk, Office of Nuclear Reactor Regulation |
| References | |
| Download: ML16252A329 (4) | |
Text
0001567 SP 0505 Document Control Desk U.S. Nuclear Regulatory Commission Washington, DC 20555-0001
-C01-P01567-I 5o- +13 / t.f/4-so-07013&9
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ACORD CERTIFICATE OF LIABILITY INSURANCE I
DATE (MM/DDNYYY)
~-
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:
PHONE I FAX 100 North T~on Street, Suite 3600
/AIC No Extl:
IAIC Nol:
Charlotte, N 28202 E-MAIL ADDRESS:
INSURERISl AFFORDING COVERAGE NAIC#
22830 -Duke-1/1-16-17 INSURER A : American Nuclear Insurers INSURED INSURERS:
Duke Energy Corporation ATIN: Ed Adams INSURERC:
ed.adams@duke-energy.com
- ~4:.
INSURERD:
- . ii
- .;
550 S. Tryon Street DEC40-C INSURERE:
Cha~otte, NC 28202 INSURER F:
COVERAGES CERTIFICATE NUMBER:
ATL-003637324-10 REVISION NUMBER:16 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 TYPE OF INSURANCE ADDL SUBR r~~Jii%MVv1,~g~6%W~1 LIMITS LTR
'""n IJ\\l\\ln POLICY NUMBER COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE
,_ D CLAIMS-MADE D OCCUR DAMAGE TO RENTED PREMISES IEa occurrencel
- . I :t.t~'-
- MED EXP (Any one person)
PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE Fl DPRO-DLOC PRODUCTS - COMP/OP AGG POLICY JECT OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT IEa accidentl ANY AUTO BODILY INJURY (Per person)
ALL OWNED SCHEDULED BODILY INJURY (Per accident) $
,_ AUTOS
,_ AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS f Per accident\\
UMBRELLA LIAB H OCCUR EACH OCCURRENCE EXCESSLIAB CLAIMS-MADE AGGREGATE OED I I RETENTION $
WORKERS COMPENSATION I PER I I OTH-AND EMPLOYERS' LIABILITY STATUTE ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE D
N/A E.L EACH ACCIDENT OFFICER/MEMBER EXCLUDED?
(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 ACORD 101 01/01/2016 01/01/2017 See Attached Acord 101 Insurance 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 Manashi Mukherjee
~~
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© 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01)
The ACORD name and logo are registered marks of ACORD
AGENCYCUSTOMERID:~2=2=8~30-=--~~~~~~~~~~~~~~~
LDC #: 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 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 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 otherwise 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. Otherwise 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]
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: LIMIT OF LIABILITY:
NF-028112/01/1983 $375 Million NW-0637 12/01/1983 $375 Million"
- 2. SITE #2-MCGUIRE 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 05/01/1977 $375 Million NW-0615 05/01/1977 $375 Million**
- 3. SITE #3 - OCONEE LOCATION OF NUCLEAR FACILITY: Oconee Nuclear Power Plantin Oconee County, South Carolina NAMED INSURED !LISTED ON POLICY]: Duke Energy Carolinas, LLC POLICY NUMBER: POLICY EFFECTIVE: LIMIT OF LIABILITY:
NF-0182 03/01/1970 $375 Million NW-0569 03/01/1970 $375 Million"
- 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-021810/25/1973 $375 Million NW-0597 10/25/1973 $375 Million"
- 5. SITE #5 - CRYSTAL RIVER LOCATION OF NUCLEAR FACILITY: Crystal River Nuclear Power Plant 7.5 Ml NW of Crystal River, Cilrus County, FL NAMED INSURED [LISTED ON POLICY]: Duke Energy Florida, Inc.; Seminole Electric Cooperative, Inc.; Orlando Utilities Commission and City of Orlando; City of Gainesville, Florida; City of Ocala; City of Leesburg, Flortda; City of Kissimmee, Florida, A Municipal Corporation; City of New Smyrna Beach, Florida and Utilities Commission of New Smyrna Beach, Florida; City of Alachua, Florida; The City of Bushnell; Florida Progress Corporation POLICY NUMBER: POLICY EFFECTIVE: LIMIT OF LIABILITY:
NF-0195 07/01/1971 $375 Million NW-0579 07/01/1971 $375 Million" Page 2
of 3
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 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
- 6. SITE #6-SHEARON HARRIS 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: LIMIT OF LIABILITY:
NF-0288 06/01/1984 $375 Million NW-0642 06/01/1984 $375 Million**
- 7. SITE #7 - H. B. ROBINSON 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: LIMIT OF LIABILITY:
NF-018010/15/1969 $375 Million NW-056710/15/1969 $375 Million" COVERAGE FOR SUPPLIER'S & TRANSPORTER'S:
- 8. US DOMESTIC S&T DESCRIPTION OF OPERATIONS: Furnishing of services, materials, 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]: Duke Energy Corporation POLICY NUMBER: POLICY EFFECTIVE: LIMIT OF LIABILITY:
NS-0340 06//22/1977 $375 Million THIS CERTIFICATE IS ISSUED AS A MATIER 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 and Certificate having reference thereto. Such limit may have been reduced by payment of claims or claims expenses.
Page 3
of 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