ML17060A346
| ML17060A346 | |
| Person / Time | |
|---|---|
| Site: | Beaver Valley, Millstone, Hatch, Monticello, Calvert Cliffs, Dresden, Davis Besse, Peach Bottom, Browns Ferry, Salem, Oconee, Mcguire, Nine Mile Point, Palo Verde, Perry, Kewaunee, Catawba, Harris, Wolf Creek, Saint Lucie, Point Beach, Oyster Creek, Watts Bar, Sequoyah, Byron, Braidwood, Susquehanna, Summer, Prairie Island, Columbia, Seabrook, Brunswick, Surry, Limerick, North Anna, Turkey Point, Crystal River, Haddam Neck, Ginna, Diablo Canyon, Vogtle, Duane Arnold, Farley, Robinson, Clinton, San Onofre, Comanche Peak, Yankee Rowe, Maine Yankee, Quad Cities, Humboldt Bay, Zion, Fort Calhoun, McGuire, LaSalle, Levy County, 07000754, 07000734, 07001201, Saxton, Lee  |
| Issue date: | 02/22/2017 |
| From: | Evans D Marsh USA |
| To: | Document Control Desk, Office of Nuclear Material Safety and Safeguards, Office of New Reactors, Office of Nuclear Reactor Regulation |
| References | |
| Download: ML17060A346 (62) | |
Text
MMARSH U.S. Nuclear Regulatory Commission
- A TIN: Document Control Desk Washington, DC 20555-0001 February 22, 2017
Subject:
2017 Nuclear Liability Certificates of Insurance Dan Evans Marsh USA Inc.
Three Logan Square 1717 Arch Street, Suite 1100 Philadelphia, PA. 19103
+1 215.2461463 Daniel.R.Evans@marsh.com www.marsh.com Enclosed, please find the 2017 Nuclear Liability Certificates of Insurance for licensees that utilize Marsh for insurance brokerage services. The Certificate of Insurance provides evidence of financial protection.
If you have any questions, please do not hesitate to contact me.
Best regards, i)J!l~
Dan Evans Nuclear Client Advisor, U.S. Nuclear Energy Practice Enclosure Copy:
T. Farward, C. Hardie.. G. Lawson SOLUTIONS... DEFINED, DESIGNED, AND DELIVERED.
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ACORD 8
CERTIFICATE OF LIABILITY INSURANCE I
~
02110/2017 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 INSlJRER(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 tenns 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 I FAX 100 North T ~on Street, Suite 3600 IA/C No Fxtl*
IA/C Nol:
Charlotte, N 28202 E-MAIL ADDRESS:
INSURER!Sl AFFORDING COVERAGE NAIC#
101-388-814-AREVA-Nuke-17-18 AREVA BWXTN INSURER A : American Nuclear Insurers INSURED INSURERS:
BWXT Nuclear Operations Group, Inc.
2016 Mt. Athas Road.
INSURERC:
Lynchburg, VA 25404 INSURERD:
INSURERE:
INSURER F:
COVERAGES CERTIFICATE NUMBER:
A TL-004027771-02 REVISION NUMBER:3 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE
- ~n lw\\/n POLICY NUMBER IMM/DD/YYYY\\ IMM/00/YYYY\\
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE
~ D CLAIMS-MADE D OCCUR DAMAGE TO RENTED PREMISES *Ea occurrence I MED EXP (Any one person) s PERSONAL & ADV INJURY s
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERALAGGREGATE Fl DPR~ DLOC PRODUCTS - COMP/OP AGG POLICY JECT s
OTHER:
s AUTOMOBILE LIABILITY fe~~~~~~t~INGLE LIMIT ANY AUTO BODILY INJURY (Per person) s ALL OWNED SCHEDULED BODILY INJURY (Per accident) $
~
AUTOS
>--- AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS I Per accident\\
~
UMBRELLA LIAB HOCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE
\\
AGGREGATE s
OED I I RETENTION$
WORKERS COMPENSATION I PER I I OTH-AND EMPLOYERS' LIABILITY STATUTE ER YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ~
N/A E.L. EACH ACCIDENT s
OFFICER/MEfy1BER EXCLUDED?
(Mandatory In NH)
I E.L. DISEASE - EA EMPLOYEE $
~~~~~~~g~ ~~~PERATIONS below I
E.L. DISEASE - POLICY LIMIT A
Nudear Energy Liability See Attached 01/0112017 01/0112018 See Attached Insurance
'ACORD 101' 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 Document Control Desk SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE.CANCELLED BEFORE U.S. Nudear 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 Cathy Fitzgerald Co.1':A+- ~.,.... *..4.,£_
© 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01)
The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: 101-388-814
~~~~~~~~~~~~~~~~~~~~~~~
LOC #: Charlotte ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED Marsh USA Inc.
BWXT Nuclear Operations Group, Inc.
2016 Mt. Athas Road POLICY NUMBER Lynchburg, VA 25404 CARRIER 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 Insure'<! named herein, wi!h 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 othelWise 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. OthelWise this ~rtificate 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 Worl<er Certificate], NS - [US Domestic Suppliers & Transporters], FS - [Foreign Suppliers & Transporters]
COVERAGE FOR NUCLEAR FACILITIES:
- 1. SITE #1 - LYNCHBURG FUEL FABRICATION FACILITY LOCATION OF NUCLEAR FACILITY: Lynchburg Fuel Fabrication Facility 550 acre plant site, approx 7mi east of Lynchburg, VA NAMED INSURED [LISTED ON POLICY]: BWXT Nuclear Operations Group, Inc. and AREVA Inc.
POLICY NUMBER:
POLICY EFFECTIVE:
LIMIT OF LIABILITY:
NF-0111 NW-0533 10/01/1961 10/01/1961
$200 Million
$450 Million-THIS CERTIFICATE IS ISSUED AS A MA TIER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.
7~-/ZP/
The _insurance afforded by the policy(ies) is subject to the exclusions, conditions and other provisions of the policy(ies). Neither this Certificate nor any contract or other document with respect to which it is issued shall amend, extend or alter the coverage afforded by the policy. The Limit of Liability shown above may have been reduced by payment of claims or claims expenses.
COMMENTS/NOTES:
- Master Worl<er Certificate - This limit is shared by all Certificates to the Master ~orl<er Policy of which each Certificate is a part and is subject to all of the provisions of such Policy and Certificate having reference thereto. Such limit may have been reduced by payment of claims or claims expenses.
r Page 2
of 2
ACORD 101 (2008/01)
© 2008 ACORD CORPORATION. All rights reserved.
Th_e ACORD name and logo are registered marks of ACORD r
ACORD@
CERTIFICATE OF LIABILITY INSURANCE I
DATE (MM/DD/YYYY)
~
01/23/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), 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 Risk & Insurance Services NAME:
PHONE I rti~ Nol:
CA License #0437153 fA/C "'o l'xt*:
777 South Figueroa Street E*MAIL ADDRESS:
Los Angeles, CA 90017 Attn: LosAngeles.CertRequest@marsh.com IF: 212-948-0535 INSURERISl AFFORDING COVERAGE
' NAIC#
08819-DRl-All-17*18 INSURER A : American Nuclear Insurers INSURED INSURER B:
Dominion Resources, Inc.
ATTN: Leslie D. Garber INSURER C:
Leslie. Garber@dom.com I
INSURER D:
701 East Cary Street. 20th Floor Richmond, VA 23219 INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER:
LOS-001839081-08 REVISION NUMBER: 13 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 TQ 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 POLICY EFF POLICY EXP LIMITS LTR
'"'en IW\\1n POLICY NUMBER fMM/DD/YYYYl fMM/DD/YYYYl COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE
=:J CLAIMS-MADE D OCCUR DAMAGE TO RENTED PREMISES !Ea occurrence\\
MED EXP (Any one person)
PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER:
GENERALAGGREGATE
=i DPR~ DLOC PRODUCTS - COMP/OP AGGI POLICY JECT OTHER:
AUTOMOBILE LIABILITY fE~~~~~~0SINGLE LIMIT ANY AUTO BODILY INJURY (Per person)
ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $
NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS f Per accidentl UMBRELILA LIAB HOCCUR EACH OCCURRENCE EXCESS LIAS CLAIMS-MADE AGGREGATE OED I I RETENTION$
WORKERS COMPENSATION I ~f~TUTE I I OTH-AND EMPLOYERS' LIABILITY ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE ~
N/A E.L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
E.L. DISEASE - EA EMPLOYEE S
~~~~~~~8~ Cl':oPERATIONS below E.L. DISEASE - POLICY LIMIT A
Nuclear Energy Liability See Attached 01101/2017 01/01/2018 See Attached Acord I
Insurance "Acord 101" 101
\\
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 0101, Additional Remarks Schedule, may be attached If more space is required)
I
'1 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 Risk & Insurance Services Shannon Moyer I
© 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01)
The ACORD name and logo are registered marks of ACORD
AGENCYCUSTOMERID:~0~8~8~1~9~~~~~~~~~~~~~~~~
LOC #:. Los Angeles ADDITIONAL REMARKS SCHEDULE r
AGENCY NAMED INSURED Marsh Risk & Insurance Services Dominion Resources, Inc.
AITN: Leslie D. Garber POLICY NUMBER Leslie.Garber@dom.com 701 East Cary Street, 20th Floor Richmond, VA 23219 CARRIER I
NAIC CODE 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 aci:ordance with the policy provisions. Otherwise this Certificate shall terminate as of the end of such December 31sL A Certificate will NOT be issued for any subsequent calendar year unless requested in writing.
Types of Insurance: NF -[Facility Form), NW- [Master Worker Certific~], NS - [US Domestic Supplie(s & Transporters], FS - [Foreign Suppliers & Transporters], N - [Secondary Financial Protection Certificate]
COVERAGE FOR NUCLEAR FACILITIES:
- 1. SITE #1 - NORTH ANNA LOCATION OF NUCLEAR FACILITY: North Anna Nuclear Power Plant 40 Ml NW of Richmond, VA NAMED INSURED [LISTED ON POLICY]: Virginia Electric & Power Company POLICY NUMBER:
POLICY EFFECTIVE:
LIMIT OF LIABILITY:
NF-0240 NW-0610 N-0063 N-0070
- 2. SITE #2 - SURRY 03/26/1976 03126/1976 11/26/1977 04/11/1980
$450 Million
$450 Million-LOCATION OF NUCLEAR FACILITY: Surry Nuclear Power Planr17 Ml NW of Newport News, VA NAMED INSURED [LISTED ON POLICY]: Virginia Electric & Power Company POLICY NUMBER:
POLICY EFFECTIVE:
LIMIT OF LIABILITY:
NF-0186 NW-0571 N-0027 N-0028
- 3. SITE #3 - MILLSTONE 06/15/1970 06/15/1970 08/01/1977 08/01/1977
$450 Million
$450Millionh LOCATION OF NUCLEAR FACILITY: Millstone Nuclear Power Plant 3.2 Ml WSW of New London, CT NAMED INSURED [LISTED ON POLICY]: Dominion Nuclear Connecticut Inc.
POLICY NUMBER:
POLICY EFFECTIVE:
LIMIT OF LIABILITY:
NF-0173 NW-0563 N-0016 N-0103
- 4. SITE #4 - KEWAUNEE 05/01/1969 05/01/1969 08/01/1977 11/25/1985
$450 Million
$450Millionh LOCATION OF NUCLEAR FACILITY: Kewaunee Nuclear Power Plant in the Town of Carlton, Kewaunee County, Wisconsin NAMED INSURED [LISTED ON POLICY]: Dominion Ene'lly Kewaunee, Inc.
POLICY NUMBER:
POLICY EFFECTIVE:
LIMIT OF LIABILITY:
NF-0204 NW-0586 01/01/1972 01/01/1972
$375 Million
$450 Million-
- D-31JS 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:_0_8_8_19~~~~~~~~~~~~~~~
LOC #: Los Angeles ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED Marsh Risk & Insurance Services Dominion Resources, Inc.
A TIN: Leslie D. Garber POLICY NUMBER Leslie.Garber@dom.com 701 Easl Cary Street, 20th Floor Richmond, VA 23219 CARRIER 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 THIS CERTIFICATE IS ISSUED AS A MA TIER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.
The insurance afforded by the policy(ies) is subject lo the exclusions, conditions and other provisions of the policy(ies).. Neither this Certificate nor any contract or other document with respect lo which it is issued shall amend, extend or alter the coverage afforded by the policy. The Limit of Liability shown above may have bee.n reduced by paym,ent of claims or claims expenses.
COMMENTS/NOTES:
" Master Worl<er Certificate - This limit is shared by all Certificates to the Master Worl<er 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.
Secondary Financial Protection Certificate - Financial 'protection available under an industry retrospective rating plan.
Page 3
of 3
ACORD 101 (2008/01)
© 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered mark.s of ACORD
\\
ACORD CERTIFICATE OF LIABILITY INSURANCE I
~
0211312017 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 ~ONTRACT 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:
100 North T ~on Street, Suite 3600 rA~gNJo Cv+I*
I r..e~ Nol:
Charlotte, N 28202 E*MAIL ADDRESS:
INSURERISI AFFORDING COVERAGE NAIC#
22830 -ONE-1/1-17-18 INSURER A : American Nuclear Insurers
\\
INSURED INSURER B:
Duke Energy Corporation ATTN: Lance Burnette INSURER C:
Lance.Bumette@duke-energy.com INSURER D:
550 S. Tryon Street DEC40-C INSURER E:
Charlotte, NC 28202 INSURER F:
COVERAGES CERTIFICATE NUMBER:
A TL-003526555-13 REVISION NUMBER:30 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 ~EQUIREMENT, TERM OR CONDITION OF ANY CONTRACT O~ OTHER DOCUMENT WITH RESPECT TO WIHICH THIS CERTIFICATE MAY BE IS.SUED 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 POLICY EFF POLICY EXP LIMITS LTR
- n.... ~
POLICY NUMBER IMM/DD/YYYYI IMM/DD/YYYYI COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE
- =:J CLAIMS-MADE D OCCUR.
DAMAGE TO RENTED PREMISES IEa occurrence\\
MED EXP (Any one person)
PERSONAL & ADV INJURY GEN'LAGGREGATE LIMIT APPLIES PER:
GENERALAGGREGATE
~
DPRO-OLoc*
t' POLICY JECT PRODUCTS - COMP/OP AGG OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT IEa accidenll ANY AUTO BODILY INJURY (Per person)
ALLOWl!IED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $
NON-OWNED PROPERTY DAMAGE s*
HIRED AUTOS AUTOS IPer accident\\
UMBRELLA LIAB H OCCUR EACH OCCURRENCE EXCESS.LIAS CLAIMS-MADE AGGREGATE OED I I RETENTION$
WORKERS COMPENSATION I ~ffTuTE I I OTH-AND EMPLOYERS' LIABILITY ER YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ~
N/A E.L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
E.L. DISEASE - EA EMPLOYEE $
If ~es, describe under
- E.L. DISEASE - POLICY LIMIT D SCRIPTION OF OPERATIONS below A
Nuclear Energy Liability SEE A TT ACHED 01/01/2017 01/0112018 SEE ATTACHED DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space ls required)
Effective September 13, 2016 in accordance with the NRG approved changes to facility operating license, Duke Energy Pr0gress,_ Inc. changed Corporate form to Duke Energy Progress, LLC and insurance policies have been amended accordingly._
l 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<~ ~ r.3c..... k-1.
© 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.:.__~~~~~~~~~~~~~~
LOC #: Charlotte
'ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED Marsh USA Inc.
Duke Energy Corporation A TIN: Lance Burnette POLICY NUMBER Lance.Burnette@duke-energy.com 550 S. Tryon Street DEC40-C CARRIER Charlotte, NC 28202 I NAIC CODE 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 ~ere is in force as of the effective date of this Certificate a Nuclear Energy Lia~ility Insurance Policy issued by members of American Nuclear Insurers as.
indicated {Companies), 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 tenminated prior to the end of Deeember 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 tenminate 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 Fonm], 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:
LIMIT OF LIABILITY:
NF-0281 NW-0637 N-0097 N-0106
- 2. SITE #2 - MCGUIRE 12/01/1983 12/01/1983 07/18/1984 12/01/1983
$450 Million
$450 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 01/23/1981 03/03/1983
$450 Million
$450Million-LOCATION OF NUCLEAR FACILITY: Oconee Nuclear Power Plant in Oconee County, South Carolina NAMED INSURED [LISTED ON POLICY]: Duke Energy Carolinas, LLC POLIC.Y NUMBER:
POLICY EFFECTIVE'
,LIMIT OF LIABILITY:
NF-0182 NW-0569 N-0022 N-0023 N-0024
- 4. SITE #4 - BRUNSWICK 03/0111970 03/01/1970 08/01/1977 08/0111977 08/01/1977
$450 Million
$450 Million-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 NW-0597 N-0054 N-0055 \\
10/25/1973 10/25/1973 08/01/1977 08/01/1977
$450 Million
$450 Million-50-jbC/ /31D Page 2
of 4
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 A TIN: Lance Burnette POLICY NUMBER Lance.Bumette@duke-energy.com 550 S. Tryon Street DEC40-C CARRIER I
Charlotte, NC 28202 I
NAIC CODE 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, LLC POLICY NUMBER:
POLICY EFFECTIVE:
LIMIT OF LIABILITY:
NF-0195 NW-0579
- 6. SITE #6 - SHEARON HARRIS 07/01/1971 07/01/1971
$375 Million
$450 Milliontt LOCATION OF NUCLEAR FACILITY: Shearon Harris Nuclear Power Plant 20 Ml SW of Raleigh, NC NAMED INSURED [LISTED ON POLICY]: Duke Energy Progress, LLC POLICY NUMBER:
POLICY EFFECTIVE:
LIMIT OF LIABILITY:
NF-0288.
NW-0642 N-0112
- 7. SITE #7 - H.B. ROBINSON 06/01/1984 06/01/1984 10/24/1986
$450Million
$450 Milliontt LOCATION OF NUCLEAR FACILITY: H.B. Robinson Nuclear Power Plant 5.Ml WNW from Hartsville, SC NAMED INSURED [LISTED ON POLICY]:, Duke Energy Progress, LLC POLICY NUMBER:
POLICY EFFECTIVE:
LIMIT OF LIABILITY:
NF-0180 NW-0567 N-0021
- 8. SITE #8 - LEVY 10/15/1969 10/15/1969 08/01/1977
$450 Million
$450 Milliontt LOCATION OF NUCLEAR FACILITY: Levy Nuclear Plant 39 Ml SW of Gainsville, FL NAMED INSURED [LISTED ON POLICY]: Duke Energy Florida, LLC 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 POLICY NUMBER:
POLICY EFFECTIVE:
NF-0355 1/112016 LIMIT OF LIABILITY:
$1 Million LIMIT OF LIABILITY:
$1 Million 52 THIS CERTIFICATE IS ISSUED AS A MA TIER 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:
tt 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
of 4
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 Page 4
of 4
AGENCY NAMED INSURED Marsh USA Inc.
Duke Energy Corporation A TIN: Lance Burnette POLICY NUMBER Lance.Bumette@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..
ACORD 101 (2008/01)
© 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
ACORD CERTIFICATE OF LIABILITY INSURANCE I
DATE (MM/DD/YYYY)
~
02108/2017 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.
rA~gNJo Extl*
Ir:,~ Nol:
1301 5th Avenue, Suite 1900 Seattle, WA 98101 E-MAIL ADDRESS:
INSURERISI AFFORDING COVERAGE NAIC#
J26976-NUC2-1&-17 INSURER A : American Nuclear Insurers INSURED INSURER B:
Energy Northwest Attn: Marie Thomas INSURERC:
P.O. Box 968 INSURER D:
Richland, WA 99352 INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER:
SEA-002714992-03 REVISION NUMBER:3 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 HER.EIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED B'( PAID CLAIMS.
INSR ADDL SUBR POLICY EFF l~~l5%~,
LIMITS LTR TYPE OF INSURANCE
'***~~ ***~
POLICY NUMBER IMM/DD/YYYYl COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE
~
o-CLAIMS-MADE D,occuR DAMAGE Tu RENTED PREMISES IEa occurrence!
f--
\\
f--
MED EXP (Any one person)
PERSONAL & ADV INJURY j
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERALAGGREGATE R
DPR~ DLOC PRODUCTS - COMP/OP AGG POLICY JECT OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT IEa accident!
f--
ANY AUTO BODILY INJURY (Per person)
~
ALL OWNED
~
SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $
~
~
NON-OWNED rp~~~~d~gAMAGE HIRED AUTOS AUTOS
~
f--
UMBRELLA LIAB H OCCUR EACH OCCURRENCE f--
EXCESS LIAB CLAIMS-MADE AGGREGATE OED I I RETENTION$
WORKERS COMPENSATION I ~ffTuTE I I OTH-AND EMPLOYERS' LIABILITY ER YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ~
N/A E.L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
E.L DISEASE - EA EMPLOYEE $
If yes, describe.under E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS below A
Nuclear Energy Liability See Attached Acord 101 01101/2017 01/01/2018 See Attached Acord 101 Insurance
(
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remar1=n~~?-
I
© 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01)
The ACORD name and logo are registered marks of ACORD
- r
AGENCJCUSTOMERID:_J_2_6_9_76~~~~~~~~~~~~~~~~
LOC #: Seattle ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED Marsh USA, Inc.
Energy Northwest Attn: Marie Thomas POLICY NUMBER P.O. Box 968 Richland, WA 99352 CARRIER 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.
such policy is canceiled or otherwise terminated prior to the end of December 31st of the calendar year in which the Effective Date of this Certificate occurs, n_otice 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 Supplie(s & Transporters], FS - [Foreign Suppliers & Transporters], N - [Secondary Financial Protection Certificate)
COVERAGE FOR NUCLEAR FACILITIES:
Page 2
of 2
- 1. SITE #1 -COLUMBIA GENERATING STATION s*o-- 3 '11 LOCATION OF NUCLEAR FACILITY: All of the premises including the land and all building and structures of Energy Northwest Columbia Generating Station including but not limited to the reactors formerly known as YJNP 1, WNP 2 and WNP located approximately 12 miles NW of Richland, Washington.
NAMED INSURED [LISTED ON POLICY]: Energy Northwest POLICY NUMBER:
NF-0270 NW-0628 N-0091 POLICY EFFECTIVE:
08/0111982 08/01/1982 12/20/1983 LIMIT OF LIABILITY:
$450 Million
$450Million-THIS CERTIFICATE IS ISSUED AS A MA TIER 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 policyOes). 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.
~ Secondary Financial 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
ACORD@
CERTIFICATE OF LIABILITY INSURANCE I
DATE(MM/DDIYYYY) !'
~
02/10/2017 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.
f IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the tenns 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 Risk & Insurance Services NAME:
PHONE I FAX 15 West South TemfJe, Suite 700 IA/C No Extl*
IAIC Nol:
Salt Lake City, UT 101 E-MAIL Attn: SaltLakeCity.certrequest@marsh.com; F aX212. 948.4373 ADDRESS:
INSURER!Sl AFFORDING COVERAGE NAIC#
J36105-NRC-NEL-17-18 INSURER A: American Nuclear Insurers INSURED INSURER B:
ZionSolutions, LLC and Exelon Generation Company, LLC INSURERC:
\\
299 South Main Street, Suite 1700 INSURERD:
Salt Lake City, UT 84111 INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER*
SEA-002671181-06 REVISION NUMBER*?
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 8.0CUMENT 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 POLICY EFF POLICY EXP LTR
- rcn """'
POLICY NUMBER IMM/DDIYYYYl IMM/ODIYYYYl LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE
- D CLAIMS-MADE D OCCUR DAMAGE TO RENTED PREMISES IEa occurrence!
MED EXP (Any one person)
PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER:
GENERALAGGREGATE
~
DPR~ DLOC POLICY.
JECT 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 IPer accident!
UMBRELLA LIAB H OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE AGGREGATE OED I I RETENTION $
WORKERS COMPENSATION I ~~~TUTE I I OTH-AND EMPLOYERS" LIABILITY I
ER YIN ANY PROPRIETOR/PARTNER/EXECUTIVE D
NIA E.L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
E.L. DISEASE - EA EMPLOYEE $
~~st~~tri8~ O'#oPERATIONS below E.L. DISEASE - POLICY LIMIT A
Nuclear Energy Liability NF-0201 01/01/2017 01/0112018 See attached Acord 101 Insurance
'See Attached Acord 101' I
/
DESCR!!'TION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space ls required)
~
CERTIFICATE HOLDER CANCELLATION DOCUMENT CONTROL DESK SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE U.S. NUCLEAR REGULA TORY COMMISSION THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN WASHINGTON, DC 20555-0001 ACCORDANCE Willi THE POLICY PROVISIONS.
AUTiiORIZED REPRESENTATIVE of Marsh USA Risk & Insurance Services I
Tiffani Berrett
~
© 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01)
The ACORD name and logo are registered marks of ACORD
AGENCYCUSTOMERID:~J~3~6~1~05=---~~~~~~~~~~~~~~~
LOC #: Salt Lake City ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED Marsh USA Risk & Insurance Services ZionSolutions, LLC and Exelon Generation Company, LLC POLICY NUMBER 299 South Main Street, Suite 1700 Salt Lake City, UT 84111 CARRIER 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 L!JC<ltiOn shown and/or with respect to the lnsured's operations described herein.
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 u_nless requested in writing.
Types of Insurance: NF* [Facility Form], NW* [Master Wor1<er Certificate], NS* [US Domestic Supplier's & Transporters], FS *[Foreign Suppliers & Transporters]
COVERAGE FOR NUCLEAR FACILITIES:
- 1. SITE #1 *ZION NUCLEAR STATION LOCATION OF NUCLEAR FACILITY: Zion Nucle~r Station, located on the Western Edge of Lake Michigan in Lake County, IL NAMED INSURED [LISTED ON POLICY]: Zion Solutions, LLC and Exelon Generation Company, LLC [NOTE 1]
POLICY NUMBER:
POLICY EFFECTIVE:
LIMIT OF LIABILITY:
NF-0201 NW-0584 12/16/1971 12/16/1971
$100 Million
$450 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:
NOTE 1 *Additional Insured Definition: Any other person or organization with respect to his legal responsibility for covered damages or covered environmental cleanup costs because of bodily injury, property damage or environmental damage caused by the nuclear energy hazard. (does not include as an insured the United States of America or any of its agencies, except the Tennessee Valley Authority)
/
~ Master Wor1<er Certificate
- This limit is shared by all Certificates to the Master Wor1<er Policy of which each Certificate is a part and is subject to all of the provisions of such Policy and Certificate having reference therefo. Such limit may have been reduced by payment of claims or claims expenses.
Page 2
of 2
ACORD 101 (2008/01)
© 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
ACORD CERTIFICATE OF LIABILITY INSURANCE I
DATE (MM/DDIYYYY)
~
02113/2017 THIS CERTIFICATE IS ISSUED AS A MAT1ER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER Tl:IE 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 Risk & Insurance Services NAME:
rA~gNJo ""
I FAX 4445 Eastgate Mall IA/C Nol:
San Diego, CA 92121 E*MAIL ADDRESS:
INSURERISl AFFORDING COVERAGE NAIC#
034348-NRC-GA-17-18 INSURER A : American Nuclear Insurers
.INSURED INSURERS:
General Atomics
)
PO Box 85608 INSURERC:
San Diego, CA 92138 INSURER D:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER*
LOS-001836936-05 REVISION NUMBER*6 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE
,... ~~ **ft~
POLICY NUMBER IMM/DDIYYYYI IM M/DD/YYYYI COMMERCIAL GENERAL-LIABILITY EACH bccuRRENCE
- D CLAIMS-MADE D OCCUR DAMAGE TO RENTED PREMISES !Ea occurrence!
MED EXP (Any one person)
PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER:
GENERALAGGREGATE Fl DPR~ DLoc PRODUCTS - COMP/OP AGG POLICY JECT I
OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
!Ea accident!
ANY AUTO BODILY INJURY (Per person)
ALL OWNED SCHEDULED BODILY INJURY (Per accident) $
AUTOS
,__ AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS IPer accidentl UMBRELLA LIAS H OCCUR EACH OCCURRENCE EXCESS LIAS CLAIMS-MADE AGGREGATE DED I I RETENTION$
WORKERS COMPENSATION I ~~fTuTE I I OTH-AND EMPLOYERS" LIABILITY ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE D
NIA E.L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
E.L. DISEASE - EA EMPLOYEE $
~m~~~-IT~~ 't)'~ClPERATIONS below E.L. DISEASE - POLICY LIMIT A
Nuclear Energy Liability See Attached 01/01/2017 01/01/2018
\\
See Attached
/'
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 2055~001 ACCORDANCE WITH THE POLICY PROVISIONS.
'AUTHORIZED REPRESENTATIVE of Marsh Risk & Insurance Services
~
.. ~,.
I K. McKenna i&~
© 1988-2014 ACORD CORPORATION. All nghts reserved.
ACORD 25 (2014/01)
The ACORD name and logo are registered marks-of ACORD
AGENCYCUSTOMERID:_0~3~4~34~8.;;.._~~~~~~~~~~~~~~~
LOC #: San Diego ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED Marsh Risk & Insurance Services General Atomics
/
PO Box 85608 POLICY NUMBER San Diego, CA 92138 CARRIER I NAIC CODE 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 Nudear Facility at the Location shown and/or with respect to the lnsured's operations described herein. If such policy is cancelled or otherwise tenninated 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 lenninate 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 Fann], NW- [Master Worker Certificate], NS - [US Domestic Suppliers & Transporters], FS - [Foreign Suppliers & Transporters]
COVERAGE FOR NUCLEAR FACILITIES:
- 1. SITE #1 - GENERAL ATOMICS LOCATION OF NUCLEAR FACILITY: San Diego, CA NAMED INSURED [LISTED ON POLICY]: General Atomics POLICY NUMBER:
NF-0034 NW-0512 POLICY EFFECTIVE:
03131/1958 03/3111958 LIMIT OF LIABILITY:
$40Million
$450 Million~
THIS CERTIFICATE IS ISSUED AS A MA TIER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.
The insurance afforded by the policy(ies) is subject to the exdusions, conditions and other provisions of the policy(ies). Neither this Certificate nor any conlract or other document with respect to which it is issued shall amend, ex1end 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 referenee thereto. Such limit may have been reduced by payment of claims or claims expenses.
Page 2
of 2
ACORD 101 (2008/01)
© 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
ACORD 8
CERTIFICATE OF LIABILITY INSURANCE I
~
02/13/2017 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 ;t,~ Nol:
TWO ALLIANCE CENTER fA/C No C-+\\*
3560 LENOX ROAD, SUITE 2400 E-MAIL ADDRESS:
ATLANTA, GA 30326 INSURER(S) AFFORDING COVERAGE NAIC#
713170-Juno-17-18 INSURER A : American Nuclear Insurers INSURED
/
INSURERS:
NexlEra Energy, Inc.
Attn: Erica McNabb INSURERC:
Erica.A.McNabb@FPL.com INSURER D:
700 Universe Blvd P.O. Box 14000 INSURER E:
Juno Beach, FL 33408 INSURER F:
COVERAGES CERTIFICATE NUMBER:
ATL-003533264-09 REVISION NUMBER:9 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LIS.TED 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 CL.AIMS.
INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR
- ~~... ~
POLICY NUMBER IMM/DD/YYYYI IM M/DD/YYYYl COMMERCIAL GENERAL LIABILITY
'. EACH OCCURRENCE I-==1 CLAIMS-MADE D occu~
DAMAGE TO RENTED PREMISES IEa occurrence\\
I-I-
MED EXP (Any one person)
PERSONAL & ADV INJURY
-GEN'LAGGREGATE LIMIT APPLIES PER:
GENERALAGGREGATE Fl.
DPRO-DLOC PRODUCTS - COMP/OP AGG POLICY JECT OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT IEa accident\\
I-ANY AUTO BODILY INJURY (Per person)
ALL OWNED SCHEDULED BODILY INJURY (Per accident) $
AUTOS AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS rPer accident\\
I-I-
UM BR ELLA LIAB H OCCUR EACH OCCURRENCE EXCESS LIAB 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 ~
E.L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED?
NIA (Mandatory In NH)
I E.L. DISEASE - EA EMPLOYEE $
~~~'1:~~p~g~ 'g'~gPERATIONS below E.L. DISEASE - POLICY LIMIT A
NUCLEAR ENERGY LIABILITY See Attached 01/01/2017 01/0112018 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 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 Washinglon, DC 2055:Hl001 ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE of Marsh USA Inc.
I Manashi Mukherjee
.:MA'VU>io'-.L **~
© 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01)
The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: _7_1_3_17_0 ______________ _
LOC #: Atlanta ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED MARSH USA, INC.
NextEra Energy, Inc.
Attn: Erica McNabb POLICY NUMBER Erica.A.McNabb@FPL.com 700 Universe Blvd P.O. Box 14000 CARRIER Juno Beach, FL 33408 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 shO"!f1 and/or with respect to the lnsured's oi>erations described herein. If such policy is cancelled or othelWise tenninated 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. OthelWise this Certificate shall tenninate as of the.end of such December 31st A Certificate will NOT be issued for any subsequent I
.1 calendar year unless requested in writing.
Types of Insurance: NF -[Facility Fann], NW- [Master Worker Certificate], NS - [US Domestic Supplier's & Transporters], FS-[Foreign Suppliers & Transporters], N-[Secondary Financial Protection Certificate]
COVERAGE FOR NUCLEAR FACILITIES:
POLICY EFFECTIVE:
LIMIT OF LIABILITY:
NF-0227 NW-0604 N-0059 N-0089
- 2. SITE #2 - TURKEY POINT 06/01/1974 06/01/1974 08/01/1977 04/06/1983
~~50Million
$450 Million-LOCATION OF NUCLEAR FACILITY: Turkey Point Nuclear Power Plantin the Southeast part ofDade County, Florida NAMED INSURED [LISTED ON POLICY]: Florida Power & Light Company POLICY NUMBER:
POLICY EFFECTIVE:
LIMIT OF LIABILITY:
NF-0185 NW-0570 N-0025 N-0026 06/01/1970 06/01/1970 08/01/1977 08/01/1977
$450 Million
$450 Million-Page 2
of 3
v 3.SITE#3-SEABROOK E" 0-1II13 J LOCATION OF NUCLEAR FACILITY: Seabrook Nuclear Power Plant in Seabrook Township, Rockingham County, New Hampshire
'7....,.. 'f i.f '-1-t../-
NAMED INSURED [LISTED ON POLICY]: NextEra Energy Seabrook, LLC; Massachusetts Municipal Wholesale Electric Company; Taunton Municipal Light Plant; and Hudson Light and Power Department POLICY NUMBER:
NF-0296 NW-0647 N-0109
- 4. SITE #4 - DUANE ARNOLD POLICY EFFECTIVE:
12115/1985 12/15/1985 10/17/1986 LIMIT OF LIABILITY:
$450Million
$450 Million-LOCATION OF NUCLEAR FACILITY: Duane Arnold Nuclear Power Plant on the Cedar River approx 2 and 1/3 Miles NNE of Palo, Iowa NAMED INSURED [LISTED ON POLICY]: NextEra Energy Duane Arnold, LLC, Central Iowa Power Cooperative and Com Belt Power Cooperative POLICY NUMBER:
POLICY EFFECTIVE:
LIMIT OF LIABILITY:
NF-0214 NW-0593 N-0050
. ACORD 101 (2008/01) 05/15/1973 05/15/1973 08/01/1977
$450Million
$450 Million-
© 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: 713170
~~~~~~~~~~~~~~~~~~~~~~
LOC #: Atlanta ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED MARSH USA, INC.
NextEra Energy, Inc.
Attn: Erica McNabb POLICY NUMBER Erica.A.McNabb@FPL.com 700 Universe Blvd P.O. Box 14000 CARRIER Juno Beach, FL 33408 I NAIC CODE EFFECTIVE DATE:
ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:
25 FORM TITLE: Certificate of Liability Insurance
POLICY EFFECTIVE:
LIMIT OF LIABILITY:
NF-0178 NW-0565 N-0018 N-0019 08/12/1969 08/12/1969 08/01/1977 08/0111~77
$450 Million
$450 Million" THIS CERTIFICATE IS ISSUED AS A MA TIER OF INFORMATION ~NL Y 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.
COMMENTSJN()TES:
" 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.
~ Secondary Financial Protection Certificate - Financial protection available under an industry retrospective rating plan.
Page 3
of 3
0 ACORD 101 (2008/01)
© 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
ACORD CERTIFICATE OF LIABILITY INSURANCE I
~
02/10/2017 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(les) 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 Heu of such endorsement(sl.
PRODUCER CONTACT NAME:
Marsh Risk & Insurance Services r:igNJo ""'"
I FAX CA License #0437153
!A/C Nol:
777 South Figueroa Street E-MAIL ADDRESS:
Los Angeles, CA 90017 Attn: LosAngeles.CertRequest@marsh.com /F: 212-948-0535 INSURERISI AFFORDING COVERAGE NAIC#
53370-NLSAN-CAS*17-18 INSURER A : American Nuclear Insurers INSURED INSURERB:
EDISON INTERNATIONAL 2244 WALNUT GROVE AVENUE INSURERC:
ROSEMEAD, CA 91770 INSURERD:
INSURERE:
INSURER F:
COVERAGES CERTIFICATE NUMBER*
LOS-001710439-10 REVISION NUMBER*
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 POLICY EFF POLICY EXP LTR
..,~n '"""
POLICY NUMBER IMM/DD/YYYYI IM M/DD/YYYYl LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE s
~
CLAIMS-MADE D OCCUR DAMAGE TO RENTED PREMISES IEa occurrence\\
s MED EXP (Any one person) s
.PERSONAL & ADV INJURY s
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERALAGGREGATE s
Fl DPR~ DLOC PRODUCTS - COMP/OP AGG POLICY JECT s
OTHER:
s AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT s
IEa accidentl ANY AUTO BODIL y INJURY (Per person). $
ALL OWNED
~SCHEDULED BODILY INJURY (Per accident) s AUTOS r--- AUTOS NON-OWNED PROP.ERTY DAMAGE s
HIRED AUTOS AUTOS IPer accidentl r---
s UMBRELLA LIAB H OCCUR EACH OCCURRENCE s
EXCESS LIAB CLAIMS-MADE AGGREGATE s
DED* [
I RETENTION$
s WORKERS COMPENSATION I ~¥~TUTE I I OTH-AND EMPLOYERS' LIABILITY ER YIN ANY PROPRIETORIPARTNERIEXECUTIVE D N/A E.L. EACH ACCIDENT s
OFFICERIMEMBER EXCLUDED?
(Mandatory In NH)
E.L. DISEASE - EA EMPLOYEE $
If ~es, describe und'er D SCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT s A
Nuclear Energy Liability See Attached ACORD 101 01/01/2017 01/0112018 See Attached Acord 101 Insurance DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remar1 l.p
..:.J (.o 2_
NAMED INSURED [LISTED ON POLICY]: Southern California Edison Company, San Diego Gas & Electric Company, The City of Anaheim, The City of Riverside POLICY NUMBER: POLICY EFFECTIVE: LIMIT OF LIABILITY:
NF-0146 04/0611966 $450 Million NW-0549 01/0111998 $450 Million" N-0081 0211611982 -
N-00871111511982-THIS CERTIFICATE IS ISSUED AS A MA TIER 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 poli~y. The Limlt 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.*
Secondary Financial 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
ACORD CERTIFICATE OF LIABILITY INSURANCE I
DATE (MM/DDIYYYY)
~
02/07/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO R.IGHTS 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, i;ubject 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 rt~ Nol:
540 W Madison 141C No c...,.
CHICAGO, IL 60661 E-MAIL ADDRESS:
Attn: chicago.CertReques!@marsh.com INSURER(S) AFFORDING COVERAGE NAIC#
101-327-820-Nucle-Nucle-17-18 I
INSURER A : American Nuclear Insurers INSURED INSURER B:
Firs!Energy Corporation Attn: Pete Nadel INSURER C:
pnadel@firslenergycorp.com INSURER D:
-\\
76 South Main Street Akron, OH 44308 INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER:
ATL-003972780-07 REVISION NUMBER: 12 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 WIHICH 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 Ct:AIMS.
INSR ADDL SUBR POLICYEFF POLICY EXP LTR TYPE OF INSURANCE
,..,~~... ~
POLICY NUMBER IMM/DD/YYYYl IMM/DD/YYYYl LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE
>-----D CLAIMS-MADE D OCCUR DAMAGE TO RENTED
.r-...
PREMISES IEa occurrence I MED EXP (Any one person)
I PERSONAL & ADV INJURY GEN'LAGGREGATE LIMIT APPLIES PER:
\\
GENERAL AGGREGATE Fl DPRO-OLOC PRODUCTS - COMP/OP AGG POLICY JECT OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT s*
(Ea accident\\
ANY AUTO BODILY INJURY (Per person)
>----- ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $
NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS I Per accident I UMBRELLA LIAB H OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE AGGREGATE OED I I RETENTION$
I WORKERS COMPENSATION '
I PER I I OTH-AND EMPLOYERS' LIABILITY
/
STATUTE ER Y/N ANY PROPRIETORIPARTNERIEXECUTIVE ~
EL EACH ACCIDENT OFFICERIMEMBER EXCLUDED?
NIA (Mandatory In NH)
EL DISEASE - EA EMPLOYEE $
If yes, describe under DESCRIPTION OF OPERATIONS below E.L DISEASE - POLICY LIMIT A
Nuclear Energy See Attached Acord 101.
01/01/2017 01/01/2018 See Attached Acord 101 Liability Insurance DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD *101, Additional Remarks Schedule, may be attached if more space is required)
I
~
CERTIFICATE HOLDER CANCELLATION I
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.
I AUTHORIZED REPRESENTATIVE of Marsh USA Inc.
I Manashi Mukherjee
,Mo..~""*-~
© 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01)
The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: 101-327-820
~~~~~~~~~~~~~~~~~~~~~~~-
LO C #: Atlanta ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED MARSH USA INC.
FirstEnergy Corporation Attn: Pete Nadel POLICY NUMBER pnadel@firstenergycorp.com 76 South Main Street Akron, OH 44308 CARRIER 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,me'.11bers 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 !nsurance: 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:
Page 2
of 3
1.SITE#1-BEAVERVALLEY 5 0 * :<311/./1 1 -;
LOCATION OF NUCLEAR FACILITY: Beaver Valley Nuclear Power Plant in Shippingport Borough, Beaver County, Pennsylvania
'-...)
7 I
L NAMED INSURED [LISTED ON POLICY]: FirstEnergy Nuclear Generation, LLC,Ohio Edison Company, The Toledo Edison Company and FirstEnergy Nuclear Operating
. Company POLICY NUMBER:
NF-0226 NW-0603 N-0058 N-01.10
- 2. SITE #2 - DAVIS-BESSE POLICY EFFECTIVE:
08/01/1974 08/01/1974 08/01/1977 05/28/1987 LIMIT OF LIABILITY:
$450 Million
$450 Millionh LOCATION OF NUCLEAR FACILITY: Davis-Besse Nuclear Power Plant on Lake Erie approx 20 miles ESE of-Toledo in Ottawa County, Ohio NAMED INSl)RED [LISTED ON POLICY]: FirstEnergy Nuclear Generation, LLC and FirstEnergy Nuclear Operating Company POLICY NUMBER:
POLICY EFFECTIVE:
LIMIT OF LIABILITY:
NF-0236 NW-0608 N-0061 11/01/1975.
11/01/1975, 08/01/1977
$450Million
$450 Millionh
POLICY EFFECTIVE:
LIMIT OF LIABILITY:
.NF-0291 09/01/1984
$450 Million NW-0644 N-0102
- 4. SITE #4 - SAXTON 09/01/1984 03/18/1986
$450 Millionh LOCATION OF NUCLEAR FACILITY: Saxton Nuclear Experimental Corporation Facility in Liberty Township, Bedford County, Pennsylvania 50- It/Ip NAMED INSURED [LISTED ON POLICY]: Saxton Nuclear Experimental_ Corporation
/
POLICY NUMBER:
POLICY EFFECTIVE:
LIMIT OF LIABILITY:
NF-0107 06/0111961
$1 Million NW-0532 06/01/1961
$450 Millionh
- 5. SITE #5 - THREE MILE ISLAND LOCATION OF NUCLEAR FACILITY: Three Mile Island Nuclear Power Plant in Londonderry Township, Dauphin County, Pennsylvania NAMED INSURED [LISTED ON POLICY]: Metropolitan Edison Company, Jersey Central Power & Light Company, Pennsylvania Electric Company and GPU Nuclear Inc.
ACORD 101 (2008/01)
© 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: 101-327-820
~~~~~~~~~~~~~~~~~~~~~~~-
LO C #: Atlanta ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED MARSH USA INC.
FirstEnergy Corporation Attn: Pete Nadel POLICY NUMBER pnadel@firstenergycorp.com 76 South Main Street Akron, OH 44308 CARRIER 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 NW-0599 12131/1973
$450 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.
Secondary Financial Protection Certificate - Financial protection available unde~ an industry retrospective rating plan.
Page 3
of 3
ACORD 101 (2008/01)
© 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
\\
ACORD 8
CERTIFICATE OF LIABILITY INSURANCE I
DATE (MMIDD/YYYY)
~
02109/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO-N 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: lf,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 endorsem,ent. A statement on this certificate does not confer rights to the
.certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT MARSH RISK & INSURANCE SERVICES NAME:
PHONE I FAX 345 CALIFORNIA STREET, SUITE 1300 IA/C No Extl:
!A/C Nol:
CALIFORNIA LICENSE NO. 0437153 E-MAIL ADDRESS:
SAN FRANCISCO, CA 94104 INSURER!Sl AFFORDING COVERAGE NAIC#
~
021716-NUC2-17-18 INSURER A : American Nuclear Insurers I
INSURED INSURERS:
PACIFIC GAS & ELECTRIC COMPANY_
ONE MARKET SPEAR TOWER INSURERC:
SUITE 2400 INSURER D:
SAN FRANCISCO, CA 94105 INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER*
SEA-002937975-06 REVISION NUMBER* 10 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 WIHICH 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE
- ~n... ~
POLICY NUMBER IM MIDD/YYYYI IMMIDD/YYYYI COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1---~
CLAIMS-MADE D OCCUR DAMAGE TO RENTED PREMISES !Ea occurrencel 1---
r MED EXP (Any one person) 1---
- PERSONAL & ADV INJURY 1---'
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERALAGGREGATE Fl DPR~ OLoc r
PRODUCTS - COMP/OP AGG POLICY JECT OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
<Ea accident) 1---
ANY AUTO BODILY INJURY (Perperson) 1---
ALL OWNED
~
SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $
1---
1--- NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS tPer accident\\
1---
1---
UMBRELLA LIAB H OCCUR EACH OCCURRENCE 1---
EXCESS LIAB CLAIMS-MADE AGGREGATE DED I I RETENTION$ **
WORKERS COMPENSATION I ~ffTuTE I I OTH-AND EMPLOYERS' LIABILITY ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE D
N/A E.L EACH ACCIDENT OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
EL DISEASE* EA EMPLOYEE $
If yes, describe under EL DISEASE* POLICY LIMIT DESCRIPTION OF OPERATIONS below A
Nuclear Energy Liability See Attached Acord 101 01/0112017 01/01/2018 See Attached Acord 101 Insurance r
DESCRIPTION OF OPERATIONS I LOCA_TIONS I VEHICLES (ACORD 101, Additional Remarl--- ~
CLAIMS-MADE. D OCCUR DAMAGE TO RENTED PREMISES *Ea occurrence\\
s MED EXP (Any one person) s PERSONAL & ADV INJURY s
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERALAGGREGATE s
R DPR~ DLOC PRODUCTS - COMP/OP AGG s POLICY JECT
- -.:i.
s OTHER:
AUTOMOBILE LIABILITY fE~~~~~t~INGLE LIMIT s
BODILY INJURY (Per person)
ANY AUTO s
ALL OWNED SCHEDULED BODILY INJURY (Per accidenl) s AUTOS
>--- AUTOS NON-OWNED PROPERTY DAMAGE s
HIRED AUTOS AUTOS
!Per accident)
~
s UMBRELLA LIAB "H OCCUR EACH OCCURRENCE s
EXCESS LIAB
- CLAIMS-MADE AGGREGATE s
OED I I RETENTION°$.
s WORKERS COMPENSATION I ~¥~T~TE I I OTH-AND EMPLOYERS' LIABILITY ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE ~
NIA E.L. EACH ACCIDENT s
OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
E.L. DISEASE - EA EMPLOYEE s If yes, describe under E.L. DISEASE - POLICY LIMIT s DESCRIPTION OF OPERATIONS below A
Nuclear Energy Liability See Attached Acord 101 01/0112017 '
01101/2018 See Atiached Aeord 101 Insurance DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remar1<s Schedule, may be attached if more space is required)
I
~
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 2055~001 ACCORDANCE WITH THE POLICY PROVISIONS.
AUTiiORIZED REPRESENTATIVE of Marsh USA Inc.
I
...,6~/C. ;?7?~~
© 1988-2014 ACORD CORPORATION. All rights reserved.
. ACORD 25 (2014/01)
The ACORD name and logo are registered marks of ACORD
AGENCYCUSTOMERID:_0~2_4~8~80;;__~~~~~~~~~~~~~~
LOC #: Boston ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED MARSH USA, INC.
General Electric Company Attn: Scott Mccurdy POLICY NUMBER scott.mccurdy@ge.com 41 Farnsworth Street Boston, MA 02210 CARRIER 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 fort:e 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. Other.vise 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 Wor1<er Certificate], NS - [US Domestic Supplier's & Transporters], FS - [Foreign Suppliers & Transporters]
COVERAGE FOR NUCLEAR FACILITIES:
- 1. SITE #1-VALLECITOS, CA MANUFACTURING FACILITY
. LOCATION OF NUCLEAR FACILITY: The GE-Hitachi Vallecitos Nuclear Center Facility 6705 Vallecltos Road, Sunol, CaJijomia NAMED INSURED [LISTED ON POLICY): GE-Hitachi Nuclear Energy Americas LLC [NOTE 1]
POLICY NUMBER:
POLICY EFFECTIVE:
LIMIT OF LIABILITY:
NF-0001 03122/1957
$25 Million NW-0500 03/22/1957
$450 Millionri
.THIS CERTIFICATE IS ISSUED AS A MA TIER 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 policyOes). 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 Llmit of Liability shown above may have been reduced by payment of claims or claims expenses.
COMMENTS/NOTES:
ri Master Wor1<er Certificate - This limit is shared by all Certificates to the Master Wor1<er 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.
NOTE 1 - Additional Insured Definition: Any other person or organization with respect to his legal responsibility for covered damages or Covered environmental cleanup costs because of bodily injury, property damage or environmental damage caused by the nuclear energy hazard. (does not include as an insured the United States of America or any of its agencies, except the Tennessee Valley Authority)
Page 2
of 2
ACORD 101 (2008/01)
© 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
ACORD CERTIFICATE OF LIABILITY INSURANCE I
~
0211612017 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(les) 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 ;t,~ Nol:
20 CHURCH STREET, 8TH FLOOR IA/C No Fxtl:
HARTFORD, CT 06103 E-MAIL ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC#
282248-NUC-17-18 INSURER A : American Nuclear Insurers INSURED INSURERB:
Connecticut Yankee Atomic Power Company 362 lnjun Hollow Road INSURERC:
East Hampton, CT 06424 INSURERD:
INSURERE:
I INSURER F:
COVERAGES CERTIFICATE NUMBER:
NYC-007079786-03 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 DOCUMENTWlTH 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 POLICY EFF POLICY EXP LIMITS LTR
- ~~ ***~
POLICY NUMBER IMM/DD/YYYYI IM M/DD/YYYYl COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE s
- :=J CLAIMS-MADE D OCCUR DAMAGE TO RENTED PREMISES !Ea occurrence\\
r MED EXP (Any one person) s PERSONAL & ADV INJURY.
s GEN'L AGGREGATE LIMIT APPLIES PER:
GENERALAGGREGATE s
~
DPR~ DLOC PRODUCTS - COMP/OP AGG POLICY JECT s
OTHER:
s AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT s
{Ea accident\\*
ANY AUTO BODILY INJURY (Per person) s ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) s NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS IPer accident' s
s UMBRELLA LIAB H OCCUR EACH OCCURRENCE s
EXCESS LIAB I
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 ~
NIA E.L. EACH ACCIDENT s
OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
E.L. DISEASE - EA EMPLOYEE S
~~s{;~~tfi8~ O~OPERATIONS below E.L. DISEASE - POLICY LIMIT s A
Nuclear Energy Liability See Attached Acord 101 01/0112017 01101/2018 See Attached Acord 101 Insurance DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarl<s Schedule, may,b_e attached if more space Is required)
CERTIFICATE HOLDER CANCELLATION Document Control Desk I
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE _CANCELLED BEFORE U.S. Nuclear Regulatory Commission THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED tN Washington, DC 20555-0001 ACCORDANCE WITH THE POLICY PROVISIONS.
AUTiiORIZED REPRESENTATIVE of Marsh USA Inc.
I Craig A. Parrow
~7f?6a
© 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01)
The ACORD name and logo are registered marks of ACORD
AGENCYCUSTOMERID:~2~8~2~2~48.;:.._~~~~~~~~~-'-~~~~~
LOC #: Hartford ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED MARSH USA, INC.
Connecticut Yankee Atomic Power Company 362 lnjun Hollow Road POLICY NUMBER East Hampton, CT 06424 CARRIER I NAIC CODE 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 i"n;ured 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 tenninated 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 tenninate as of the end of such December 31st A Certificate will NOT be issued for any subsequent caiendar year unless requested in writing.
Types of Insurance: NF - [Facility Fonn), NW- [Master Worker Certificate], NS -1\\JS Domestic Supplier's & Transporters], FS - [Foreign Suppliers & Transporters]
COVERAGE FOR NUCLEAR FACILITIES:
- 1. SITE #1 - CONNECTICUT YANKEE LOCATION OF NUCLEAR FACILITY: Connecticut Yankee Plant located in Middlesex County, State of Connecticut NAMED INSURED [LISTED ON POLICY]: Connecticut Yankee Atomic Power Company POLICY NUMBER:
POLICY EFFECTIVE:
LIMIT _OF-LIABILITY:
NF-0151 NW-0552 09/1511966 09/15/1966
$100Million
$450 Million" 60-Z/3 THIS CERTIFICATE IS ISSUED AS A MA TIER 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 poli~y(ies). Neither this Certificate nor any contract or other document with respect to which it is issued shall a~end, extend or alter the coverage afforded by the policy. The L!mit of Liability shown above may have been reduced by payment of claims or daims expenses.
\\
COMMENTS/NOTES:
" Master Worker Certificate - This li,mit is shared by all Certificates to the Master Worker Policy of which each Certificate i.s 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 2
of 2
ACORD 101 (2008/01)
© 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
ACORD CERTIFICATE OF LIABILITY INSURANCE I
DATE (MM/DDIYYYY)
~ '
02116/2017 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 endor_sed. 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 I ~.. M Nol:
20 CHURCH STREET, 8TH FLOOR fA/C No l'vtl*
HARTFORD, CT 06103 E*MAIL ADDRESS:
INSURER!SI AFFORDING COVERAGE NAIC#
J44032-NUC-17-18 INSURER A : American Nudear Insurers INSURED INSURER B:
Maine Yankee Atomic Power Company 321 Old Ferry Road INSURERC:
Wiscasset, ME 04578 INSURER D:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER:
NYC-007316427-03 REVISION NUMBER:S 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 WTH 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 ADDL SUBR POLICY EFF
- POLICY EXP LIMITS LTR TYPE OF INSURANCE l***on ~m POLICY NUMBER fMMIDDIYYYYl fMMIDDIYYYYl COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE I-D CLAIMS-MADE D OCCUR DAMAGE TO RENTED PREMISES !Ea occurrencel I-MED EXP (Any one person)
I-PERSONAL & ADV INJURY I-GEN'L AGGREGATE LIMIT APPLIES PER:
GENERALAGGREGATE R
POLICY D ~~g D LOC PRODUCTS - COMP/OP AGG OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
!Ea accident)
I-ANY AUTO BODILY INJURY (Per person)
I-ALL OWNED
- SCHEDULED BODILY INJURY (Per accident) $
AUTOS I-AUTOS
~
NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS f Per accidentl I-I-
UMBRELLA LIAB H OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE AGGREGATE I
OED I I RETENTION $
WORKERS COMPENSATION I ~¥~TUTE I I OTH-.
AND EMPLOYERS' LIABILITY ER YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ~
N/A E.L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
E.L. DISEASE - EA EMPLOYEE $
~~st~f~~~ 'O#oPERATIONS below E.L. DISEASE - POLICY LIMIT A
Nuclear Energy Liability See Attached Acord 101 01/01/2017 01/01/2018 See Attached Acord 101 lnsuranCE!
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. Nudear 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
...M.a.~.... ~*
© 1988-2014 ACORD CORPORATION. All nghts reserved.
ACORD 25 (2014/01)
The ACORD name and logo are registered marks of ACORD I
AGENCYCUSTOMERID:_J_4_4_03_2~~~~~~~~~~~~~~~
LOC #: Hartford ADD!TIONAL REMARKS SCHEDULE AGENCY NAMED INSURED MARSH USA, INC.
Maine Yankee Atomic Power Company 321 Old Ferry Road POLICY NUMBER Wiscasset, ME 04578 CARRIER I
NAIC CODE EFFECTIVE DA TE:
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 forte 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:
POLICY EFFECTIVE:
NF-0194 NW-0578 08/01/1971 08/01/1971 LIMIT OF LIABILITY:
$100 Million
$450 MillionH THIS CERTIFICATE IS ISSUED AS A MA TIER 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 ame_nd, 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:
H 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 2
of 2
ACORD 101 (2008/01)
© 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
ACOR De CERTIFICATE OF LIABILITY INSURANCE I
~
02/16/2017 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 CERT_IFICATE 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:
20 CHURCH STREET, 8TH FLOOR rA~gNJo Exile J ifi~ Nol:
HARTFORD, CT 06103 E-MAIL ADDRESS:
Attn: Hartford.certrequest@marsh.com I Fax: 212-948-0186 INSURERISl AFFORDING COVERAGE NAIC#
798153-NUC-17-18 INSURER A : American Nuclear Insurers INSURED INSURER B:
Yankee Atomic Electric Company 49 Yankee Road INSURER C:
Rowe, MA 01367 INSURERD:
INSURERE:
INSURER F:
COVERAGES CERTIFICATE NUMBER:
NYC-007330493-05 REVISION NUMBER:3 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 WIHICH 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.
I INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE l****n l*ORm POLICY NUMBER IM M/DD/YYYYI IMM/DD/YYYYI LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE s
- D CLAIMS-MADE D OCCUR DAMAGE TO RENTED PREMISES IEa occurrence\\
s MED EXP (Any one person) s PERSONAL & ADV INJURY
~
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE s
~
DPR~ DLOC..
PRODUCTS - COMP/OP AGG POLICY JECT OTHER:
r s
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT s
IEa accident\\
ANY AUTO BODILY INJURY (Per person) s ALL OWNED SCHEOULEO BODILY INJURY (Per accident) s AUTOS AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS.
tPer accident\\
f--
s UMBRELLA LIAB H OCCUR EACH OCCURRENCE s
EXCESS LIAB AGGREGATE CLAIMS-MADE s
OED I I RETENTION s s
WORKERS COMPENSATION I PER I I OTH-AND EMPLOYERS' LIABILITY STATUTE ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE ~
N/A E.L. EACH ACCIDENT s
OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
E.L. DISEASE - EA EMPLOYEE S m.~~~t-IT8~ ~#~PERATIONS below E.L. DISEASE - POLICY LIMIT A
Nudear Energy Liability See Attached Acord 101 01/01/2017 01/0112018 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 DESCRlBED POLICIES BE CANCELLED BEFORE U.S. Nudear 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 Mukhe~ee
..:M.a_~..:;. ~
© 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01)
The ACORD name and logo are registered marks of ACORD
AGENCYCUSTOMERID:_7~9~8~1~5~3~~~~~~~~~~~~~~~
LOC #: Hartford ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED MARSH USA, INC.
Yankee Atomic Electric Company 49 Yankee Road POLICY NUMBER Rowe, MA 01367 CARRIER I NAIC CODE 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 respecl to the Nuclear Facility at the Location shown and/or with respect to the lnsured's operations described herein. If such policy is cancelled orothelWise tenninated 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. OtheJWise this Certificate shall tenninate 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 Fonn], NW- [Master Worker Certificate], NS-llJS Domestic Suppliers & Transporters], FS - [Foreign Suppliers & Transporters]
COVERAGE FOR NUCLEAR FACILITIES:
- 1. SITE #1 - YANKEE ROWE LOCATION OF NUCLEAR FACILITY: Town of Rowe, State of Massachusetts NAMED INSURED [LISTED ON POLICY]: Yankee Atomic Electric Company POLICY NUMBER:
POLICY EFFECTIVE:
NF-0076 NW-0522 10123/1959 10123/1959 LIMIT OF LIABILITY:
$100 Million
$450 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 subjecl 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 2
of 2
ACORD 101 (2008/01)
© 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
ACORD CERTIFICATE OF LIABILITY INSURANCE I
DATE (MM/DD/YYYY)
~
02110/2017 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 pollcy(les) 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:
One Towne Square, Suite 1100 mgNJo "xt" I fti~ Nol:
Southfield, Ml 48076 E-MAIL ADDRESS:
INSURERISI AFFORDING COVERAGE NAIC#
012387-Dow-NucEn-17-18 INSURER A, American Nuclear Insurers INSURED The Dow Chemical Company INSURER B:
2030 Dow Center INSURER C:
Midland, Ml 48674 INSURER D:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER*
CHl-005719623-05 REVISION NUMBER*5 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 DOClJMENT 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 11&3lil5~1 1,~m5i~1 LTR
'"'en luft~
POLICY NUMBER LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE s
I--=:J* CLAIMS-MADE D OCCUR DAMAGE TO RENTED PREMISES 'Ea occurrence' s
~
MED EXP (Any one person) s PERSONAL & ADV INJURY
~
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE R
POLICY D ';~8-r D LOC PRODUCTS - COMP/OP AGG s OTHER:
j s
AUTOMOBILE LIABILITY rE~~~~;~t~INGLE LIMIT s
ANY AUTO BODILY INJURY (Per person) s ALL OWNED
~SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) s 1-- NON-OWNED fp~~~~d~t~AMAGE HIRED AUTOS AUTOS s
1--
s UMBRELLA LIAB H OCCUR EACH OCCURRENCE s
CLAIMS-~ADE EXCESS LIAB AGGREGATE s
OED I I RETENTION s I
s WORKERS COMPENSATION I ~f~TUTE I I OTH-AND EMPLOYERS' LIABILITY ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE D NIA E.L. EACH ACCIDENT s
OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
E.L. DISEASE - EA EMPLOYEE s
\\
~~~~~~~g~ ~~'gPERATIONS below I
E.L. DISEASE* POLICY LIMIT* s A
Nuclear Energy Liability See Attached Acord 101 01101/2017 01101/2018 Limit See Attached Insurance DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remar1---- ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON-OWNED AUTOS UMBRELLA LIAS L _ I OCCUR EXCESS.LIAS
.n CLAIMS-MADE OED I I RETENTION$
ADDL SUBR'
,.,~n wvn WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
Y/N
~N/A g~~~~~~8~ 'O#oPERATIONS below POLICY NUMBER Nuclear Energy Liability Insurance
!. See Attached Acord 1 Oi POLICY EFF POLICY EXP fMMIOD/YYYYl fMMIOD/YYYYl LIMITS EACH OCCURRENCE DAMAGE TO RENTED PREMISES fEa occurrence!
MED EXP (Any one per.;cin)
PERSONAL & ADV INJURY GENERALAGGREGATE PRODUCTS - COMP/OP AGG COMBINED SINGLE LIMIT
!Ea accident\\
BODILY INJURY (Per person)
BODILY INJURY (Per accident) $
PROPERTY DAMAGE f Per accident!
EACH OCCURRENCE AGGREGATE I ~f~TUTE I I OTH-ER E.L. EACH ACCIDENT
/*
E.L. DISEASE - EA EMPLOYEE.$
E.L. DISEASE - POLICY LIMIT 01/01/2017 01/0112018 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 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
~~
...... ~
© 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01)
The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: 822759
~~~~~~~~~~~~~~~~~~~~~~~-
LO C #: Kansas City ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED Marsh USA Inc:
Omaha Public Power District Attn: Lisa Hough POLICY NUMBER 444 S 16th Street Mall 8E/EP1 Omaha, NE 68102 CARRIER I NAIC CODE
~FFECTIVE 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 show~ 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 Supplie(s & Transporters], FS - [Foreign Suppliers & Transporters], N - [Secondary
, Financial Protection Certificate]
COVERAGE FOR NUCLEAR FACILITIES:
- 1. SITE #1 - FORT CALHOUN LOCATION OF NUCLEAR FACILITY: The Fort Calhoun Station is situated on the southwest bank of the Missouri River in Washington County, Nebraska, NAMED INSURED [LISTED ON POLICY]: Omaha Public Power District POLICY NUMBER:
POLICY EFFECTIVE:
LIMIT OF LIABILITY:
NF- 0207 NW-0588 N-0046 12/15/197i
, 12/15/1972 08/01/1977
$450Million
$450 Million" THIS CERTIFICATE IS ISSUED AS A MA TIER 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 policyOes), Neither this Certificate nor any contract or other document wilt\\ 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 prpvisions 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 indusrry retrospective rating plan, Page 2
of 2
ACORD 101 (2008/01)
© 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
ACORD 8
CERTIFICATE OF LIABILITY INSURANCE I
~
02117/2017 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 Ir:,~ Nol:
_)
445 SOUTH STREET IA/C No Fxtl*
MORRISTOWN, NJ 07960-6454 E-MAIL ADDRESS:
Attn: Morristown.CertRequest@marsh.com INSURER(S) AFFORDING COVERAGE NAIC#
074725-PSE&G-NUCLE-17-18.
INSURER A : American Nuclear Insurers INSURED INSURER B:
PSEG NUCLEAR LLC ATTN: ROBERT GREEN INSURER C:
ROBERT.GREEN2@PSEG.COM INSURER D:
80 PARK Pl.:AZA, MAIL CODE T-68 NEWARK, NJ 07101 INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER:
NYC-007087875-10 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 b!AVE BEEN REDUCED BY PAID CLAIMS.
INSR ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE 1,.,.,n wvn POLICY NUMBER
!MM/DD/YYYYl !MM/DD/YYYYl COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE
- ~
CLAIMS-MADE D OCCUR DAMAGE TO RENTED PREMISES IEa occurrence\\
- MED EXP (Any one person)
PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER:
GENERALAGGREGATE Fl POL;CY o r;r&
D*LOC..
PRODUCTS - COMP/OP AGG OTHER:
AUTOMOBILE LIABILITY.
COMBINED SINGLE LIMIT fEa accident\\
ANY AUTO BODILY INJURY (Per person)
ALL OWNED
~SCHEDULED BODILY INJURY (Per accident) $
AUTOS AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS IPer accident\\
UMBRELLA LIAB H OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE AGGREGATE OED I I RETENTION$
WORKERS COMPENSATION I ~~~T~TE I I OTH-AND EMPLOYERS' LIABILITY ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE ~
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 A TT ACHED ACORD 101 01/01/2017 01/01/2018 SEE ATTACH.ED ACORD 101 INSURANCE
\\)ESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarl<s 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 REGULA TORY 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 Mukhe~ee
~~
...... ~
© 1988-2014 ACORD CORPORATION. All rights reserved.
- ACORD 25 (2014/01)
The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: _0_7_4_72_5 ______________ _
LOC #: Morristown ADDITIONAL REMARKS SCHEDULE Page 2
of 2
AGENCY NAMED INSURED MARSH USA, INC.
PSEG NUCLEAR LLC ATIN: ROBERT GREEN POLICY NUMBER ROBERT.GREEN2@PSEG.COM 80 PARK PLAZA, MAIL CODE T-6B NEWARK, NJ 07101 CARRIER I
NAIC CODE 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 forte 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 Certifieate 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: Ni= - [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 5"1J-z 7 L. / 3 11 LOCATION OF NUCLEAR FACILITY: Salem Nuclear Power Plant and Hope Creek Nuclear Power Plant in Lower Alloways Creek Township, Salem County, New Jersey
/
~
NAMED INSURED [LISTED ON POLICY]: PSEG Nuclear LLC and Exelon Generation Company, LLC POLICY NUMBER:
POLICY EFFECTIVE:
LIMIT OF LIABILITY:
- NF-0230 NW-0606 N-0060 N-0072 N-0104 10115/1974 10/15/1974 08/01/1977 04/18/1980' 04/14/1986
$450 Million
$450 Millionh THIS CERTIFICATE IS ISSUED AS A MATIER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.
The insurance afforded by th_e policyOes) is subject to the exclusions, conditions and other provisions of the policy(ies). Neither this CertifJCate 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:
h Master WorkerCertifJCate - 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.
Secondary Financial Protection Certificate - Financial protection available under an industry retrospective rating plan.
I ACORD 101 (2008/01)
© 2008 ACORD CORPO.RATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
ACORD 8
CERTIFICATE OF LIABILITY INSURANCE I
DAlE (MM/DD/YYYY)
~
02110/2017 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 ALTE~ 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.
I IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, s~bject to the tenns and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holde.r in lieu of such endorsement(s).
PRODUCER CONTACT Marsh USA Inc.
NAME:
PHONE I FAX 100 North T~on Street, Suite 3600 IA/C No Extl*
IA/C Nol:
Charlotte, N 28202 E*MAIL ADDRESS:
INSURER!Sl AFFORDING COVERAGE NAIC#
070250-SCAN-NUKE-17-18 INSURER A : American Nuclear Insurers INSURED INSURER B:
SCANA Corporation ATTN: John Mellette INSURERC:
JMELLETTE@scana.com INSURER'D:
100 SCANA Parkway Cayce, SC 29033 INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER:
- A TL-003396433-03 REVISION NUMBER:5 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 DESCR.IBED HERE!N 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 POLICY EFF POLICY EXP LTR
,.,en *.vun POLICY NUMBER IM M/DD/YYYYl IMM/DD/YYYYl LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE
- =i CLAIMS-MADE D OCCUR DAMAGE TO RENTED PREMISES IEa occurrence\\
MED EXP (Any one person)
PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER; GENERALAGGREGATE Fl DPR~ DLoc.
POLICY JECT PRODUCTS - COMP/OP AGG OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT IEa accident\\
ANY AUTO BODILY INJURY (Per person)
ALL OWNED SCHEDULED BODILY INJURY (Per accident) $
AUTOS AUTOS NON-OWNED r:.?~&fd~gAMAGE HIRED AUTOS AUTOS UMBRELLA LIAB H OCCUR EACH.OCCURRENCE EXCESS LIAB CLAIMS-MADE AGGREGATE OED I I RETENTION$
WORKERS COMPENSATION I ~~~TUTE I.
I OTH-AND EMPLOYERS' LIABILITY ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE ~
E.L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED?
N/A (Mandatory In NH)
E.L. DISEASE - EA EMPLOYEE $
~~;t~F~~~ 'O#oPERATIONS below E.L. DISEASE - POLICY LIMIT A
Nuclear Energy Liability See Attached Acord 101
- ' 01/0112017 01/0112018 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.
AUTiiORIZED REPRESENTATIVE of Marsh USA Inc.
I Manashi Mukherjee
~~~ ~
© 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01)
The ACORD name ~nd logo are registered marks of-ACORD.
AGENCYCUSTOMERID:_0_7_0_25_0~~~~~~~~~~~~~~~
LOC #: Charlotte ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED Marsh USA Inc.
SCANA Corporation ATIN: John Mellette POLICY NUMBER JMELL.ETIE@scana.com 100 SCANA Parkway Cayce, SC 29033 CARRIER I
NAIC CODE 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 !Orce 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 orothelWise terminated prior to the end ofDecember 31st of the calendar year in which the Effective Date of this Certificate occurs, notice will be delivered in accordance with the policy provisions. OthelWise 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 - IUS Domestic Supplier's & Transporters], FS - !Foreign Suppliers & Transporters], N -[Secondary Financial Protection Certificate I COVERAGE FOR N.UCLEAR FACILITIES:
- 1. SITE #1 -VIRGIL C. SUMMER NUCLEAR STATION L?CATION OF NUCLEAR FACILITY: Virgil C. Summer Nuclear Station 2.5 miles N of Parr, Fairfield County, South Carolina NAMED INSURED [LISTED ON POLICY]: South Carolin~ Electric & Gas Company and South Carolina Public Service Authority POLICY NUMBER:
POLICY EFFECTIVE:
LIMIT OF LIABILITY:
NF-0252 NW-0616 N-0078 03/21/1978 03/21/1978.
08/05/1982'
$450 Million
$450 MillionH THIS CERTIFICATE IS ISSUED AS A MA TIER OF INFORMA TIO~ ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.
The insurance afforded by the policyOes) 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 tiy the policy. The Limit of Liability shown above may have been reduced by payment of claims or claims expenses.
COMMENTS/NOTES:
H Master Worker Certificate - This limit is shared by all Cert~cates 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.
Secondary Financial Protection Certificate - Financial protection available under an industry retrospective rating plan.
Page 2
of 2
ACORD 101 (2008/01).
© 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
ACOR De CERTIFICATE OF LIABILITY INSURANCE I
~
02110/2017 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:
TWO ALLIANCE CENTER rA~gNJo Extl*
Ir.:;~ Nol:
3560 LENOX ROAD, SUITE 2400 E-MAIL ATLANTA, GA 30326 ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC#
J21970-2-Nuke'-17-18 INSURER A : American Nuclear. Insurers INSURED INSURER B:
Southern Company Services, Inc.
Attn: Deborah Gaffney INSURER C:
dsgaffne@southernco.com INSURER D:
30 Ivan Allen Jr. Boulevard NW Bin SC1404 INSURER E:
Atlanta, G,A 30308 INSURER F:
COVERAGES CERTIFICATE NUMBER:
ATL-003408141-10 REVISION NUMBER: 14 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED1NAMED 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 POLICY EFF POLICY EXP LTR
"~~ ***~
POLICY NUMBER
- IMM/DD/YYYYl IMM/DD/YYYYl LIMITS COMMERCIAL GENERAL LIABILITY
(
EACH OCCURRENCE
~
CLAIMS-~ADE D OCCUR DAMAGE TO RENTED PREMISES IEa occurrence!
MED EXP (Any one person)
PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
=i DPR~ DLoc POLICY JECT 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) $
f--
NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS IPer accident*
f--
c UMBRELLA LIAB H OCCUR EACH OCCURRENCE EXCESS LIAB.
- 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
NIA E.L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
E.L. DISEASE - EA EMPLOYEE $
II yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE* POLICY LIMIT A
Nuclear Energy Liability See Attached Acord 101 01/01/2017 01/01/2018 See Attached Acord 101 see addl page text Insurance, DESCRIPTION OF OPERATIONS I LDCA TIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached ii 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 DELIV!=RED IN Washington, DC 20555-0001 ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE of Marsh USA Inc.
~
(
I Manashi Mukherjee
~~~
© 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01),
The ACORD name and logo are registered marks of ACORD
AGENCYCUSTOMERID:~J~2~1~97~0=---~~~~~~~~~~~~~~~
LOC #: Atlanta ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED MARSH USA, INC.
Southern Company Services, Inc.
Attn: Deborah Gaffney POLICY NUMBER dsgaffne@southernco.com 30 Ivan Allen Jr. Boulevard NW Bin SC1404 CARRIER Atlanta, GA 30308 I NAIC CODE 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 inWhich 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 31sl A Certificate will NOT be issued for any subsequent calendar year unless requested in writing.
Types of Insurance: NF - [Facility Form], NW- [Master Woriler Certificate], NS- [US Domestic Supplier's & Transporters], FS - [Foreign Suppliers & Transporters], N - (Secondary Financial Protection Certificate]
COVERAGE FOR NUCLEAR FACILITIES:
POLICY EFFECTIVE:
LIMIT OF LIABILITY:
NF-0238 NW-0609 N-0062 N-0073
- 2. SITE #2 - HATCH 02/01/1976 02/01/1976 08/0111977 10/23/1980, u
$450 Million
$450 Million-LOCATION OF NUCLEAR FACILITY: Hatch Nuclear Power Plant 11 Ml N of Baxley, GA NAMED INSURED [LISTED ON POLICY]: Georgia Power Company, Southern Nuclear Operating Company, Oglethorpe Power Corporation, Municipal Electric Authority of Georgia, City of Dalton, Georgia POLICY NUMBER:
NF-0215 NW-0594 N-0051 N-0067
- 3. SITE #3 -ALVIN W. VOGTLE POLICY EFFECTIVE:
06126/1~73 06126/1973 08/01/1977 06/13/1978 LIMIT OF LIABILITY:
$450 Million
$450 Million-LOCATION OF NUCLEAR FACILITY: Alvin W. Vogtle Nuclear Power Plant 26 Ml SSE of Augusta, GA NAMED INSURED !LISTED ON POLICY]: Georgia Power Company, Southern Nuclear Operating Company, Oglethorpe Power Corporation, Municipal Electric Authority of Georgia, City of Dalton, Georgia POLICY NUMBER:
NF-0302 NW-0653 N-0111 N-0117 POLICY EFFECTIVE:.
06/01/1986 06/01/1986 01/16/1987 02/09/1989 LIMIT OF LIABILITY:
$450 Million
$450 Million-THIS CERTIFICATE IS ISSUED AS A MA TIER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.
The insurance afforded by the policy(ies) is subject to th\\ 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.
Page 2
of 3
ACORD 101 (2008/01)
© 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: J21970
~~~~~~~~~~~~~~~~~~~~~
LOC #: Atlanta ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED MARSH USA, INC.
Southern Company Services, Inc.
Attn: Deborah Gaffney POLICY NUMBER dsgaffne@southernco.com 30 Ivan Allen Jr. Boulevard NW Bin SC1404 CARRIER I NAICCODE Atlanta. GA 30308 EFFECTIVE DATE:
ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDUL_E TO ACORD FORM, FORM NUMBER:
25 FORM TITLE: Certificate of Liability Insurance tt 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 reducild by payment of claims or claims expenses.
~ Secondary Financial Protection Certificate* Financial protection available under an industry retrospective rating plan.
Page 3
of 3
ACORD 101 (2008/01)
© 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered ma.rks of ACORD
ACORD CERTIFICATE OF LIABILITY INSURANCE I
DATE (MMIDD/YYYY)
~
I 02109/2017 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 I r
.. M No*:
TWO ALLIANCE CENTER 1111C No Fxt\\*
3560 LENOX ROAD, SUITE 2400 E-MAIL ATLANTA, GA 30326.
ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC#
S77608-Nucl-Nuke-17-18 INSURER A : American Nuclear Insurers INSURED INSURER B:
Tennessee Valley Authority Attention: Kirk Kelley INSURER C:
400 W. Summit Hill Drive, WT 4C INSURER D:
Knoxville, TN 37919 INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER*
ATL-003494057-07 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 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 POLICY EFF POLICY EXP LIMITS LTR 1... ~n IW\\m POLICY NUMBER IM MIDD/YYYY) I IMMIDD/YYYYl COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1--D CLAIMS-MADE D OCCUR.
DAMAGE TO RENTED 1--
PREMISES !Ea occurrence\\
MED EXP (Any one person)
~
PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER:
GENERALAGGREGATE R
DPR~. [J LDC POLICY JECT PRODUCTS - COMP/OP AGG OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT IEa accidentl ANY AUTO BODILY INJURY (Per person)
ALL OWNED SCHEDULED BODILY INjURY (Per accident) $
I-AUTOS 1-- AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS
<Per accident!
1--
i--
UMBRELLA LIAB HOCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE AGGREGATE OED I I RETENTION $
WORKERS COMPENSATION-.
I ~ffTuTE I I OTH-AND EMPLOYERS' LIABILITY '
ER YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ~
N/A E.L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
E.L. DISEASE - EA EMPLOYEE $
~m:~ftfi3~ ~~gPERATIONS below E.L. DISEASE - POLICY LIMIT A
Nuclear Energy Liability See Attached Acord 101 01/0112017 01/01/2018 See Attached Acord 101 see addl page text Insurance DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additi_onal Remarks Schedule, may be attached if more space is required)
I CERTIFICATE HOLDER CANCELLATION Document Control Desk SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE U.S. Nudear 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 Ronald A. Santaniello
~~A-0~
© 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01)
The ACORD name and logo are registered marks of ACORD
AGENCYCUSTOMERID:_S_7_7_6_0_8~~~~~~~~~~~~~~
LOC #: Atlanta ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED MARSH USA, INC.
Tennessee Valley Authority Attention: Kirk Kelley POLICY NUMBER 400 W. Summit Hill Drive, WT 4C Knoxville, TN 37919 CARRIER 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 cir 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], N - [Secondary Financial Protection Certificate]
COVERAGE FOR NUCLEAR FACILITIES:
Page 2
of 3
POLICY EFFECTIVE:
LIMIT OF LIABILITY:
NF-0198 NW-0581 N-0038 N-0039 N-0040
- 2. SITE #2 - SEQUOYAH 0912211971 0912211971 OS/01/1977 08/01/1977 08/01/1977
$450Million
$450 Million" LOCATION OF NUCLEAR FACILITY: Sequoyah Nuclear Power Plant 9.5 Ml NE of Chattancioga, TN NAMED INSURED [LISTED ON POLICY]: Tennessee Valley Authority POLICY NUMBER:
POLICY EFFECTIVE:
LIMIT OF Ll,'\\BILl:iY:
NF-0247 NW-0614 N-0066 N-0075
- 3. SITE #3 - WA ns BAR 03/11/1977 03/11/1977 02129/1980 06125/1981
$450 Million
$450Million"
.LOCATION OF NUCLEAR FACILITY: Watts Bar Nuclear Power Plant 10 Ml S of Spring City, TN NAMED INSURED [LISTED ON POLICY]: Tennessee Valley Authority POLICY NUMBER:
POLICY EFFECTIVE:
LIMIT OF LIABILITY:
NF-0256 NW-0618 N-0080 N-0120.
09/04/1979 09/04/1979 11/09/1995 10/2212015
$450 Million
$450 Million" 5D-5CJD/3q/
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 policyOes). 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:
I ACORD 101 (2008/01)
© 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
AGENCYCUSTOMERID:_S~7_7~6~0~8~~~~~~~~~~~~~~~
LOC #: Atlanta ADDITIONAL REMARKS SCHEDULE AGENCY NAMEO*INSUREO MARSH USA, INC.
Tennessee Valley Authority Attention: Kirk Kelley POLICY NUMBER 400 W. Summit Hill Drive, WT 4C Knoxville, TN 37919 CARRIER 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 H 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.
Secondary Financial Protection Certificate - Financial protection available under an industry retrospective rating plan.
Page 3
of 3
ACORD 101 (2008/01)
© 2008 ACORD CORPORATION.. All rights reserved.
The ACORD name and logo are registered marks of ACORD
ACORD CERTIFICATE OF LIABILITY INSURANCE I
DATE (MM/DD/YYYY)
~
02113/2017 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 I :'fi~ Nol:
1717 Arch Street t4/C No Extl*
Philadelphia, PA 19103-2797 E-MAIL ADDRESS:
Attn: Philadelphia.Certs@marsh.com/fax-212-948-0360 INSURER(SI AFFORDING COVERAGE NAIC#
S27324-NUC-ENR-17-18 INSURER A : American Nuclear Insurers INSURED INSURER B:
Susquehanna Nuclear, LLC and Allegheny Electric Cooperative, Inc.
INSURER C:
Corporate Risk & Insurance INSURER D:
835 Hamilton Street, Suite 150, GENPL7N I
Allentown, PA 18101 INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER:
CLE-0044437 48-06 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.
INSR ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE
- en """
'POLICY NUMBER IMM/DD/YYYYl IMM/DD/YYYYl COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE
,____ D CLAIMS-MADE D OCCUR DAMAGE 10 RENTED PREMISES IEa occurrence\\
I
\\
MED EXP (Any one person)
PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE R
DPR~ D PRODUCTS - COMP/OP AGG POLICY JECT
... LOC I
OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT IEa accident\\
ANY AUTO BODILY INJURY (Per person)
ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $
NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS IPer accident\\
UMBRELLA LIAB H OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE AGGREGATE OED I I RETENTION $
I WORKERS COMPENSATION I ~~~TUTE I I OTH-AND EMPLOYERS" LIABILiTY ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE ~
E.L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED?
NIA (Mandatory In NH)
E.L. DISEASE - EA EMPLOYEE $
~m~~t-fi8~ 'O#oPERATIONS below E.L. DISEASE* POLICY LIMIT A
Nuclear Energy Liability See Attached 01101/2017 01/01/2018 See Attached Acord 101 Insurance
'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 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
~~
....,~
© 1988-2014 ACORD CORPORATION. All nghts reserved.
ACORD 25 (2014/01)
The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: S27324
~~~~~~~~~~~~~~~~~~~~~~~-
LO C #: Philadelphia ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED Marsh USA Inc.
Susquehanna Nuclear, LLC and Allegheny Electric Cooperative, Inc.
POLICY NUMBER Corporate Risk & Insurance 835 Hamilton Street, Suite 150, GENPL7N Allentown, PA 18101 CARRIER I NAIC CODE EFFECTIVE DA TE:
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 1.nsurance 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*1nsured'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 yYorker Certificate], NS - [US Domestic Supplier's & Transporters], 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:
LIMIT OF LIABILITY:
NF-0262 NW-0622 N-0084 N-0096 01/01/1981 01/0111981 0711711982 03/2311984
$450 Million
$450 Million" THIS CERTIFICATE IS ISSUED AS A MA TIER OF. INFOR.MA TION 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 beeri reduced by payment of claims or claims expenses.
NOTE 1 - NS-0422: Suppliers & T~nsporters Coverage -Additional Named Insured - R~stricted Coverage Such insurance as is afforded by ttie policy shall also apply to Allegheny Electric Cooperative, Inc. and Talen Energy CorJioration, 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.
Page 2
of 2
ACORD 101 (2008/01)
© 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD -
ACOR De CERTIFICATE OF LIABILITY INSURANCE I
DATE (MM/DD/YYYY)
~
02110/2017 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 I FAX
' 500 Dallas Street, Suite 1500
- A*C No O'xtl*
IA/C Nol:
Houston, TX 77002 E-MAIL ADDRESS:
INSURERISl AFFORDING COVERAGE NAIC#
377089-Wolf-Nucle-17-18 INSURER A : American Nudear Insurers INSURED INSURERS:
Wolf Creek Nuclear Operating Corporation Attn: Angela Cool INSURERC:
Angela.Cool@westarenergy.com INSURERD:
818 Kansas Avenue P.O. Box 889 INSURERE:
Topeka, KS 66601 INSURER F:
COVERAGES CERTIFICATE NUMBER*
HOU-002496763-04 REVISION NUMBER-6 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE l***~n,... ~
POLICY NUMBER IMM/DD/YYYYl IMM/DD/YYYYl COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE I-D CLAIMS-MADE D OCCUR DAMAGE TO RENTED PREMISES <Ea occurrence\\
I-MED EXP (Any one person)
I-PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER:
GENERALAGGREGATE Fl POLICY o ~m D LOC PRODUCTS - COMP/OP AGG OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT I-
<Ea accidentl ANY AUTO BODILY INJURY (Per person)
I-ALL OWNED
~
SCHEDULED BODILY INJURY (Per accident) $
I-AUTOS
,__ AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS f Per accidentl I-UMBRELLA LIAB H OCCUR EACH OCCURRENCE I-EXCESS LIAB CLAIMS-MADE AGGREGATE OED I I RETENTION$
WORKERS COMPENSATION I ~ffTuTE I I OTH-ER AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE ~
N/A E.L. EACH. ACCIDENT OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
E.L. DISEASE - EA EMPLOYEE $
~~~~~ftfr3~ ~#~PERATIONS below E.L. DISEASE - POLICY LIMIT A
Nuclear Energy Liability See Attached Acord 101 01/01/2017 01/01/2018 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 CA NC ELLA TION Document Control Desk SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE U.S. Nudear 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.
r I
Manashi Mukherjee
-MA~~
- .,~
© 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01)
The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: 377089
~~~~~~~~~~~~~~~~~~~~~~~-
LO C #: Houston ADDITIONAL REMARKS SCHEDULE Page 2
of 2
AGENCY NAMED INSURED Marsh USA Inc.
Wolf Creek Nuclear Operating Corporation Attn: Angela Cool I
POLICY NUMBER Angela.Cool@westarenergy.com 818 Kansas Avenue P.O. Box 889 CARRIER I
NAIC CODE Topeka, KS 66601 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 fon:e 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 othelWise 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. OthelWise 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 Worner Certificate], NS - [US Domestic Suppliers & Transporters], FS - [Foreign Suppliers & Transporters], N - [Secondary Financial Protection Certificate]
COVERAGE FOR NUCLEAR FACILITIES:
- 1. SITE #1 - WOLF CREEK LOCATION OF NUCLEAR FACILITY: Wolf Creek Generating Stati9n in BuMington, Kansas NAMED INSURED [LISTED ON POLICY]: Wott Creek Nuclear Operating Corporation; Kansas Gas and Electric Company (formeMy KCA Corporation); Kansas City Power & Light Company; Kansas Electric Power Cooperative, Inc.; Western Resoun:es, *Inc.
POLICY NUMBER:
POLICY EFFECTIVE:
NF-0283 0211711984 NW-0639 N-0099 0211711984 03/1111985 LIMIT OF LIABILITY:
$450 Million
$450 Million-THIS CERTIFICATE IS ISSUED AS A MA TIER 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 Worner Certificate - This limit is shared by all Certificates to the Master Worner 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.
Secondary Financial Protection Certificate - ~inancial 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
ACORD CERTIFICATE OF LIABILITY INSURANCE I
~
02110/2017 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 i,M Nol:
333 South 7th Street, Suite 1400 14/C No i=vt1-Minneapolis, MN 55402-2400 E-MAIL ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC#
- .. -NUCLR-17-18 INSURER A : American Nuclear Insurer,;
INSURED INSURER B:
Xcel Energy, Inc.
Attn: Robert L. Miller INSURER C:
Robert.L.Miller@xcelenergy.com INSURER 0:
414 Nicollet Mall, 4th Floor Minneapolis, MN 55401 INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER:
CHl-006140703-04 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 WHICI-! 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 POLICY EFF POLICY EXP LIMITS LTR
'"'~" '~m POLICY NUMBER
/MM/00/YYYYl IMM/00/YYYYl COMMERCIAL GENERAL LIABILITY
\\
EACH OCCURRENCE
- D CLAIMS-MADE D OCCUR DAMAGE 10 RENTED PREMISES IEa occurrence' MED EXP (Any one person)
PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL~GGREGATE Fl DPRO- []
LOC PRODUCTS - COMP/OP AGG POLI.CY JECT*
OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT IEa accident!
ANY AUTO BODILY IN,JURY (Per person)
ALL OWNED SCHEDULED BODILY INJURY (Per accident) $
~
AUTOS
,____ AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS IPer accident!
\\
UMBRELLA LIAB H OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE AGGREGATE s
OED I I RETENTION s s
WORKERS COMPENSATION I ~f~TUTE I I OTH-AND EMPLOYERS' LIABILITY ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE ~
N/A E.L. EACH ACCIDENT s
OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
E.L. DISEASE - EA EMPLOYEE s
~~st~~~g~ 'g'~~PERATIONS below E.L. DISEASE - POLICY LIMIT A
Nuclear Energy Liability See Attached ACORD 101' 01101/2017 01/01/2018 See Attached ACORD 101 Insurance DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space ls required) r 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
..J'lit.a. ""°°....... ~
© 1988-2014 ACORD CORPORATION. All nghts reserved.
ACORD 25 (2014/01)
The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID:~~~~~~~~~~~~~~~~~~
LOC #: Minneapolis ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED Marsh USA Inc.
Xcel Energy, Inc.
Attn: Robert L. Miller POLICY NUMBER Robert.L.Miller@xcelenergy.com 414 Nicollet Mall, 4th Floor I
Minneapolis, MN 55401 CARRIER C'
I NAICCODE EFFECTIVE DATE:
ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:
25 FORM TITLE: Certificat~ of Liability Insurance CERTIFICATE OF NUCLEAR ENERGY LIABILITY INSURANCE This is to certify that there is in forte 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 ~OT be issued for any subsequent calendar year unless requested in writing.
Types of Insurance: NF - [Facility Form], NW-.[Master Worker Certificate], NS - [US Domestic Supplie~s & Transporters], FS - [Foreign Suppliers & Transporters], N - [Secondary Financial Protection Certificate]
COVERAGE FOR NUCLEAR FACILITIES:
- 1. SITE #1 - PRAIRIE ISLAND LOCATION OF NUCLEAR FACILITY: Prairie Island Nuclear Power Plant on the Mississippi River in Goodhue County, Minnesota NAMED INSURED [LISTED ON POLICY]: Northern States Power Company POLICY NUMBER:
POLICY EFFECTIVE:
LIMIT OF LIABILITY:
NF-0197 NW-0580 N-0036 N-0037
- 2. SITE #2 - MONTICELLO 09/01/1971 09/0111971 08/01/1977
' 08/01/1977
$450 Million
$450 Million-LOCATION OF NUCLEAR FACILITY: Monticello Nuclear Power Plant on the Mississippi River in Wright County, Minnesota.
NAMED INSURED [LISTED ON POLICY]:, Northern Stales Power Company POLICY NUMBER:
POLICY EFFECTIVE:
LIMIT OF LIABILITY:
NF-0174 NW-0564 N-0017 06/09/1969 06/09/1969 08/01/1977
$450 Million
$450Million-THIS CERTIFICATE IS ISSUED AS A MA TIER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.
The insurance afforded by the policy(ies) is subject lo the exclusions, conditions and other provisions of the policy(ies). Neither this Certificate nor any contract or other document with respect lo which ii 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 lo 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..
Secondary Financial Protection Certificate - Financial protection available under an industry retrospective rating plan.
r Page 2
of 2
ACORD 101 (2008/01)
© 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
ACORD CERTIFICATE OF LIABILITY INSURANCE I
DATE (MM/DD/YYYY)
~
02/08/2017 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(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement orhhis certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT Marsh USA Inc.
NAME:
PHONE I FAX 500 Dallas Street, Suite 1500 fA/C..,-A Extl:
IA/C Nol:
Houston, TX 77002 E-MAIL ADDRESS:
INSURERISl AFFORDING COVERAGE NAIC#
J03175-Sp-17-18 INSURER A : American Nudear Insurers INSURED INSURERS:
Arizona Public Service Company, et al'
/
Mail Station: 9618 PO Box 53999 INSURERC:
Phoenix, AZ. !j5072-3999 INSURER D:
INSURERE:
INSURER F:
COVERAGES CERTIFICATE NUMBER:
HOU-002668951-09 REVISION NUMBER:33 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 POLICY EFF POLICY EXP LIMITS LTR l***~n IUA~
POLICY NUMBER fMM/DD/YYYYI IMM/DD/YYYYI COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE
- ::::J CLAIMS-MADE D OCCUR DAMAGE TO RENTED PREMISES fEa occurrence\\
MED EXP (Any one person)
PERSONAL & ADV INJURY GEN'L AGGREGATE LiMIT APPLIES PER:
GENERALAGGREGATE
=i DPR~ DLOC.
PRODUCTS - COMP/OP AGG POLICY JECT OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT IEa accidenl\\
ANY AUTO BODILY INJURY (Per person)
ALL OWNED SCHEDULED BODILY INJURY (Per accident) $
AUTOS AUTOS
\\
NON-OWNED rp~~~2:dVnt?AMAGE HIRED AUTOS AUTOS UMBRELLA LIAB H OCCUR EACH OCCURRENCE
('
EXCESS LIAB CLAIMS-MADE AGGREGATE OED I I RETENTION$
WORKERS COMPENSATION I PER I I OTH-AND EMPLOYERS" LIABILITY STATUTE ER YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ~
(
E.L EACH ACCIDENT OFFICER/MEMBER EXCLUDED?
N/A (Mandatory In NH)
EL DISEASE - EA EMPLOYEE $
~m~~~~~ 'O#oPERATIONS below E.L DISEASE - POLICY LIMIT A
Nudear Energy Liability See Attached 01/01/2017 01/01/2018 See Attached Acord 101 Insurance Acord 101 I
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
I 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
..JlltA~~ ~
© 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/0~).
The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: J03175
~~~~~~~~~~~~~~~~~~~~~~~-
L 0 C #: Houston ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED Marsh USA Inc.
Arizona Public Service Company, et a1*
Mail Station: 9618 PO Box 53999 POLICY NUMBER '
i Phoenix, AZ 85072-3999 I
CARRIER I
NAIC CODE EFFECTIVE DA TE:
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 Worl<er Certificate], NS - (US Domestic Supplier's & Transporters], FS: [Foreign Suppliers & Transporters], N- [Secondary*
Financial Protection Certificate]
COVERAGE FOR NUCLEAR FACILITIES:
- 1. SITE #1 - PALO VERDE
_LOCATION OF NUCLEAR FACILITY: Palo Verde Nuclear Generating Station located in Wintersburg, Arizona NAMED INSURED [LISTED ON POLICY): Arizona Public Service Company, et al POLICY NUMBER:
POLICY EFFECTIVE:
LIMIT OF LIABILITY:
NF-0266 NW-0625 N-0088 N-0107 N-0114 08/0711981.
08/0711981 1213111984 1210911985 0312511987
$450 Million
$450 Million" THIS CERTIFICATE IS ISSUED AS A MA TIER 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 Worl<er Certificate - This limit is shared by all Certificates to the Master Worl<er 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.
- The following are Named Insureds: Arizona Public Service Company, Southern California Edison Company, Salt River Project Agricultural Improvement and Power District Pubflc Service Company of New Mexico, El Paso Electric Company, Southern California Public Power Authority, and The Department of Water and Power of the City of Los Angeles.
- Page 2
of 2
ACORD 101 (2008/01)
© 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
ACORD CERTIFICATE OF LIABILITY INSURANCE I
\\,._,...../
01/27/2017 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 Ir:,~ Nol:
500 Dallas Street, Suite 1500 IA/C No Fxtl*
Houston, TX 77002 E-MAIL ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC#
897592-Vistr-Nucle-17-18 INSURER A *; American Nu.clear Insurers INSURED INSURER B:
Comanche Peak Power Company LLC*
1601 Bryan Street INSURER C:
Dallas, TX 75201 INSURER D:
INSURER E:
INSURER F:
COVERAGES
- CERTIFICATE NUMBER:
HOU-002497200-05 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 INDICATIOD. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WlTH 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 A.ND CONDITIONS,OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE
"**en ""'"'
POLICY NUMBER fMM/DD/YYYY\\ fM M/DD/YYYYl COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE I
-==i CLAIMS-MADE D OCCUR DAMAGE TO RENTED
\\
PREMISES tEa occurrence\\
MED EXP (Any one person)
. PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER:
GENERALAGGREGATE
=i' D PRO-Owe, POLICY JECT PRODUCTS - COMP/OP AGG OTHER' AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT iEa accidentf*
ANY AUTO BODILY INJURY (Per person)
ALL OWNED
~SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $
r----
NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS
!Per accidentl r----
UMBRELLA LIAB. H OCCUR EACH OCCURRENCE EXCESS LIAS CLAIMS-MADE AGGREGATE OED I I RETENTION$
WORKERS COMPENSATION I ~~~TUTE I I OTH-AND EMPLOYERS' LIABILITY ER Y'/N ANY PROPRIETORIPARTNERIEXECUTIVE ~
E.L. EACH ACCIDENT
(
OFFICERIMEMBER EXCLUDED?
_N/A (Mandatory In NH)
E.L. DISEASE - EA EMPLOYEE $
~~s~~r~-IT8~ '8'~~PERATIONS below E.L. DISEASE - POLICY LIMIT A
Nuclear Energy Liability See Attached Acord 101 01/0112017
. 0110112018 See Attached Acord 101 Insurance DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if mo're space Is required)
CERTIFICATE HOLDER CANCELLATION i
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 Jessie Guerrero I
~~~"""'"
© 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01)
The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER.ID: _8_9....,7_5_9_2 _______________ _
LOC #: Houston ADDITIONAL REMARKS SCHEPULE Page 2
of 2
AGENCY NAMED INSURED Marsh USA Inc.
Comanche Peak Power Company UC 1601 Bryan Street POLICY NUMBER Dallas, TX 75201 CARRIER I NAIC CODE, 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 member5 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 caneelled or otherwise terminated prior to the end of December 31st of the calendar year in which the Effective Date ofthis Certificate occurs, notice will be delivered in acco111ance with the policy provisions. 'otherwise this Certificate shall terminate as of the end of such Dece~ber 31st A Certificate Will NOT be issued for any subsequent calendar year unless requested in writing.
Types oflnsurance: NF - [Facility Form], NW-(1.laster Worker C~rtificate], NS - [US Domestic Supplier's & Transporters], FS - [Foreign Suppliers & Transporters], N- [Secondary Financial Protection Certificate)
I COVERAGE FOR NUCLEAR FACILITIES:
- 1. SITE #1-COMANCHE PEAK
'.6 0 ~ 1-/ 4 5 //I " I LOCATION OF NUCLEAR FACILITY: Comanche Peak Nuclear Power Plant is located on the south bank of Squaw Creek Reservoir near the town of Glen Rose in Somervell
NAMED INSURED [LISTED ON POLICY): Comanche Peak Power Com*pany LLC POLICY NUMBER:
POLICY EFFECTIVE:
LIMIT OF LIABILITY:
NF-0274 NW-0631 N-0090 N-0119 I
01/01/1983 01/01/1983 02108/1990 02/0211993
$450Million
$450 Million-THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NP 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 issue.d 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 Certmcates to the1Master'Worker Policy of which each Certificate is a part and is subject tCi all of the provisions of such Poiicy
- 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 a~ industry retrospective rating plan.
ACORD 101 (2008/01)
© 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD