ML18065A183
| ML18065A183 | |
| Person / Time | |
|---|---|
| Site: | Beaver Valley, Davis Besse, Perry, Crane  |
| Issue date: | 02/21/2018 |
| From: | Mukherjee M Marsh USA |
| To: | Document Control Desk, Office of Nuclear Material Safety and Safeguards, Office of Nuclear Reactor Regulation |
| References | |
| Download: ML18065A183 (4) | |
Text
0001113 SP 0084
- -C01-P01113-I Document Control Desk U.S. Nuclear Regulatory Commission Washington, DC 20555-0001
ACORD CERTIFICATE OF LIABILITY INSURANCE I
DATE (MM/DDNYYY)
~-
02/21/2018 THIS CERTIFICATE IS ISSUED AS A MATIER 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 INSURANGE 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 have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT
- Marsh USA, Inc.
NAME:
PHONE I FAX Two Alliance Center IA/C **- Cv"*
IA/C Nol:
3560 Lenox Road, Suite 2400 E-MAIL ADDRESS:
Atlanta, GA 30326 Attn: Atlanta.CertRequest@marsh.com INSURER(Sl AFFORDING COVERAGE NAIC#
101-327-820-AII-Nuc-18-19 INSURER A : American Nuclear Insurers INSURED INSURERB:
FirstEnergy Corporation Attn: Pete Nadel INSURERC:
pnadel@firstenergycorp.com INSURERD:
76 South Main Street Akron, OH 44308 INSURERE:
INSURERF:
COVERAGES CERTIFICATE NUMBER:
ATL-004731224-11 REVISION NUMBER: 16 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADDL SUBR
,:gJag}'JVv,,:g~J%ivWv1 LIMITS LTR TYPE OF INSURANCE
,.,.,n IJIJ\\/n POLICY NUMBER COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE f.-- ~
CLAIMS-MADE D OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence\\
f.--
MED EXP (Any one person)
PERSONAL & ADV INJURY f.--
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE Fl DPRO-DLOC PRODUCTS - COMP/OP AGG POLICY JECT OTHER:
AUTOMOBILE LIABILITY
. COMBINED SINGLE LIMIT
{Ea accident\\
1--.
ANY AUTO BODILY INJURY (Per person)
OWNED SCHEDULED BODILY INJURY (Per accident) $
~
AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident\\
UMBRELLA LIAB H OCCUR EACH OCCURRENCE EXCESSLIAB CLAIMS-MADE AGGREGATE DED I I RETENTION$
WORKERS COMPENSATION I PER I I OTH-AND EMPLOYERS' LIABIL.ITY STATUTE ER YIN ANYPROPRIETOR/PARTNER/EXECUTIVE 0 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 See Attached Acord 101 01/01/2018 01/01/2019 See Attached Acord 101 Liability Insurance DESCRIPTION OF OPERATIONS/ LOCATIONS/ 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
-M.o..'Vl,.QIO~ ~
© 1988-2016 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03)
The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: _1_0_1_-3_2_7_-8_2_0 _____________
LOC #: 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 members of American Nuclear Insurers as indicated (Companies), to the Insured named herein, with respect to the Nuclear Facility at the Location shown and/or with respect to the lnsured's operations described herein. If such policy is cancelled or otherwise terminated prior to the end of December 31st of the calendar year in which the Effective Date of this Certificate occurs, notice will be delivered in accordance with the policy provisions. Otherwise this Certificate shall terminate as of the end of such December 31st. A Certificate will NOT be issued for any subsequent calendar year unless requested in writing.
Types of Insurance: NF - (Facility Form]. NW- [Master Worker Certificate], NS- [US Domestic Supplier's & Transporters], FS- [Foreign Suppliers & Transporters]
COVERAGE FOR NUCLEAR FACILITIES:
- 1. SITE #1 - BEAVER VALLEY LOCATION OF NUCLEAR FACILITY: Beaver Valley Nuclear Power Plant in Shippingport Borough, Beaver County, Pennsylvania NAMED INSURED [LISTED ON POLICY]: FirstEnergy Nuclear Generation, LLC, and FirstEnergy Nuclear Operating Company Operating Company POLICY NUMBER:
NF-0226 NW-0603
- 2. SITE #2-DAVIS-BESSE POLICY EFFECTIVE:
08/01/1974 08/01/1974 LIMIT OF LIABILITY:
$450 Million
$450 Million" LOCATION OF NUCLEAR FACILITY: Davis-Besse Nuclear Power Plant on Lake Erie approx 20 miles ESE of Toledo in Ottawa County, Ohio NAMED INSURED [LISTED ON POLICY]: FirstEnergy Nuclear Generation, LLC and FirstEnergy Nuclear Operating Company POLICY NUMBER:
POLICY EFFECTIVE:
LIMIT OF LIABILITY:
NF-0236 11/01/1975
$450 Million NW-0608 11/01/1975
$450 Million"
- 3. SITE #3 - PERRY LOCATION OF NUCLEAR FACILITY: Perry Nuclear Power Plant on Lake Erie approx 35 miles NE of Cleveland, Ohio NAMED INSURED [LISTED ON POLICY]: FirstEnergy Nuclear Generation, LLC, and FirstEnergy Nuclear Operating Company POLICY NUMBER:
POLICY EFFECTIVE:
LIMIT OF LIABILITY:
NF-0291 09/01/1984
$450 Mi\\\\ion NW-0644 09/01/1984
$450 Mi\\\\ion"
- 4. SITE #4-SAXTON LOCATION OF NUCLEAR FACILITY: Saxton Nuclear Experimental Corporation Facility in Liberty Township, Bedford County, Pennsylvania NAMED INSURED [LISTED ON POLICY]: Saxton Nuclear Experimental Corporation POLICY NUMBER:
POLICY EFFECTIVE:
LIMIT OF LIABILITY:
NF-0107 NW-0532
- 5. SITE #5 - THREE MILE ISLAND 06/01/1961 06/01/1961
$1 Million
$450 Million" LOCATION OF NUCLEAR FACILITY: Three Mile Island Nuclear Power Plant in Londonderry Township, Dauphin County, Pennsylvania NAMED INSURED [LISTED ON POLICY]: Exelon Generation Company, LLC [NF-0220 ONLY], Metropolitan Edison Company, Jersey Central Power & Light Company, Pennsylvania Electric Company and GPU Nuclear Inc.
POLICY NUMBER:
POLICY EFFECTIVE:
NF-0220 12/31/1973 NW-0599 12/31/1973 LIMIT OF LIABILITY:
$450 Mi\\\\ion
$450 Million" Page 2
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ACORD 101 (2008/01)
© 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: 101-327-820 LO C #: Atlanta ACORD
'---/
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 COVERAGE FOR SUPPLIER'S & TRANSPORTER'S:
- 6. US DOMESTIC S&T DESCRIPTION OF OPERATIONS: Furnishing of services, materials, parts or equipment in connection with the planning, construction, maintenance, involving the handling, storage, shipment, use or disposal of specified types of nuclear materials.
NAMED INSURED [LISTED ON POLICY]: FirstEnergy Nuclear Generation, LLC POLICY NUMBER:
POLICY EFFECTIVE:
LIMIT OF LIABILITY:
NS-0465 03/15/1965
$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:
" Master Worker Certificate - This limit is shared by all Certificates to the Master Worker Policy of which each Certificate is a part and is subject to all of the provisions of such Policy and Certificate having reference thereto. Such limit may have been reduced by payment of claims or claims expenses.
Page 3
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ACORD 101 (2008/01)
© 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD