ML18313A128
| ML18313A128 | |
| Person / Time | |
|---|---|
| Site: | Comanche Peak  |
| Issue date: | 11/01/2018 |
| From: | Guerrero J Marsh USA |
| To: | Document Control Desk, Office of Nuclear Reactor Regulation |
| References | |
| 897592 | |
| Download: ML18313A128 (3) | |
Text
0001770 SP 0678 -C01-P01770-I Document Control Desk U.S. Nuclear Regulatory Commission Washington, DC 20555-0001
DATE (MM/DDNYYYJ ACORD
~- CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS I 11/01/2018 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 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 NAME:
Marsh USA Inc.
500 Dallas Street, Suite 1500 PHONE IA/C No EvH*
I IA/C FAX Nol:
Houston, TX 77002 E-MAIL ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC#
897592-Vistr-Nucie-18-19 INSURER A : American Nuclear Insurers INSURED INSURERS:
Comanche Peak Power Company LLC 6555 Sierra Drive Irving, TX 75039
£* 0- I ift11? q-4-~ INSURERC:
INSURERD:
INSURERE:
INSURERF:
COVERAGES CERTIFICATE NUMBER: HOU-003196127-10 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 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 LTR TYPE OF INSURANCE ADDL SUBR
,.,~n lun,n POLICY NUMBER ,~g}-Jg}'JVv, POLICY EXP IMM/DD/YYYYI LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $
f--
D CLAIMS-MADE D OCCUR DAMAGE TO RENTED PREMISES !Ea occurrence) $
MED EXP (Any one person) $
f--
f--
PERSONAL & ADV INJURY $
FlGEN'L AGGREGATE LIMIT APPLIES PER:
POLICY DPRO-OTHER:
JECT DLoc GENERAL AGGREGATE PRODUCTS - COMP/OP AGG AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $
f--
/Ea accident\
ANY AUTO BODILY INJURY (Per person) $
f--
OWNED
- SCHEDULED BODILY INJURY (Per accident) $
f-- AUTOS ONLY - AUTOS HIRED NON-OWNED $
AUTOS ONLY AUTOS ONLY rp~~~&,~de;,gAMAGE f-- -
f--
UMBRELLA LIAB EXCESSLIAB H OCCUR CLAIMS-MADE EACH OCCURRENCE AGGREGATE OED I I RETENTION $ $
WORKERS COMPENSATION I PER STATUTE I I OTH- ER AND EMPLOYERS' LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH) 0 N/A E.L. DISEASE - EA EMPLOYEE $
If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $
A Nuclear Energy Liability See Attached ACORD 101 01/01/2019 01/01/2020 See Attached Acord 101 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 Jessie Guerrero
<:: ....... .. .. ~-" "::*.*, --*-~---~" -:_-
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© 1988-2016 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: _8_9_7_5_92_ _ _ _ _ _ _ _ _ _ _ _ _ _ __
LOC #: Houston
-~
ACORD ADDITIONAL REMARKS SCHEDULE Page 2 of 2
~--*-/
AGENCY NAMED INSURED Marsh USA Inc. Comanche Peak Power Company LLC 6555 Sierra Drive POLICY NUMBER Irving, TX 75039 CARRIER 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], N- [Secondary Financial Protection Certificate]
COVERAGE FOR NUCLEAR FACILITIES:
- 1. SITE #1 - COMANCHE PEAK 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 County, Texas approximately 35 miles southwest of Fort Worth and 67 miles southwest of Dallas, Texas.
NAMED INSURED [LISTED ON POLICY]: Comanche Peak Power Company LLC POLICY NUMBER: POLICY EFFECTIVE: LIMIT OF LIABILITY:
NF-0274 01/01/1983 $450 Million NW-0631 01/01/1983 $450 Million" N-0090 02/08/1990 N-0119 02/02/1993 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 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