ML18319A092

Marsh USA, Inc., Certificate of Liability Insurance

ML18319A092
Person / Time
Site:	Hatch, Vogtle, Farley
Issue date:	10/29/2018
From:	Marsh USA
To:	Document Control Desk, Office of Nuclear Reactor Regulation
References
Download: ML18319A092 (3)

Text

0001 777 SP 0663 -C01-P01777-I Document Control Desk U.S. Nuclear Regulatory Commission Washington, DC 20555-0001

I DATE (MM/DD/YYYY)

ACORD CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 10/29/2018 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).

CONTACT PRODUCER NAME:

MARSH USA, INC.

ritJgN~o E*tl:

I IAJC FAX Nol:

1WO ALLIANCE CENTER 3560 LENOX ROAD, SUITE 2400 E-MAIL ADDRESS:

ATLANTA, GA 30326 INSURER!Sl AFFORDING COVERAGE NAIC#

CN102113409-4-Nuke-19-20 INSURER A : American Nuclear Insurers INSURED INSURERS:

Southern Company Seivices, Inc.

Attn: Deborah Gaffney INSURERC:

dsgaffne@southemco.com INSURERD:

30 Ivan Allen Jr. Boulevard NW Bin SC1404 INSURERE:

AHanta, GA 30308 INSURERF:

COVERAGES CERTIFICATE NUMBER: ATL-004781494-14 REVISION NUMBER: 4 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 II POLICY EFF POLICY EXP TYPE OF INSURANCE IMC>n WVD POLICY NUMBER MM/DD/YYYYI IMM/DD/YYYYl LIMITS LTR COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $

f--

D CLAIMS-MADE D OCCUR DAMAGE TO RENTED PREMISES /Ea occurrence I MED EXP (Any one person) f--

- PERSONAL & ADV INJURY $

R GEN'LAGGREGATE LIMIT APPLIES PER:

POLICY DPRO-OTHER:

JECT D LOG GENERAL AGGREGATE PRODUCTS - COMP/OP AGG COMBINED SINGLE LIMIT f--

AUTOMOBILE LIABILITY ANY AUTO IEa accidentl BODILY INJURY (Per person)

OWNED AUTOS ONLY HIRED AUTOS ONLY SCHEDULED AUTOS NON-OWNED AUTOS ONLY BODILY INJURY (Per accident) $

iP~~~&,~~8AMAGE $

UMBRELLA LIAB EXCESSLIAB H OCCUR CLAIMS-MADE EACH OCCURRENCE AGGREGATE DED I I RETENTION $ $

WORKERS COMPENSATION I PER STATUTE I I OTH-ER AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $

OFFICER/MEMBER EXCLUDED? N/A D

(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $

If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE* POLICY LIMIT $

A Nuclear Energy Liability See Attached Acord 101 01/01/2019 01/01/2020 See Attached Acord 101 see addl page text 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.

Manashi Mukherjee ..J',ito..""""""'°i..... ~

I

© 1988-2016 ACORD CORPORATION. All rights reserved.

ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD

AGENCY CUSTOMER ID: _C:....:N....:..1.:..c0:_2...c.1....:..13-'-4_0:_9_ _ _ _ _ _ _ _ _ _ _ __

LOC #: Atlanta

/~

ACORD AGENCY

-- ADDITIONAL REMARKS SCHEDULE NAMED INSURED Page 2 of 2 MARSH USA, INC. Southern Company Services, Inc.

Attn: Deborah Gaffney POLICY NUMBER dsgaffne@southemco.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 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 - JOSEPH M. FARLEY LOCATION OF NUCLEAR FACILITY: Joseph M. Farley Nuclear Power Plant 16.5 Ml E of Dothan, AL NAMED INSURED [LISTED ON POLICY]: Alabama Power Company and Southern Nuclear Operating Company POLICY NUMBER: POLICY EFFECTIVE: LIMIT OF LIABILITY:

NF-0238 02/01/1976 $450 Million NW-0609 02/01/1976 $450 Million**

2. SITE #2 - HATCH 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: POLICY EFFECTIVE: LIMIT OF LIABILITY:

NF-0215 06/26/1973 $450 Million NW-0594 06/2611973 $450 Million**

3. SITE #3 - ALVIN W. VOGTLE 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, MEAG Power SPVM, LLC, MEAG Power SPVJ, LLC, MEAG Power SPVP, LLC and City of Dalton, Georgia POLICY NUMBER: POLICY EFFECTIVE: LIMIT OF LIABILITY:

NF-0302 06/01/1986 $450 Million NW-0653 06/01/1986 $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 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