ML22048B586
| ML22048B586 | |
| Person / Time | |
|---|---|
| Site: | Summer  |
| Issue date: | 10/29/2021 |
| From: | Acord Corporation, Marsh USA |
| To: | Office of Nuclear Reactor Regulation |
| References | |
| Download: ML22048B586 (1) | |
Text
A GE NCY CU S TOrAER ID: CN 1022309 46 --- ---- - - - --- ---- - ------
LO C # : Ch a rlotte ADD! TIONAL RE MA, Pa ge 2 of 2
AG ENCY 1#1-.r U R ED -..
- i "ir '..... 'SCANA Corpilratidri *'
- ,, c;, ltfTT!ll: 11llison M. Mo sef *., *
. ~1\\.-Q ~ ~-v ~ ~ne rgy _~iqis, IY-.
- * 'Ci.M ghou se Bu ildin g - Co rJ)6ra te Risk 121.l Tredegar Street P':hmond, VA 2321 9
ADD ITIO NA L REMA R K S THIS AD DITIONAL R E lll',A l"' 1. ~k.!:20U
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FO RM NU MB ER: 2 5 -,..,l TIT LE :
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CERTIFICATE OF NUCLE AR EN ERGY LIABILITY INSU RAN CE
~- This is-~ certify t~~ thefe*is~~}/ot' l' J~ dive ii16 o( this Ce rtificate a t'lu i:: ii a; E~;;gy ~ bility ln su rencef'ol '"'t:ir ~ ~ fiiii:i; o fA~rica n N~(1ea r Insur ers as
!: *' : /, -, * **l/ -.J.* 1.J,. ;*. *. 1.. * ~,-~:....,,,.,.. */ 1 </111 l' J ~*:'"l. I iodic ated,_ (.(:Q!Tlpanie s), te:l~\\l. ~~ su red;~t,,.11e\\lt~r~ip,,Wi th reslljl~\\ to the Nu slea r Fa c'li!y at th~ L~ atio~ shq,'~n.riir** Jct to,1!1e. lns,ured 'fo~ ~ra _tio n s described herein'., lf 1,vc h policy is ca ~oeUed..or o thsrwise:Jt?miBated pri:Jr lo lhe en d of Dece mber 31slo f ih t: ca lenda r ya a c in W~"'.fe; ~ " ~,.1 i.0, Qf())is Olrtlfica te occu rs, not ice.will b e delivered in accordan c e with the policy provisions. Otherwise this Ce rtificate shall termin ate as of the* er.\\! ot sucll;~ t,, r 31st
- A-Certific aie"will NOT be issu eif fo l a ~y sub sequllnt calendar yea r unless req u e:;_ted in w riting.. J,I
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Type s of In su ra n ce : NF - [Facility Form} ; Nw : [Mas taf _i'?rker Certifica te], NS - [U S Domes tic Su pp lier's & Tran sporters], FS - [For eign Suppliers & Tra n sporters]
COVERAGE FOR NU CLEAR FACILITIE S:
- 1. SITE #1
- VIRG IL C. SU MMER NUC LEAR *STATI0 N LOCATION OF NUCLEAR FAC ILITY: <V irgil C: Su mme r Nu c lea r Station 2.5 miles N of Parr, Fairfield Co u nty, Sout h Car o lina NAMED IN SUR E_D [LISTED ON PO LI CY]: South Caro lina Electric & Ga s Company and So uth Ca rolin a Public Se rvic e Au thority PO LI CY NUMBER : PO LICY.EFFECTIVE : LIMIT OF LI ABI LITY :
NF-0252 03/21/1978 $450 Million NW-06 16 03/21 /1978 $450 Million..
COVERAGE FOR SU PPLIER'S & TRA NSPORTER'S:
- 2. U S DOMESTIC S&T DESCRIPTION OF OPE.RAT(O NS: Fu roishing o f services, m aterials, parts o r equipm en t in co n nection w ith the pla nni ng, co ns truction, m a in tena n ce, jnv olvLng the ha ndling, * * * "*
storage, shipment, u se o r dispos al o f spec ified typ es o f n u c lear materials.
NAMED INSURED [LISTED ON POU CY]:. SCANA Cor po ra tion PO LI CY NUMBER:,, POLI CY EFFE~ TIVE : LIMIT OF LI AB ILITY :
NS-0420 08/05/1982 $450 Million
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THI S CERTI FI CATE IS ISSUE D AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGH TS UP ON THE CER TI FICATE HOLDER.
Th e in su rance afforded by the polic y (ies) is sub jec t to tha ex : :.isior<E, c0 ~dilicn s a nd o!!;er,pro vlsio;l#o f the.poli0y(ies}., tilei:11.ir.this G'c'.Aificat e r.o r a r.y c o n tract or o ther docu r:ien t with respect to wh ich it is issu ed sha ll a m end, exte nd or a lter the cov erage afforded by the po licy. The Limit o f Liab ility show n a bove m ay have bee n redu ce d b y payme nt o f c laims o r c la ims ex pen ses.
CO MME NTS/NOTES:
.. Mas ter Wo rker Ce rtifica te - This limit is share d b y a ll Certifica tes to the Mas ter W or ker Po licy of which each Certificate is a part an d is su bjec t to all of the provisions of su ch Policy a nd Ce rtifica te hav ing referen ce thereto. Su c h lil!!i! m a y ~ave bee3 ~ed u ced _br_ payme n t o ! _c laim s or c la ims _e,x 1:_e nses.
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ACORD 101 ( 2008/01) © 2008 ACORD CORPORATION. All rights 1 The ACORD name and logo are registered marks of ACORD
04 76-0 1-00-000513 8 -0002 -0010513 Ii
Dear Certificate Holder:
As many companies have moved to a remote working environment, mailing Certificates of Insurance to a physical address can cause unnecessary delays in providing you proof of insurance. To streamline de It very and in an effort to support our firm's commitment to sustainabi lity, going forward, we would Ii ke to distribute your Certificates of Insurance electronically if possible.
We are kindly requesbng Certificate Holders provfde us an emai l address where we can deliver your CO i in the future.
Please send your response to: US0perations.email@marsh.com and provide the following information so that we can expediteyourCOl delivery:
- Certificate# {Shown below Insured Name -e.g.: ABC~123456789-01)
- E-Mai l for future delivery:
For undefiverable email add resses, our system is configured to automatically redirect the Certificate for deliveryvia USPS.
Lastly, if you no longer need this COi please respond to USOperations.email@marsh.com with the Certificate number and we will inactive the record in our system to avoid future automatic de livery.
Thank you.
US Operations,. Marsh USA, Inc.
. * 'f ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YYYY)
~ - 10/29/2021 THIS CERTIFICATE IS ISSUED AS A MA TIER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE H9LDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED B\\' THE POLICIES BELOW. THIS CERTIFICATE OF INSURANc r.:* DOE~ i\\Cff 1~0 1f - -,'; ~"'.f ;&_ (;ONTP.t,c-;*_ Bi:rw:::i=:\\l fKI: ISSUING INSURER($), AU1FIORl2E.D REPRESENTATIVE OR PRODUCER, A ~ D THE CERTIFICATE H'J!..~ I... ~*
IMPORTANT: If the certificate holder is an ADDITIONAL 1,iistJh.:,, the: policf! ies) mu st have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the t~ m ~s an d cC'.,d;.~i~ns of fhe. polic;y, certain policies may require.: n. en do cse m ent. _A statement on this certificate does not confer rights to tt;o c.3/4rtific.:te hoi :' :n li~u of ~uch cn(l*Qrsement(s). - - --
PRODUCER ' "
Marsh USA Inc. I --< I FAX Charlotte100 North, N 28202 ;llrT ~Oil Street, Su ite 3600 - *- ___ / _ ~- IA/C Nol : ~ '
- -.. -..,............. - - -- - -J.. S: *--- -- - -- --- - -* --. -*-----
-.. -*.... ~ ~..., -.... ".. -- - < -.. - -- IN SUkER(S) AFFOR D!NG COVEAA,GE ____ _.
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CN102230946-SCANA-NUKE 23 It'_~ "~ -, -. _.-1... r. ar. ~~ UC' ~_.:t~.... c-..... -., *- _ _j_ _1__ ____ '..._: - - --- --
INSURED.SCANA Corporation ' *** :~. "--*~:-***-*_: L ' -~-- --- ~ _.. *,* ___ "
ATTN: Allison M. Moser *.......... " " 11\\!SURER *--. ****,,,-,-,--:;-,-c :.. - -- -- -* " ' -
Dominion Energy Se,vices, Inc. INSURERD :
Clearinghouse Building - Corporate Risk 120 Tredegar Street INSURER E:
Richmond, VA 23219.,,........ ' *' INSU RE R t':
COVERAGES CERTIFICATE NU F. BE ?
- ATL-004418500-15, _....,.. * ***--U *r---r-'._.---,---,,,-.,,---, : <..,;_ \\-,-. --*- - --* -*REVISIO"'I Nl'M~I="'.: 20 - ***..,.~ - **-----,-
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LIS1 ow HAVE BEEN 1ss41:o TO THE INSURED NAM E O ABOVE FOR,HE POLICY PERIOD '
INDICATED. NOTWITHSTANDING 'ANY REQUiREMENT, TERll/i * -,. ~ :ON OF ANY -CONlRACT C)R OTHER DOCUMErl.-*\\n/lTH RESl't:CT TG WHICH THIS CERTIFICATE MAY BE ISSUED 'OF! MAY PERT AIN, T HE H.. SU. "*...,-.F-. ""CED ' S/I' THE ~ OUCIES DESCR IBcD H:.REIN !S ~JB JEC;T 7C ALL THE TER,ilS, EXCLUSIONS AND CONDITION&QF- ~-L!CH POLICIES. ~.Ill.II;~ Sl:i0\\'1.'N M/,Y '. *,,,c i3:;!::~ Rl=:DUC ED BY PAID CL.Al.MS. "
INSR TYPE OF INSURANCE ADDL SUBR POLICYEFF POLICY EXP \\..:Ml'!'S LTR,.,.,n lwvo POLICY NUMBER IMM/DD/YYYYI IMM/DD/YYY Y I '..
COMMERCIAL GENERAL LIABILITY EA.CH OCC UR RE NCE $
- D,, '.:,:*.
- 1 :.* 1.:*.~,i,t~tu,. '. I*~,I,.1,J* 1 ~ * '., ' C,,\\i,,,,,; ~ s YE"""' l ICU ' '
t--- PREMISES Ea occurrence I $ CLA IM S-MADE OCCUR
t-- MED EXP ( Any one p~) $
t-- PERSONAL & ADV INJURY $..
GEN 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGG R EGATE $ !
Fl PRO - LOC POLICY JECT,,,'.,.,, -. ; P~ODU CTS - CO M 0 /O P *AGG $
OTHER: **,.,.,Ii },.,.,* $
AUTOMOBILE LIABILITY f Ea accidentl $ OMBINED SING LE LIMIT
- AN Y AUTO BOD ILY. INJURY (Per person) $
- OWNE D - SC HEDUL ED
- -AUTOS ONLY AUTOS BO DILY INJURY (Per acciden t) $
HIRED NON -OWNED PROPERTY DAMAGE t-- - $ AUTOS ONLY AUTOS ONLY. tPer accident\\ $ '
UMBRELLA LIAB H OCCUR EACH OCCURRENCE $
t--
EXCESSLIAB CLA IMS-MADE AGGREGATE $
DED I I RETENTION $ " "' *"",. r,*,, ;. $
WORKERS COMPENSATION I PER I I OTH -
AND EMPLOYERS" LIABILITY '* *Sl'ATUTE
- ER '* Y/N ANY.PROPRIETOR/PARTNER/EXECUTIVE ***- * <i.L EACH AC<::1DENT ' $
OFFICER/M EMBER EXCLU DED? N/A 1 *:,_; 1tF -, :, *:
(Mandatory in NH) ; 1 ii.-~, I l:i.' rnsb,.iE
- EA EMPLOYEE $
If yes, describe under,;\\!!'1,_1:;r,, El. -1.
DES CRIPTION OF OPER ATION S he!ow $ Dl!'.iEASE - POLICY LIMIT A Nuclear Energy Liability.. SEE ATTACHED -- - 01/01/2022 01/01/2023 SEE ATTACHED Insu rance ~ ' . d, -... :.1 j *,*.,.r, '-t! j -~ \\ \\.,l :1i,, *, 1 *;:., '. j 1, 1i ;.,,.'*J, ' * ' (
DESCRIPTION OF OPERATIONS/ LOC A TI ONS/ '!/EHICt.ES ; (ACORD 101, !, Jdltl ona* 110:cia 1k:: !!';cl>e**'-'!>!, : 1.;.bl* att1,:~.: :I If m<>re ~c~ h reqli:fl'8d)., *, ; :,* '. '> ; *';!,; '*
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- CERTIFICATE HOLDER CANCELLATION -
Document Control Desk ' SHOULD A NY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE,
U.S. Nuclear Regu latory Commission THE EXPIRATION DAT E THEREOF, NOTICE WILL BE DE LIVERED ~ --
Washington, DC 20555-0001 ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
I ~ USA ~He.
© 1988 -2016 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
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0005 13 8 S P 047 6 -C0 1-P05140 i Document Contro l bE3 sk U.S. Nuclear Regu latory Co mmiss io rl Washington, DC 20555-0061
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0476-01 0005138-0001-0010512