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| {{#Wiki_filter:February 22, 2022 NOC-AE-22003870 10 CFR 140.11(a)(4) 10 CFR 140.15 STI: 35285120 ATTN: Document Control Desk Director, Office of Nuclear Reactor Regulation U.S. Nuclear Regulatory Commission Washington, DC 20555-0001 South Texas Project Units 1 and 2 Docket No. STN 50-498 and STN 50-499 Evidence of Financial Protection Pursuant to the requirements of 10 CFR 140.11(a)(4) and 10 CFR 140.15, STP Nuclear Operating Company submits the attached American Nuclear Insurers Evidence of Financial Protection {{letter dated|date=December 6, 2021|text=letter dated December 6, 2021}}. | | {{#Wiki_filter:February 22, 2022 NOC-AE-2 2003870 10 CFR 140.11(a)(4) 10 CFR 140.15 STI: 35285120 |
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| | ATTN: Document Control Desk Director, Office of Nuclear Reactor Regulation U.S. Nuclear Regulatory Commission Washington, DC 20555- 0001 |
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| | South Texas Project Units 1 and 2 Docket No. STN 50-498 and STN 50- 499 Evidence of Financial Protection |
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| | Pursuant to the requirements of 10 CFR 140.11(a)(4) and 10 CFR 140.15, STP Nuclear Operating Company submits the attached American Nuclear Insurers Evidence of Financial Protection {{letter dated|date=December 6, 2021|text=letter dated December 6, 2021}}. |
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| There are no commitments in this letter. | | There are no commitments in this letter. |
| Should you have any questions, concerns, or require additional information on this matter, please contact Tim Hammons at (361) 972-7347 or me at (361) 972-4767. | | |
| Brittany Werner Manager, Finance th | | Should you have any questions, concerns, or require additional information on this matter, please contact Tim Hammons at (361) 972-7347 or me at (361) 972 -4767. |
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| | Brittany Werner Manager, Finance |
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| ==Attachment:== | | ==Attachment:== |
| Evidence of Financial Protection cc: | | Evidence of Financial Protection |
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| Regional Administrator, Region IV U.S. Nuclear Regulatory Commission 1600 E. Lamar Boulevard Arlington, TX 76011-4511 | | Regional Administrator, Region IV U.S. Nuclear Regulatory Commission 1600 E. Lamar Boulevard Arlington, TX 76011-4511 |
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| EVIDENCE OF FINANCIAL PROTECTION To: Document Control Desk U.S. Nuclear Regulatory Commission Washington, DC 20555-0001 This is to confirm that there is in force as of the effective date of this Evidence of Financial Protection, a Nuclear Energy Liability Policy (Facility Form), a certificate to the Master Worker Policy [Nuclear Energy Liability Policy (Facility Worker Form)], and one or more certificates to Master Policy No. 1 [Nuclear Energy Liability Insurance (Secondary Financial Protection)] issued by the members of American Nuclear Insurers, hereafter called the companies, to the Insured named herein, with respect to the Nuclear Facility at the Location stated below. If such policy and/or certificates are cancelled or otherwise terminated prior to the end of December 31st of the calendar year in which the Effective Date of this Evidence of Financial Protection occurs, the companies will mail written notice thereof to the United States Nuclear Regulatory Commission in accordance with policy provisions and this Evidence of Financial Protection shall thereupon terminate. | | EVIDENCE OF FINANCIAL PROTECTION |
| Otherwise this Evidence of Financial Protection shall terminate as of the end of such December 31st.
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| Name and Mailing Address of Insured Effective Date of this Evidence of Financial Protection STP Nuclear Operating Company January 1, 2022 P.O. Box 289 Wadsworth, TX 77483 Policy/Certificate Number Policy/Certificate Effective Date Limit of Liability Facility Form Policy No. NF -0307 November 13, 1986 $450,000,000 Facility Worker Form Certificate No. NW -0657 January 1, 1998 $450,000,000*
| | To: Document Control Desk U.S. Nuclear Regulatory Commission Washington, DC 20555- 0001 |
| SFP Certificate No. N -0113 August 22, 1987 **
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| SFP Certificate No. N -0116 December 16, 1988 **
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| Location of the Nuclear Facility South Texas Project located in Matagorda County, State of Texas
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| *This is an aggregate limit of liability shared by all participants to the Master Worker Policy [Nuclear Energy Liability Policy (Facility Worker Form)] of which each certificate is a part and is subject to all of the provisions of such Policy and certificate having reference thereto.
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| **As per Condition 3 of Master Policy No. 1 [Nuclear Energy Liability Insurance (Secondary Financial Protection)].
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| Page 1 of 2 American Nuclear Insurers 95 Glastonbury Blvd., Suite 300 Glastonbury, CT 06033-4453 Voice: (860) 682-1301 Fax: (860) 659-0002 NRC1000 (12/1/2014) Evidence of Financial Protection Form
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| This Evidence of Financial Protection is not an insurance policy, is issued as a matter of information only and confers no rights upon the holder. This Evidence of Financial Protection neither affirmatively nor negatively amends, extends or alters the coverage afforded by the above stated policies and certificates. | | This is to confirm that there is in force as of the effective date of this Evidence of Financial Protection, a Nuclear Energy Liability Policy (Facility Form), a certificate to the Master Worker Policy [Nuclear Energy Liability Policy (Facility Worker Form)], and one or more certificates to Master Policy No. 1 [Nuclear Energy Liability Insurance (Secondary Financial Protection)] issued by the members of American Nuclear Insurers, hereafter called the companies, to the Insured named herein, with respect to the Nuclear Facility at the Location stated below. If such policy and/or certificates are cancelled or otherwise terminated prior to the end of December 31st of the calendar year in which the Effective Date of this Evidence of Financial Protection occurs, the c ompanies will mail written notice thereof to the United States Nuclear Regulatory Commission in accordance with policy provisions and this Evidence of Financial Protection shall thereupon terminate. |
| | Otherwise this Evidence of Financial Protection s hall terminate as of the end of such December 31st. |
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| | Name and Mailing Address of Insured Effective Date of this Evidence of Financial Protection |
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| | STP Nuclear Operating Company January 1, 2022 P.O. Box 289 Wadsworth, TX 77483 |
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| | Policy/Certificate Number Policy/Certificate Effective Date Limit of Liability |
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| | Facility Form Policy No. NF -0307 November 13, 1986 $450,000,000 Facility Worker Form Certificate No. NW -0657 January 1, 1998 $450,000,000* |
| | SFP Certificate No. N -0113 August 22, 1987 ** |
| | SFP Certificate No. N -0116 December 16, 1988 ** |
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| | Location of the Nuclear Facility |
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| | South Texas Project located in Matagorda County, State of Texas |
| | * This is an aggregate limit of liability shared by all participants to the Master Worker Policy [Nuclear Energy Liability Policy (Facility Worker Form)] of which each certificate is a part and is subject to all of the provisions of such Policy and certificate having reference thereto. |
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| | **As per Condition 3 of Master Policy No. 1 [Nuclear Energy Liability Insurance ( Secondary Financial Protection)]. |
| | Page 1 of 2 |
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| | American Nuclear Insurers 95 Glastonbury Blvd., Suite 300 Glastonbury, CT 06033-4453 Voice: (860) 682-1301 Fax: (860) 659-0002 NRC1000 (12/1/201 4) Evidence of Financial Protection Form This Evidence of Financial Protection is not an insurance policy, is issued as a matter of information only and confers no rights upon the holder. T his Evidence of Financial Protection neither affirmatively nor negatively amends, extends or alters the coverage afforded by the above stated policies and certificates. |
| Notwithstanding any requirement, term or condition of any contract or other document with respect to which this Evidence of Financial Protection may be issued or may pertain, the insurance afforded by the policies and certificates described herein is subject to all the terms, exclusions and conditions of the policies and certificates. The Limits of Liability shown above may have been reduced by payment of claims or claims expenses. | | Notwithstanding any requirement, term or condition of any contract or other document with respect to which this Evidence of Financial Protection may be issued or may pertain, the insurance afforded by the policies and certificates described herein is subject to all the terms, exclusions and conditions of the policies and certificates. The Limits of Liability shown above may have been reduced by payment of claims or claims expenses. |
| (Signature of Authorized Representative) | | |
| Jim Palaia - Vice President, Underwriting (Name and Title of Authorized Representative) 12/6/2021 (Date) | | (Signature of Authorized Representative ) |
| Page 2 of 2 NRC1000 (12/1/2014) Evidence of Financial Protection Form}} | | |
| | Jim Palaia - Vice President, Underwriting |
| | ( Name and Title of Authorized Representative ) |
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| | 1 2/6/2021 (Date) |
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| | Page 2 of 2 |
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| | NRC1000 (12/1/201 4) Evidence of Financial Protection Form}} |
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Category:Financial Assurance Document
MONTHYEARML24088A3022024-03-28028 March 2024 Financial Assurance for Decommissioning - 2024 Update ML24079A1312024-03-0505 March 2024 Nuclear Insurance Protection ML24050A0082024-02-19019 February 2024 Evidence of Financial Protection ML23089A0622023-03-29029 March 2023 Financial Assurance for Decommissioning - 2023 Update ML23053A1462023-02-21021 February 2023 Evidence of Financial Protection ML22053A2672022-02-22022 February 2022 Evidence of Financial Protection ML21202A1852021-07-20020 July 2021 Nuclear Insurance Protection NOC-AE-21003820, Nuclear Insurance Protection2021-07-20020 July 2021 Nuclear Insurance Protection NOC-AE-20003709, Evidence of Financial Protection2020-02-13013 February 2020 Evidence of Financial Protection NOC-AE-19003635, Financial Assurance for Decommissioning 2019 Update2019-03-26026 March 2019 Financial Assurance for Decommissioning 2019 Update NOC-AE-19003621, Evidence of Financial Protection2019-02-19019 February 2019 Evidence of Financial Protection ML19023A1952019-01-0909 January 2019 Certificate of Liability Insurance for South Texas Project Nuclear Plant NOC-AE-18003570, Submittal of Nuclear Insurance Protection2018-05-0202 May 2018 Submittal of Nuclear Insurance Protection NOC-AE-17003452, Financial Assurance for Decommissioning - 2017 Update2017-03-29029 March 2017 Financial Assurance for Decommissioning - 2017 Update NOC-AE-16003377, Submittal of Nuclear Insurance Protection2016-05-25025 May 2016 Submittal of Nuclear Insurance Protection NOC-AE-16003339, Evidence of Financial Protection2016-02-17017 February 2016 Evidence of Financial Protection NOC-AE-15003316, Nuclear Insurance Protection2015-11-23023 November 2015 Nuclear Insurance Protection ML15097A0142015-03-26026 March 2015 Financial Assurance for Decommissioning - 2015 Update NOC-AE-15003230, Nuclear Insurance Protection2015-02-25025 February 2015 Nuclear Insurance Protection NOC-AE-15003229, Evidence of Financial Protection2015-02-25025 February 2015 Evidence of Financial Protection NOC-AE-14003091, Nuclear Insurance Protection2014-02-18018 February 2014 Nuclear Insurance Protection NOC-AE-14003092, Evidence of Financial Protection2014-02-18018 February 2014 Evidence of Financial Protection NOC-AE-13002985, Financial Assurance for Decommissioning - 2013 Update2013-04-25025 April 2013 Financial Assurance for Decommissioning - 2013 Update ML1307205372013-02-21021 February 2013 Submittal of Nuclear Insurance Protection NOC-AE-12002799, Nuclear Insurance Protection2012-02-13013 February 2012 Nuclear Insurance Protection NOC-AE-12002800, Submittal of Evidence of Financial Protection2012-02-13013 February 2012 Submittal of Evidence of Financial Protection ML1123719082011-11-14014 November 2011 2010 DFS Report Analysis for South Texas Project, Unit 1 ML1123719092011-11-14014 November 2011 2010 DFS Report Analysis for South Texas Project, Unit 2 NOC-AE-11002663, Regarding Financial Assurance for Decommissioning - 2011 Update (Revised)2011-04-13013 April 2011 Regarding Financial Assurance for Decommissioning - 2011 Update (Revised) NOC-AE-10002526, Submittal of Nuclear Insurance Protection Policies2010-02-24024 February 2010 Submittal of Nuclear Insurance Protection Policies NOC-AE-10002527, Submittal of Evidence of Financial Protection2010-02-24024 February 2010 Submittal of Evidence of Financial Protection ML0907209482009-02-16016 February 2009 Nuclear Insurance Protection NOC-AE-07002125, Nuclear Insurance Protection2007-02-27027 February 2007 Nuclear Insurance Protection NOC-AE-07002124, Evidence of Financial Protection2007-02-26026 February 2007 Evidence of Financial Protection NOC-AE-06001972, Evidence of Financial Protection2006-02-0606 February 2006 Evidence of Financial Protection NOC-AE-05001941, Comprehensive Annual Financial Report2005-10-18018 October 2005 Comprehensive Annual Financial Report NOC-AE-05001844, Submittal of Nuclear Insurance Protection2005-02-0707 February 2005 Submittal of Nuclear Insurance Protection NOC-AE-04001672, Evidence of Financial Protection2004-01-20020 January 2004 Evidence of Financial Protection NOC-AE-03001476, Evidence of Financial Protection2003-02-26026 February 2003 Evidence of Financial Protection 2024-03-05
[Table view] Category:Letter
MONTHYEARML24318C5082024-11-13013 November 2024 Condition Prohibited by Technical Specifications IR 05000498/20253012024-11-0707 November 2024 Notification of NRC Initial Operator Licensing Examination 05000498/2025301; 05000499/2025301 IR 05000498/20240032024-11-0707 November 2024 Integrated Inspection Report 05000498/2024003 and 05000499/2024003 ML24304B0512024-10-30030 October 2024 Cycle 26 Core Operating Limits Report IR 05000498/20244022024-10-23023 October 2024 Security Baseline Inspection Report 05000498/2024402 and 05000499/2024402 05000499/LER-2024-003, Containment Isolation Valve Inoperable Resulting in Condition Prohibited by Technical Specification and Prevention of Fulfillment of Safety Function2024-10-22022 October 2024 Containment Isolation Valve Inoperable Resulting in Condition Prohibited by Technical Specification and Prevention of Fulfillment of Safety Function ML24295A0772024-10-21021 October 2024 Licensed Operator Positive Fitness-for-Duty Test 05000499/LER-2024-002, Two Control Room Envelope HVAC Trains Inoperable Resulting in a Condition That Could Have Prevented Fulfillment of a Safety Function2024-10-17017 October 2024 Two Control Room Envelope HVAC Trains Inoperable Resulting in a Condition That Could Have Prevented Fulfillment of a Safety Function ML24290A1162024-10-16016 October 2024 Change to South Texas Project Electric Generating Station (STPEGS) Emergency Plan ML24255A0322024-09-30030 September 2024 The Associated Independent Spent Fuel Storage Installation - Notice of Consideration of Approval of Direct Transfer of Licenses and Opportunity to Request a Hearing (EPID L-2024-LLM-0002) - Letter ML24269A1762024-09-25025 September 2024 Tpdes Permit Renewal Application WQ0001 908000 05000498/LER-2024-004, Loss of Offsite Power Resulting in Unit 1 Automatic Reactor Trip and Actuation of Emergency Diesel Generators and Auxiliary Feedwater Pumps2024-09-19019 September 2024 Loss of Offsite Power Resulting in Unit 1 Automatic Reactor Trip and Actuation of Emergency Diesel Generators and Auxiliary Feedwater Pumps ML24271A3022024-09-18018 September 2024 STP-2024-09 Post-Exam Comments - Redacted ML24274A0902024-09-16016 September 2024 Written Response - EA-24-026 STP Operator - Redacted ML24250A1882024-09-11011 September 2024 Request for Information for an NRC Post-Approval Site Inspection for License Renewal ML24249A3372024-09-0404 September 2024 Inservice Inspection Summary Report - 2RE23 05000499/LER-2024-001-01, Supplement to Automatic Reactor Trip and Actuation of Two of Three Emergency Diesel Generators2024-08-29029 August 2024 Supplement to Automatic Reactor Trip and Actuation of Two of Three Emergency Diesel Generators ML24234A0912024-08-27027 August 2024 NRC Initial Operator Licensing Examination Approval 05000498/2024301; 05000499/2024301 IR 05000498/20240052024-08-22022 August 2024 Updated Inspection Plan for South Texas Project Electric Generating Station, Units 1 and 2 (Report 05000498/2024005 and 05000499/2024005) IR 05000498/20240022024-08-0909 August 2024 Integrated Inspection Report 05000498/2024002 and 05000499/2024002 IR 05000498/20240102024-08-0808 August 2024 Biennial Problem Identification and Resolution Inspection Report 05000498/2024010 and 05000499/2024010 ML24213A0842024-07-31031 July 2024 Application for Order Consenting to Direct Transfer of Licenses ML24218A1462024-07-26026 July 2024 2. EPA Comments on South Texas Project Exemption Ea/Fonsi ML24207A1782024-07-25025 July 2024 Licensed Operator Positive Fitness-For-Duty Test 05000499/LER-2024-001, Automatic Reactor Trip and Actuation of Two of Three Emergency Diesel Generators2024-07-0202 July 2024 Automatic Reactor Trip and Actuation of Two of Three Emergency Diesel Generators 05000498/LER-2024-003, Condition Prohibited by Technical Specifications and Potential Loss of Safety Function Due to Inoperable Low Head Safety Injection Pump2024-07-0101 July 2024 Condition Prohibited by Technical Specifications and Potential Loss of Safety Function Due to Inoperable Low Head Safety Injection Pump 05000498/LER-2024-002-01, Two Essential Chilled Water Trains Inoperable Resulting in a Condition That Could Have Prevented Fulfillment of a Safety Function2024-06-27027 June 2024 Two Essential Chilled Water Trains Inoperable Resulting in a Condition That Could Have Prevented Fulfillment of a Safety Function 05000498/LER-2023-003-01, Two Essential Chilled Water Trains Inoperable Resulting in a Condition That Could Have Prevented Fulfillment of a Safety Function2024-06-19019 June 2024 Two Essential Chilled Water Trains Inoperable Resulting in a Condition That Could Have Prevented Fulfillment of a Safety Function ML24141A0482024-05-17017 May 2024 EN 56958_1 Ametek Solidstate Controls, Inc ML24136A2872024-05-15015 May 2024 Submittal of 2024 Nrc/Fema Evaluated Exercise Scenario Manual ML24136A2842024-05-15015 May 2024 Independent Spent Fuel Storage Installation Supplement to Request for Exemption from Various Part 72 Regulations Resulting from Fuel Basket Design Control Compliance ML24130A2712024-05-0909 May 2024 Re Two Essential Chilled Water Trains Inoperable Resulting in a Condition That Could Have Prevented Fulfillment of a Safety Function ML24128A1572024-05-0707 May 2024 Independent Spent Fuel Storage Installation Request for Exemption from Various Part 72 Regulations Resulting from Fuel Basket Design Control Compliance IR 05000498/20240012024-05-0606 May 2024 Integrated Inspection Report 05000498/2024001 & 05000499/2024001 ML24120A3762024-04-29029 April 2024 Annual Dose Report for 2023 ML24116A2282024-04-25025 April 2024 Annual Environmental Operating Report 05000498/LER-2023-004-01, Condition Prohibited by Technical Specifications Due to Inoperable Train of Essential Chilled Water2024-04-25025 April 2024 Condition Prohibited by Technical Specifications Due to Inoperable Train of Essential Chilled Water ML24116A3032024-04-25025 April 2024 Operations Quality Assurance Plan Condition Adverse to Quality Definition Change Resulting in a Reduction in Commitment ML24117A1602024-04-24024 April 2024 2023 Radioactive Effluent Release Report ML24102A2452024-04-23023 April 2024 Exemption from Select Requirements of 10 CFR Part 73 (EPID L-2023-LLE-0046 (Security Notifications, Reports, and Recordkeeping and Suspicious Activity Reporting)) ML24113A3122024-04-22022 April 2024 Cycle 24 Core Operating Limits Report ML24097A0072024-04-0606 April 2024 Relief Request Number RR-ENG-4-07 – Request for an Alternative to ASME Code Case N-729-6 for Reactor Vessel Head Penetration 75 05000498/LER-2024-001, Re Two Steam Generator Power Operated Relief Valves (Porvs) Inoperable Resulting in a Condition That Could Have Prevented Fulfillment of a Safety Function2024-04-0101 April 2024 Re Two Steam Generator Power Operated Relief Valves (Porvs) Inoperable Resulting in a Condition That Could Have Prevented Fulfillment of a Safety Function ML24088A3022024-03-28028 March 2024 Financial Assurance for Decommissioning - 2024 Update NOC-AE-240040, Response to Request for Additional Information for Request for Exemption from Enhanced Weapons, Firearms Background Checks, and Security Event Notifications Implementation2024-03-21021 March 2024 Response to Request for Additional Information for Request for Exemption from Enhanced Weapons, Firearms Background Checks, and Security Event Notifications Implementation ML24080A2902024-03-19019 March 2024 Nuclear Liability Certificates of Insurance ML24066A2002024-03-0606 March 2024 10 CFR 50.46 Thirty-Day Report of Significant ECCS Model Changes ML24079A1312024-03-0505 March 2024 Nuclear Insurance Protection ML24060A1742024-02-28028 February 2024 Submittal of Annual Fitness for Duty Performance Report for 2023 IR 05000498/20230062024-02-28028 February 2024 Annual Assessment Letter for South Texas Project Electric Generating Station, Units 1 and 2 (Report 05000498/2023006 and 05000499/2023006) 2024-09-04
[Table view] |
Text
February 22, 2022 NOC-AE-2 2003870 10 CFR 140.11(a)(4) 10 CFR 140.15 STI: 35285120
ATTN: Document Control Desk Director, Office of Nuclear Reactor Regulation U.S. Nuclear Regulatory Commission Washington, DC 20555- 0001
South Texas Project Units 1 and 2 Docket No. STN 50-498 and STN 50- 499 Evidence of Financial Protection
Pursuant to the requirements of 10 CFR 140.11(a)(4) and 10 CFR 140.15, STP Nuclear Operating Company submits the attached American Nuclear Insurers Evidence of Financial Protection letter dated December 6, 2021.
There are no commitments in this letter.
Should you have any questions, concerns, or require additional information on this matter, please contact Tim Hammons at (361) 972-7347 or me at (361) 972 -4767.
Brittany Werner Manager, Finance
th
Attachment:
Evidence of Financial Protection
cc:
Regional Administrator, Region IV U.S. Nuclear Regulatory Commission 1600 E. Lamar Boulevard Arlington, TX 76011-4511
EVIDENCE OF FINANCIAL PROTECTION
To: Document Control Desk U.S. Nuclear Regulatory Commission Washington, DC 20555- 0001
This is to confirm that there is in force as of the effective date of this Evidence of Financial Protection, a Nuclear Energy Liability Policy (Facility Form), a certificate to the Master Worker Policy [Nuclear Energy Liability Policy (Facility Worker Form)], and one or more certificates to Master Policy No. 1 [Nuclear Energy Liability Insurance (Secondary Financial Protection)] issued by the members of American Nuclear Insurers, hereafter called the companies, to the Insured named herein, with respect to the Nuclear Facility at the Location stated below. If such policy and/or certificates are cancelled or otherwise terminated prior to the end of December 31st of the calendar year in which the Effective Date of this Evidence of Financial Protection occurs, the c ompanies will mail written notice thereof to the United States Nuclear Regulatory Commission in accordance with policy provisions and this Evidence of Financial Protection shall thereupon terminate.
Otherwise this Evidence of Financial Protection s hall terminate as of the end of such December 31st.
Name and Mailing Address of Insured Effective Date of this Evidence of Financial Protection
STP Nuclear Operating Company January 1, 2022 P.O. Box 289 Wadsworth, TX 77483
Policy/Certificate Number Policy/Certificate Effective Date Limit of Liability
Facility Form Policy No. NF -0307 November 13, 1986 $450,000,000 Facility Worker Form Certificate No. NW -0657 January 1, 1998 $450,000,000*
SFP Certificate No. N -0113 August 22, 1987 **
SFP Certificate No. N -0116 December 16, 1988 **
Location of the Nuclear Facility
South Texas Project located in Matagorda County, State of Texas
- This is an aggregate limit of liability shared by all participants to the Master Worker Policy [Nuclear Energy Liability Policy (Facility Worker Form)] of which each certificate is a part and is subject to all of the provisions of such Policy and certificate having reference thereto.
- As per Condition 3 of Master Policy No. 1 [Nuclear Energy Liability Insurance ( Secondary Financial Protection)].
Page 1 of 2
American Nuclear Insurers 95 Glastonbury Blvd., Suite 300 Glastonbury, CT 06033-4453 Voice: (860) 682-1301 Fax: (860) 659-0002 NRC1000 (12/1/201 4) Evidence of Financial Protection Form This Evidence of Financial Protection is not an insurance policy, is issued as a matter of information only and confers no rights upon the holder. T his Evidence of Financial Protection neither affirmatively nor negatively amends, extends or alters the coverage afforded by the above stated policies and certificates.
Notwithstanding any requirement, term or condition of any contract or other document with respect to which this Evidence of Financial Protection may be issued or may pertain, the insurance afforded by the policies and certificates described herein is subject to all the terms, exclusions and conditions of the policies and certificates. The Limits of Liability shown above may have been reduced by payment of claims or claims expenses.
(Signature of Authorized Representative )
Jim Palaia - Vice President, Underwriting
( Name and Title of Authorized Representative )
1 2/6/2021 (Date)
Page 2 of 2
NRC1000 (12/1/201 4) Evidence of Financial Protection Form