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{{#Wiki_filter:ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE (MM'DD/YYYY) 3/17/2016 THIS CERTIFICATE IS ISSUED AS A MATTER 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 INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),
{{#Wiki_filter:ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE (MM'DD/YYYY) 3/17/2016 THIS CERTIFICATE IS ISSUED AS A MATTER 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 INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT:
AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT:
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed.
If the certificate holder is an ADDITIONAL  
: INSURED, the policy(ies) must be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement.
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).
A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER Jennifer Dissette Premark Associated  
PRODUCER Jennifer Dissette Premark Associated Agencies, Inc.
: Agencies, Inc.
i:vt1* (716) 633-8401 I Nol: (716) 633-8429 6470 Main St., Ste #2 jdissette@promarkinsurance.com PO Box 530 INSURER(S)
i:vt1* (716) 633-8401 I
Nol: (716) 633-8429 6470 Main St., Ste #2 jdissette@promarkinsurance.com PO Box 530 INSURER(S)
AFFORDING COVERAGE NAIC# Williamsville NY 14231-0530 INSURER A :RLI Insurance Companv -A&E 13056 INSURED INSURER B One Beacon Insurance Companv 21970 MRB Group INSURER C: 145 Culver Road, Suite 160 INSURER D: INSURER E: Rochester NY 14620 INSURER F: COVERAGES CERTIFICATE NUMBER;CL1631703524 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.
AFFORDING COVERAGE NAIC# Williamsville NY 14231-0530 INSURER A :RLI Insurance Companv -A&E 13056 INSURED INSURER B One Beacon Insurance Companv 21970 MRB Group INSURER C: 145 Culver Road, Suite 160 INSURER D: INSURER E: Rochester NY 14620 INSURER F: COVERAGES CERTIFICATE NUMBER;CL1631703524 REVISION NUMBER: 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.
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.
Line 32: Line 28:
[i] OCCUR DAMAGE TO RENTED A PREMISES IEa occurrence\  
[i] OCCUR DAMAGE TO RENTED A PREMISES IEa occurrence\  
$ 1,000,000  
$ 1,000,000  
-PSB0003207 5/1/2016 5/1/2017 MED EXP (Any one person) $ 10,000 -PERSONAL  
-PSB0003207 5/1/2016 5/1/2017 MED EXP (Any one person) $ 10,000 -PERSONAL & ADV INJURY $ 1,000,000  
& ADV INJURY $ 1,000,000  
-GEN'LAGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE  
-GEN'LAGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE  
$ 2,000,000 R 0PRO-DLOC PRODUCTS  
$ 2,000,000 R 0PRO-DLOC PRODUCTS -COMP/OP AGG $ 2,000,000 POLICY JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 rEa accident\  
-COMP/OP AGG $ 2,000,000 POLICY JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 rEa accident\  
-ANY AUTO BODILY INJURY (Per person) $ A -ALL OWNED -SCHEDULED AUTOS AUTOS PSA0001996 3/5/2016 3/5/2017 BODILY INJURY (Per accident)  
-ANY AUTO BODILY INJURY (Per person) $ A -ALL OWNED -SCHEDULED AUTOS AUTOS PSA0001996 3/5/2016 3/5/2017 BODILY INJURY (Per accident)  
$ --NON-OWNED x HIRED AUTOS x AUTOS $ --$ x UMBRELLA LIAB M OCCUR EACH OCCURRENCE  
$ --NON-OWNED x HIRED AUTOS x AUTOS $ --$ x UMBRELLA LIAB M OCCUR EACH OCCURRENCE  
$ 5 000 000 -A EXCESS LIAB CLAIMS-MADE AGGREGATE  
$ 5 000 000 -A EXCESS LIAB CLAIMS-MADE AGGREGATE  
$ 5 000 000 OED I x I RETENTION$
$ 5 000 000 OED I x I RETENTION$
10 000 PSE0003023 5/1/2016 5/1/2017  
10 000 PSE0003023 5/1/2016 5/1/2017 $ WORKERS COMPENSATION x I I I OTH-AND EMPLOYERS' LIABILITY ER YIN ANY PROPRIETOR/PARTNER/EXECUTIVE 0 E.L. EACH ACCIDENT $ 1 000 000 OFFICER/MEMBER EXCLUDED?
$ WORKERS COMPENSATION x I I I OTH-AND EMPLOYERS' LIABILITY ER YIN ANY PROPRIETOR/PARTNER/EXECUTIVE 0 E.L. EACH ACCIDENT  
N/A A (Mandatory in NH) PSW0001923 5/1/2016 5/1/2017 E.L. DISEASE -EA EMPLOYEE $ 1 000 000 I below E.L. DISEASE -POUCY LIMIT $ 1 000 000 B Professional Liability DPL-4987-15 12/31/2015 12/31/2016 Per Claim 2,000,000 Aggregate 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be atached if more spaceis required)
$ 1 000 000 OFFICER/MEMBER EXCLUDED?
N/A A (Mandatory in NH) PSW0001923 5/1/2016 5/1/2017 E.L. DISEASE -EA EMPLOYEE  
$ 1 000 000 I below E.L. DISEASE -POUCY LIMIT $ 1 000 000 B Professional Liability DPL-4987-15 12/31/2015 12/31/2016 Per Claim 2,000,000 Aggregate 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be atached if more spaceis required)
Holder is an additional insured for the general liability only in regards toservices provided by the insured to the entity when required by executed written contract.
Holder is an additional insured for the general liability only in regards toservices provided by the insured to the entity when required by executed written contract.
Professional Liability limits shown are per claim and aggregate for all projects of the named insured.
Professional Liability limits shown are per claim and aggregate for all projects of the named insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE RE Ginna Nuclear Power THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Plant, LLC ACCORDANCE WITH THE POLICY PROVISIONS.
CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE RE Ginna Nuclear Power THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Plant, LLC ACCORDANCE WITH THE POLICY PROVISIONS.
750 East Pratt Street Baltimore, MD 21202 AUTHORIZED REPRESENTATIVE c Alderson/HWITTM  
750 East Pratt Street Baltimore, MD 21202 AUTHORIZED REPRESENTATIVE c Alderson/HWITTM  
..-..I
..-..I
Line 56: Line 46:
ACORD 25 (2014/01)
ACORD 25 (2014/01)
INS025 r?o14011 The ACORD name and logo are registered marks of ACORD ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDD/YYYY)  
INS025 r?o14011 The ACORD name and logo are registered marks of ACORD ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDD/YYYY)  
"'---" 3/17/2016 THIS CERTIFICATE IS ISSUED AS A MATTER 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 INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),
"'---" 3/17/2016 THIS CERTIFICATE IS ISSUED AS A MATTER 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 INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT:
AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT:
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed.
If the certificate holder is an ADDITIONAL  
: INSURED, the policy(ies) must be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement.
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).
A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER Jennifer Dissette Premark Associated  
PRODUCER Jennifer Dissette Premark Associated Agencies, Inc.
: Agencies, Inc.
Cv+I* (716) 633-8401 I Nol: (716) 633-8429 6470 Main St., Ste #2 jdissette@promarkinsurance.com PO Box 530 INSURER!Sl AFFORDING COVERAGE NAIC# Williamsville NY 14231-0530 INSURER A :RLI Insurance Comoanv -A&E 13056 INSURED INSURER B One Beacon Insurance Comoany 21970 MRB Group INSURERC:
Cv+I* (716) 633-8401 I
Nol: (716) 633-8429 6470 Main St., Ste #2 jdissette@promarkinsurance.com PO Box 530 INSURER!Sl AFFORDING COVERAGE NAIC# Williamsville NY 14231-0530 INSURER A :RLI Insurance Comoanv -A&E 13056 INSURED INSURER B One Beacon Insurance Comoany 21970 MRB Group INSURERC:
145 Culver Road, Suite 160 INSURER D: INSURER E: Rochester NY 14620 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1631703524 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.
145 Culver Road, Suite 160 INSURER D: INSURER E: Rochester NY 14620 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1631703524 REVISION NUMBER: 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.
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.
Line 71: Line 57:
;:SUBR I POLICY EFF LIMITS LTR \Af\fn POLICY NUMBER MMIDD/YYYYl x COMMERaAL GENERAL LIABILITY EACH OCCURRENCE  
;:SUBR I POLICY EFF LIMITS LTR \Af\fn POLICY NUMBER MMIDD/YYYYl x COMMERaAL GENERAL LIABILITY EACH OCCURRENCE  
$ 1,000,000 A I CLAIMS-MADE  
$ 1,000,000 A I CLAIMS-MADE  
[iJ OCCUR DAMAGE TO RENTED PREMISES  
[iJ OCCUR DAMAGE TO RENTED PREMISES !Ea occurrencel  
!Ea occurrencel  
$ 1,000,000 PSB0003207 5/1/2016 5/1/2017 MED EXP (Any one person) $ 10,000 -PERSONAL & ADV INJURY* $ 1,000,000  
$ 1,000,000 PSB0003207 5/1/2016 5/1/2017 MED EXP (Any one person) $ 10,000 -PERSONAL  
& ADV INJURY* $ 1,000,000  
-GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE  
-GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE  
$ 2,000,000  
$ 2,000,000  
=i 0 PRO-DLoc PRODUCTS  
=i 0 PRO-DLoc PRODUCTS -COMP/OP AGG $ 2,000,000 POLICY JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident\  
-COMP/OP AGG $ 2,000,000 POLICY JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident\  
-ANY AUTO BODILY INJURY (Per person) $ A -ALL OWNED -SCHEDULED AUTOS AUTOS PSA0001996 3/5/2016 3/5/2017 BODILY INJURY (Per accident)  
-ANY AUTO BODILY INJURY (Per person) $ A -ALL OWNED -SCHEDULED AUTOS AUTOS PSA0001996 3/5/2016 3/5/2017 BODILY INJURY (Per accident)  
$ --NON-OWNED PROPERTY DAMAGE x HIRED AUTOS x AUTOS IPer accidentl  
$ --NON-OWNED PROPERTY DAMAGE x HIRED AUTOS x AUTOS IPer accidentl  
Line 85: Line 68:
-A EXCESS LIAB CLAIMS-MADE AGGREGATE  
-A EXCESS LIAB CLAIMS-MADE AGGREGATE  
$ 5 000 000 OED I x I RETENTION$
$ 5 000 000 OED I x I RETENTION$
10 000 PSE0003023 5/1/2016 5/1/2017  
10 000 PSE0003023 5/1/2016 5/1/2017 $ WORKERS COMPENSATION x I I I OTH-AND EMPLOYERS' LIABILITY ER YIN ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1 000 000 OFFICER/MEMBER EXCLUDED?
$ WORKERS COMPENSATION x I I I OTH-AND EMPLOYERS' LIABILITY ER YIN ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT  
N/A A (Mandatory in NH) PSW0001923 5/1/2016 5/1/2017 E.L. DISEASE -EA EMPLOYEE $ 1 000 000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1 000 000 B Professional Liability DPL-4987-15 12/31/2015 12/31/2016 Per Claim 2,000,000 Aggregate 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remall<s Schedule, may be atached if more spaceis required)
$ 1 000 000 OFFICER/MEMBER EXCLUDED?
N/A A (Mandatory in NH) PSW0001923 5/1/2016 5/1/2017 E.L. DISEASE -EA EMPLOYEE  
$ 1 000 000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1 000 000 B Professional Liability DPL-4987-15 12/31/2015 12/31/2016 Per Claim 2,000,000 Aggregate 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remall<s  
: Schedule, may be atached if more spaceis required)
The County of Ontario is an additional insured for the general liability only in regards to services provided by the insured to the entity when required by executed written contract.
The County of Ontario is an additional insured for the general liability only in regards to services provided by the insured to the entity when required by executed written contract.
CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE R.E. Ginna Nuclear Power Plant THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1503 Lake Road ACCORDANCE WITH THE POLICY PROVISIONS.  
CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE R.E. Ginna Nuclear Power Plant THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1503 Lake Road ACCORDANCE WITH THE POLICY PROVISIONS.
: Ontario, NY 14519 AUTHORIZED REPRESENTATIVE c Alderson/HWITTM c--:_I-*-
Ontario, NY 14519 AUTHORIZED REPRESENTATIVE c Alderson/HWITTM c--:_I-*--....... ...-.! 6 ... __ ..... HH**< &#xa9; 1988-2014 ACORD CORPORATION.
-....... ...-.! 6 ... __ ..... HH**< &#xa9; 1988-2014 ACORD CORPORATION.
All rights reserved.
All rights reserved.
ACORD 25 (2014/01)
ACORD 25 (2014/01)
Line 101: Line 79:
:* ., -..
:* ., -..
BM! Ji. L "'
BM! Ji. L "'
ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE (MM'DD/YYYY) 3/17/2016 THIS CERTIFICATE IS ISSUED AS A MATTER 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 INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),
ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE (MM'DD/YYYY) 3/17/2016 THIS CERTIFICATE IS ISSUED AS A MATTER 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 INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT:
AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT:
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed.
If the certificate holder is an ADDITIONAL  
: INSURED, the policy(ies) must be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement.
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).
A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER Jennifer Dissette Premark Associated  
PRODUCER Jennifer Dissette Premark Associated Agencies, Inc.
: Agencies, Inc.
i:vt1* (716) 633-8401 I Nol: (716) 633-8429 6470 Main St., Ste #2 jdissette@promarkinsurance.com PO Box 530 INSURER(S)
i:vt1* (716) 633-8401 I
Nol: (716) 633-8429 6470 Main St., Ste #2 jdissette@promarkinsurance.com PO Box 530 INSURER(S)
AFFORDING COVERAGE NAIC# Williamsville NY 14231-0530 INSURER A :RLI Insurance Companv -A&E 13056 INSURED INSURER B One Beacon Insurance Companv 21970 MRB Group INSURER C: 145 Culver Road, Suite 160 INSURER D: INSURER E: Rochester NY 14620 INSURER F: COVERAGES CERTIFICATE NUMBER;CL1631703524 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.
AFFORDING COVERAGE NAIC# Williamsville NY 14231-0530 INSURER A :RLI Insurance Companv -A&E 13056 INSURED INSURER B One Beacon Insurance Companv 21970 MRB Group INSURER C: 145 Culver Road, Suite 160 INSURER D: INSURER E: Rochester NY 14620 INSURER F: COVERAGES CERTIFICATE NUMBER;CL1631703524 REVISION NUMBER: 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.
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.
Line 118: Line 92:
[i] OCCUR DAMAGE TO RENTED A PREMISES IEa occurrence\  
[i] OCCUR DAMAGE TO RENTED A PREMISES IEa occurrence\  
$ 1,000,000  
$ 1,000,000  
-PSB0003207 5/1/2016 5/1/2017 MED EXP (Any one person) $ 10,000 -PERSONAL  
-PSB0003207 5/1/2016 5/1/2017 MED EXP (Any one person) $ 10,000 -PERSONAL & ADV INJURY $ 1,000,000  
& ADV INJURY $ 1,000,000  
-GEN'LAGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE  
-GEN'LAGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE  
$ 2,000,000 R 0PRO-DLOC PRODUCTS  
$ 2,000,000 R 0PRO-DLOC PRODUCTS -COMP/OP AGG $ 2,000,000 POLICY JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 rEa accident\  
-COMP/OP AGG $ 2,000,000 POLICY JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 rEa accident\  
-ANY AUTO BODILY INJURY (Per person) $ A -ALL OWNED -SCHEDULED AUTOS AUTOS PSA0001996 3/5/2016 3/5/2017 BODILY INJURY (Per accident)  
-ANY AUTO BODILY INJURY (Per person) $ A -ALL OWNED -SCHEDULED AUTOS AUTOS PSA0001996 3/5/2016 3/5/2017 BODILY INJURY (Per accident)  
$ --NON-OWNED x HIRED AUTOS x AUTOS $ --$ x UMBRELLA LIAB M OCCUR EACH OCCURRENCE  
$ --NON-OWNED x HIRED AUTOS x AUTOS $ --$ x UMBRELLA LIAB M OCCUR EACH OCCURRENCE  
$ 5 000 000 -A EXCESS LIAB CLAIMS-MADE AGGREGATE  
$ 5 000 000 -A EXCESS LIAB CLAIMS-MADE AGGREGATE  
$ 5 000 000 OED I x I RETENTION$
$ 5 000 000 OED I x I RETENTION$
10 000 PSE0003023 5/1/2016 5/1/2017  
10 000 PSE0003023 5/1/2016 5/1/2017 $ WORKERS COMPENSATION x I I I OTH-AND EMPLOYERS' LIABILITY ER YIN ANY PROPRIETOR/PARTNER/EXECUTIVE 0 E.L. EACH ACCIDENT $ 1 000 000 OFFICER/MEMBER EXCLUDED?
$ WORKERS COMPENSATION x I I I OTH-AND EMPLOYERS' LIABILITY ER YIN ANY PROPRIETOR/PARTNER/EXECUTIVE 0 E.L. EACH ACCIDENT  
N/A A (Mandatory in NH) PSW0001923 5/1/2016 5/1/2017 E.L. DISEASE -EA EMPLOYEE $ 1 000 000 I below E.L. DISEASE -POUCY LIMIT $ 1 000 000 B Professional Liability DPL-4987-15 12/31/2015 12/31/2016 Per Claim 2,000,000 Aggregate 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be atached if more spaceis required)
$ 1 000 000 OFFICER/MEMBER EXCLUDED?
N/A A (Mandatory in NH) PSW0001923 5/1/2016 5/1/2017 E.L. DISEASE -EA EMPLOYEE  
$ 1 000 000 I below E.L. DISEASE -POUCY LIMIT $ 1 000 000 B Professional Liability DPL-4987-15 12/31/2015 12/31/2016 Per Claim 2,000,000 Aggregate 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be atached if more spaceis required)
Holder is an additional insured for the general liability only in regards toservices provided by the insured to the entity when required by executed written contract.
Holder is an additional insured for the general liability only in regards toservices provided by the insured to the entity when required by executed written contract.
Professional Liability limits shown are per claim and aggregate for all projects of the named insured.
Professional Liability limits shown are per claim and aggregate for all projects of the named insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE RE Ginna Nuclear Power THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Plant, LLC ACCORDANCE WITH THE POLICY PROVISIONS.
CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE RE Ginna Nuclear Power THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Plant, LLC ACCORDANCE WITH THE POLICY PROVISIONS.
750 East Pratt Street Baltimore, MD 21202 AUTHORIZED REPRESENTATIVE c Alderson/HWITTM  
750 East Pratt Street Baltimore, MD 21202 AUTHORIZED REPRESENTATIVE c Alderson/HWITTM  
..-..I
..-..I
Line 142: Line 110:
ACORD 25 (2014/01)
ACORD 25 (2014/01)
INS025 r?o14011 The ACORD name and logo are registered marks of ACORD ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDD/YYYY)  
INS025 r?o14011 The ACORD name and logo are registered marks of ACORD ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDD/YYYY)  
"'---" 3/17/2016 THIS CERTIFICATE IS ISSUED AS A MATTER 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 INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),
"'---" 3/17/2016 THIS CERTIFICATE IS ISSUED AS A MATTER 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 INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT:
AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT:
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed.
If the certificate holder is an ADDITIONAL  
: INSURED, the policy(ies) must be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement.
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).
A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER Jennifer Dissette Premark Associated  
PRODUCER Jennifer Dissette Premark Associated Agencies, Inc.
: Agencies, Inc.
Cv+I* (716) 633-8401 I Nol: (716) 633-8429 6470 Main St., Ste #2 jdissette@promarkinsurance.com PO Box 530 INSURER!Sl AFFORDING COVERAGE NAIC# Williamsville NY 14231-0530 INSURER A :RLI Insurance Comoanv -A&E 13056 INSURED INSURER B One Beacon Insurance Comoany 21970 MRB Group INSURERC:
Cv+I* (716) 633-8401 I
Nol: (716) 633-8429 6470 Main St., Ste #2 jdissette@promarkinsurance.com PO Box 530 INSURER!Sl AFFORDING COVERAGE NAIC# Williamsville NY 14231-0530 INSURER A :RLI Insurance Comoanv -A&E 13056 INSURED INSURER B One Beacon Insurance Comoany 21970 MRB Group INSURERC:
145 Culver Road, Suite 160 INSURER D: INSURER E: Rochester NY 14620 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1631703524 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.
145 Culver Road, Suite 160 INSURER D: INSURER E: Rochester NY 14620 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1631703524 REVISION NUMBER: 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.
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.
Line 157: Line 121:
;:SUBR I POLICY EFF LIMITS LTR \Af\fn POLICY NUMBER MMIDD/YYYYl x COMMERaAL GENERAL LIABILITY EACH OCCURRENCE  
;:SUBR I POLICY EFF LIMITS LTR \Af\fn POLICY NUMBER MMIDD/YYYYl x COMMERaAL GENERAL LIABILITY EACH OCCURRENCE  
$ 1,000,000 A I CLAIMS-MADE  
$ 1,000,000 A I CLAIMS-MADE  
[iJ OCCUR DAMAGE TO RENTED PREMISES  
[iJ OCCUR DAMAGE TO RENTED PREMISES !Ea occurrencel  
!Ea occurrencel  
$ 1,000,000 PSB0003207 5/1/2016 5/1/2017 MED EXP (Any one person) $ 10,000 -PERSONAL & ADV INJURY* $ 1,000,000  
$ 1,000,000 PSB0003207 5/1/2016 5/1/2017 MED EXP (Any one person) $ 10,000 -PERSONAL  
& ADV INJURY* $ 1,000,000  
-GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE  
-GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE  
$ 2,000,000  
$ 2,000,000  
=i 0 PRO-DLoc PRODUCTS  
=i 0 PRO-DLoc PRODUCTS -COMP/OP AGG $ 2,000,000 POLICY JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident\  
-COMP/OP AGG $ 2,000,000 POLICY JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident\  
-ANY AUTO BODILY INJURY (Per person) $ A -ALL OWNED -SCHEDULED AUTOS AUTOS PSA0001996 3/5/2016 3/5/2017 BODILY INJURY (Per accident)  
-ANY AUTO BODILY INJURY (Per person) $ A -ALL OWNED -SCHEDULED AUTOS AUTOS PSA0001996 3/5/2016 3/5/2017 BODILY INJURY (Per accident)  
$ --NON-OWNED PROPERTY DAMAGE x HIRED AUTOS x AUTOS IPer accidentl  
$ --NON-OWNED PROPERTY DAMAGE x HIRED AUTOS x AUTOS IPer accidentl  
Line 171: Line 132:
-A EXCESS LIAB CLAIMS-MADE AGGREGATE  
-A EXCESS LIAB CLAIMS-MADE AGGREGATE  
$ 5 000 000 OED I x I RETENTION$
$ 5 000 000 OED I x I RETENTION$
10 000 PSE0003023 5/1/2016 5/1/2017  
10 000 PSE0003023 5/1/2016 5/1/2017 $ WORKERS COMPENSATION x I I I OTH-AND EMPLOYERS' LIABILITY ER YIN ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1 000 000 OFFICER/MEMBER EXCLUDED?
$ WORKERS COMPENSATION x I I I OTH-AND EMPLOYERS' LIABILITY ER YIN ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT  
N/A A (Mandatory in NH) PSW0001923 5/1/2016 5/1/2017 E.L. DISEASE -EA EMPLOYEE $ 1 000 000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1 000 000 B Professional Liability DPL-4987-15 12/31/2015 12/31/2016 Per Claim 2,000,000 Aggregate 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remall<s Schedule, may be atached if more spaceis required)
$ 1 000 000 OFFICER/MEMBER EXCLUDED?
N/A A (Mandatory in NH) PSW0001923 5/1/2016 5/1/2017 E.L. DISEASE -EA EMPLOYEE  
$ 1 000 000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1 000 000 B Professional Liability DPL-4987-15 12/31/2015 12/31/2016 Per Claim 2,000,000 Aggregate 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remall<s  
: Schedule, may be atached if more spaceis required)
The County of Ontario is an additional insured for the general liability only in regards to services provided by the insured to the entity when required by executed written contract.
The County of Ontario is an additional insured for the general liability only in regards to services provided by the insured to the entity when required by executed written contract.
CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE R.E. Ginna Nuclear Power Plant THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1503 Lake Road ACCORDANCE WITH THE POLICY PROVISIONS.  
CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE R.E. Ginna Nuclear Power Plant THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1503 Lake Road ACCORDANCE WITH THE POLICY PROVISIONS.
: Ontario, NY 14519 AUTHORIZED REPRESENTATIVE c Alderson/HWITTM c--:_I-*-
Ontario, NY 14519 AUTHORIZED REPRESENTATIVE c Alderson/HWITTM c--:_I-*--....... ...-.! 6 ... __ ..... HH**< &#xa9; 1988-2014 ACORD CORPORATION.
-....... ...-.! 6 ... __ ..... HH**< &#xa9; 1988-2014 ACORD CORPORATION.
All rights reserved.
All rights reserved.
ACORD 25 (2014/01)
ACORD 25 (2014/01)

Revision as of 12:41, 8 July 2018

Re Ginna Nuclear Power Plant, LLC - Certificate of Liability Insurance
ML16118A288
Person / Time
Site: Ginna Constellation icon.png
Issue date: 03/17/2016
From: Alderson C
Acord Corporation, Promark Associated Agencies
To:
Document Control Desk, Office of Nuclear Reactor Regulation
References
Download: ML16118A288 (3)


Text

ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE (MM'DD/YYYY) 3/17/2016 THIS CERTIFICATE IS ISSUED AS A MATTER 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 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 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 Jennifer Dissette Premark Associated Agencies, Inc.

i:vt1* (716) 633-8401 I Nol: (716) 633-8429 6470 Main St., Ste #2 jdissette@promarkinsurance.com PO Box 530 INSURER(S)

AFFORDING COVERAGE NAIC# Williamsville NY 14231-0530 INSURER A :RLI Insurance Companv -A&E 13056 INSURED INSURER B One Beacon Insurance Companv 21970 MRB Group INSURER C: 145 Culver Road, Suite 160 INSURER D: INSURER E: Rochester NY 14620 INSURER F: COVERAGES CERTIFICATE NUMBER;CL1631703524 REVISION NUMBER: 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 POLICY EFF LTR TYPE OF INSURANCE 1*0Cn 1m1n POLICY NUMBER IMM/DD/YYYYI LIMITS x COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE

$ 1,000,000

-D CLAIMS-MADE

[i] OCCUR DAMAGE TO RENTED A PREMISES IEa occurrence\

$ 1,000,000

-PSB0003207 5/1/2016 5/1/2017 MED EXP (Any one person) $ 10,000 -PERSONAL & ADV INJURY $ 1,000,000

-GEN'LAGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE

$ 2,000,000 R 0PRO-DLOC PRODUCTS -COMP/OP AGG $ 2,000,000 POLICY JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 rEa accident\

-ANY AUTO BODILY INJURY (Per person) $ A -ALL OWNED -SCHEDULED AUTOS AUTOS PSA0001996 3/5/2016 3/5/2017 BODILY INJURY (Per accident)

$ --NON-OWNED x HIRED AUTOS x AUTOS $ --$ x UMBRELLA LIAB M OCCUR EACH OCCURRENCE

$ 5 000 000 -A EXCESS LIAB CLAIMS-MADE AGGREGATE

$ 5 000 000 OED I x I RETENTION$

10 000 PSE0003023 5/1/2016 5/1/2017 $ WORKERS COMPENSATION x I I I OTH-AND EMPLOYERS' LIABILITY ER YIN ANY PROPRIETOR/PARTNER/EXECUTIVE 0 E.L. EACH ACCIDENT $ 1 000 000 OFFICER/MEMBER EXCLUDED?

N/A A (Mandatory in NH) PSW0001923 5/1/2016 5/1/2017 E.L. DISEASE -EA EMPLOYEE $ 1 000 000 I below E.L. DISEASE -POUCY LIMIT $ 1 000 000 B Professional Liability DPL-4987-15 12/31/2015 12/31/2016 Per Claim 2,000,000 Aggregate 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be atached if more spaceis required)

Holder is an additional insured for the general liability only in regards toservices provided by the insured to the entity when required by executed written contract.

Professional Liability limits shown are per claim and aggregate for all projects of the named insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE RE Ginna Nuclear Power THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Plant, LLC ACCORDANCE WITH THE POLICY PROVISIONS.

750 East Pratt Street Baltimore, MD 21202 AUTHORIZED REPRESENTATIVE c Alderson/HWITTM

..-..I

_ _, .........

© 1988-2014 ACORD CORPORATION.

All rights reserved.

ACORD 25 (2014/01)

INS025 r?o14011 The ACORD name and logo are registered marks of ACORD ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDD/YYYY)

"'---" 3/17/2016 THIS CERTIFICATE IS ISSUED AS A MATTER 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 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 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 Jennifer Dissette Premark Associated Agencies, Inc.

Cv+I* (716) 633-8401 I Nol: (716) 633-8429 6470 Main St., Ste #2 jdissette@promarkinsurance.com PO Box 530 INSURER!Sl AFFORDING COVERAGE NAIC# Williamsville NY 14231-0530 INSURER A :RLI Insurance Comoanv -A&E 13056 INSURED INSURER B One Beacon Insurance Comoany 21970 MRB Group INSURERC:

145 Culver Road, Suite 160 INSURER D: INSURER E: Rochester NY 14620 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1631703524 REVISION NUMBER: 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 TYPE OF INSURANCE

SUBR I POLICY EFF LIMITS LTR \Af\fn POLICY NUMBER MMIDD/YYYYl x COMMERaAL GENERAL LIABILITY EACH OCCURRENCE

$ 1,000,000 A I CLAIMS-MADE

[iJ OCCUR DAMAGE TO RENTED PREMISES !Ea occurrencel

$ 1,000,000 PSB0003207 5/1/2016 5/1/2017 MED EXP (Any one person) $ 10,000 -PERSONAL & ADV INJURY* $ 1,000,000

-GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE

$ 2,000,000

=i 0 PRO-DLoc PRODUCTS -COMP/OP AGG $ 2,000,000 POLICY JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident\

-ANY AUTO BODILY INJURY (Per person) $ A -ALL OWNED -SCHEDULED AUTOS AUTOS PSA0001996 3/5/2016 3/5/2017 BODILY INJURY (Per accident)

$ --NON-OWNED PROPERTY DAMAGE x HIRED AUTOS x AUTOS IPer accidentl

$ --$ x UMBRELLA LIAB M OCCUR EACH OCCURRENCE

$ 5,000,000

-A EXCESS LIAB CLAIMS-MADE AGGREGATE

$ 5 000 000 OED I x I RETENTION$

10 000 PSE0003023 5/1/2016 5/1/2017 $ WORKERS COMPENSATION x I I I OTH-AND EMPLOYERS' LIABILITY ER YIN ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1 000 000 OFFICER/MEMBER EXCLUDED?

N/A A (Mandatory in NH) PSW0001923 5/1/2016 5/1/2017 E.L. DISEASE -EA EMPLOYEE $ 1 000 000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1 000 000 B Professional Liability DPL-4987-15 12/31/2015 12/31/2016 Per Claim 2,000,000 Aggregate 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remall<s Schedule, may be atached if more spaceis required)

The County of Ontario is an additional insured for the general liability only in regards to services provided by the insured to the entity when required by executed written contract.

CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE R.E. Ginna Nuclear Power Plant THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1503 Lake Road ACCORDANCE WITH THE POLICY PROVISIONS.

Ontario, NY 14519 AUTHORIZED REPRESENTATIVE c Alderson/HWITTM c--:_I-*--....... ...-.! 6 ... __ ..... HH**< © 1988-2014 ACORD CORPORATION.

All rights reserved.

ACORD 25 (2014/01)

INS0251?014011 The ACORD name and logo are registered marks of ACORD '

Promark Agencies 64 70 Main Street Suite 2 P.O.Box530 Williamsville, New York 14231-0530

  • ., -..

BM! Ji. L "'

ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE (MM'DD/YYYY) 3/17/2016 THIS CERTIFICATE IS ISSUED AS A MATTER 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 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 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 Jennifer Dissette Premark Associated Agencies, Inc.

i:vt1* (716) 633-8401 I Nol: (716) 633-8429 6470 Main St., Ste #2 jdissette@promarkinsurance.com PO Box 530 INSURER(S)

AFFORDING COVERAGE NAIC# Williamsville NY 14231-0530 INSURER A :RLI Insurance Companv -A&E 13056 INSURED INSURER B One Beacon Insurance Companv 21970 MRB Group INSURER C: 145 Culver Road, Suite 160 INSURER D: INSURER E: Rochester NY 14620 INSURER F: COVERAGES CERTIFICATE NUMBER;CL1631703524 REVISION NUMBER: 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 POLICY EFF LTR TYPE OF INSURANCE 1*0Cn 1m1n POLICY NUMBER IMM/DD/YYYYI LIMITS x COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE

$ 1,000,000

-D CLAIMS-MADE

[i] OCCUR DAMAGE TO RENTED A PREMISES IEa occurrence\

$ 1,000,000

-PSB0003207 5/1/2016 5/1/2017 MED EXP (Any one person) $ 10,000 -PERSONAL & ADV INJURY $ 1,000,000

-GEN'LAGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE

$ 2,000,000 R 0PRO-DLOC PRODUCTS -COMP/OP AGG $ 2,000,000 POLICY JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 rEa accident\

-ANY AUTO BODILY INJURY (Per person) $ A -ALL OWNED -SCHEDULED AUTOS AUTOS PSA0001996 3/5/2016 3/5/2017 BODILY INJURY (Per accident)

$ --NON-OWNED x HIRED AUTOS x AUTOS $ --$ x UMBRELLA LIAB M OCCUR EACH OCCURRENCE

$ 5 000 000 -A EXCESS LIAB CLAIMS-MADE AGGREGATE

$ 5 000 000 OED I x I RETENTION$

10 000 PSE0003023 5/1/2016 5/1/2017 $ WORKERS COMPENSATION x I I I OTH-AND EMPLOYERS' LIABILITY ER YIN ANY PROPRIETOR/PARTNER/EXECUTIVE 0 E.L. EACH ACCIDENT $ 1 000 000 OFFICER/MEMBER EXCLUDED?

N/A A (Mandatory in NH) PSW0001923 5/1/2016 5/1/2017 E.L. DISEASE -EA EMPLOYEE $ 1 000 000 I below E.L. DISEASE -POUCY LIMIT $ 1 000 000 B Professional Liability DPL-4987-15 12/31/2015 12/31/2016 Per Claim 2,000,000 Aggregate 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be atached if more spaceis required)

Holder is an additional insured for the general liability only in regards toservices provided by the insured to the entity when required by executed written contract.

Professional Liability limits shown are per claim and aggregate for all projects of the named insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE RE Ginna Nuclear Power THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Plant, LLC ACCORDANCE WITH THE POLICY PROVISIONS.

750 East Pratt Street Baltimore, MD 21202 AUTHORIZED REPRESENTATIVE c Alderson/HWITTM

..-..I

_ _, .........

© 1988-2014 ACORD CORPORATION.

All rights reserved.

ACORD 25 (2014/01)

INS025 r?o14011 The ACORD name and logo are registered marks of ACORD ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDD/YYYY)

"'---" 3/17/2016 THIS CERTIFICATE IS ISSUED AS A MATTER 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 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 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 Jennifer Dissette Premark Associated Agencies, Inc.

Cv+I* (716) 633-8401 I Nol: (716) 633-8429 6470 Main St., Ste #2 jdissette@promarkinsurance.com PO Box 530 INSURER!Sl AFFORDING COVERAGE NAIC# Williamsville NY 14231-0530 INSURER A :RLI Insurance Comoanv -A&E 13056 INSURED INSURER B One Beacon Insurance Comoany 21970 MRB Group INSURERC:

145 Culver Road, Suite 160 INSURER D: INSURER E: Rochester NY 14620 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1631703524 REVISION NUMBER: 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 TYPE OF INSURANCE

SUBR I POLICY EFF LIMITS LTR \Af\fn POLICY NUMBER MMIDD/YYYYl x COMMERaAL GENERAL LIABILITY EACH OCCURRENCE

$ 1,000,000 A I CLAIMS-MADE

[iJ OCCUR DAMAGE TO RENTED PREMISES !Ea occurrencel

$ 1,000,000 PSB0003207 5/1/2016 5/1/2017 MED EXP (Any one person) $ 10,000 -PERSONAL & ADV INJURY* $ 1,000,000

-GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE

$ 2,000,000

=i 0 PRO-DLoc PRODUCTS -COMP/OP AGG $ 2,000,000 POLICY JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident\

-ANY AUTO BODILY INJURY (Per person) $ A -ALL OWNED -SCHEDULED AUTOS AUTOS PSA0001996 3/5/2016 3/5/2017 BODILY INJURY (Per accident)

$ --NON-OWNED PROPERTY DAMAGE x HIRED AUTOS x AUTOS IPer accidentl

$ --$ x UMBRELLA LIAB M OCCUR EACH OCCURRENCE

$ 5,000,000

-A EXCESS LIAB CLAIMS-MADE AGGREGATE

$ 5 000 000 OED I x I RETENTION$

10 000 PSE0003023 5/1/2016 5/1/2017 $ WORKERS COMPENSATION x I I I OTH-AND EMPLOYERS' LIABILITY ER YIN ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1 000 000 OFFICER/MEMBER EXCLUDED?

N/A A (Mandatory in NH) PSW0001923 5/1/2016 5/1/2017 E.L. DISEASE -EA EMPLOYEE $ 1 000 000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1 000 000 B Professional Liability DPL-4987-15 12/31/2015 12/31/2016 Per Claim 2,000,000 Aggregate 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remall<s Schedule, may be atached if more spaceis required)

The County of Ontario is an additional insured for the general liability only in regards to services provided by the insured to the entity when required by executed written contract.

CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE R.E. Ginna Nuclear Power Plant THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1503 Lake Road ACCORDANCE WITH THE POLICY PROVISIONS.

Ontario, NY 14519 AUTHORIZED REPRESENTATIVE c Alderson/HWITTM c--:_I-*--....... ...-.! 6 ... __ ..... HH**< © 1988-2014 ACORD CORPORATION.

All rights reserved.

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