ML15260A557

Certificate of Liability Insurance

ML15260A557
Person / Time
Site:	Saint Lucie, Point Beach, Seabrook, Turkey Point, Duane Arnold
Issue date:	08/28/2015
From:	Marsh USA
To:	Office of Nuclear Reactor Regulation
References
Download: ML15260A557 (4)

Text

ACO9RD CERTIFICATE OF LIABILITY INSURANCE SDATE (MM/DD/YYYY) 08/28/2015 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 endorsementls).

PRODUCER CONTACT MARSHUSAINC.NAME:

MRHUAIN.PHONE FAXC TWO ALLIANCE CENTER

• Ac o

x A/C, No):

3560 LENOX ROAD, SUITE 2400 E-MAIL ATLANTA, GA 30326 ADDRESS:

INSURER(S) AFFORDING COVERAGE NAIC #I 7131 70-NUCLE-15-16 INSURER A : American Nuclear Insurers INSURED ENRY N.INSURER B :*"

JACUMBA SOLAR, INC.

INSURER C :

700 UNIVERSE BLVD INSURER D :

P.O. BOX 14000 JUNO BEACH, FL 33408 INSURER E :..

INSURER F: :_____

COVERAGES CERTIFICATE NUMBER:

ATL-003406479-06 REVISION NUMBER:6 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:.*.

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-lE CI IP t'L I If (ICC I flhITC C*L'fIAILIl AAAV UA\\IC DCCkl DcrnI IPCrCf DV DAmn (I AIIACO..

INSR ADOL SUBH POLICY EFF POLICY EXP LTRn_

TYPE OF INSURANCE INS V

POLICY NUMBER IMMIDD/YYYYI (MMIDD/YYYYI LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE m

DAMAGE TO RENTED CLAIMS-MADE LjOCCUR PREMISES lEa occurrence)

_______________________MED EXP (Any one person)

____________________PERSONAL

& ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER:

GENERAL AGGREGATE POLICY JEcOT

~

LO PRODUCTS -COMP/OP AGG $

OTHER:

AUTOMOBILE LIABIUTY COMBINED SINGLE LIMIT (Ee accidentl ANY AUTO BODILY INJURY (Per person)

ALL OWNIED SCHEDULED BODILY INJURY (Per accident)

__AUTOS

__AUTOS NON-OWNED PROPERTY DAMAGE

__HIRED AUTOS

__AUTOS (Per accidentl UMBRELLA UAB OCCUR EACH OCCURRENCE S

EXCESS LgAB I

CLAIMS-MADE AGGREGATE DEDI RETENTION $_____

WORKERS COMPENSATION PER 0H AND EMPLOYERS' LIABILITY Y IN ER ANY PROPRIETORJPARTNERIEXECUTIVE F1 E.L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED?

N IA A________

(Mandatory in NH)

E.L. DISEASE - EA EMPLOYEE $

If yes, describe under D)ESCRIPTION OF OPERATIONS below

___________E.L.

DISEASE - POLICY LIMIT ANUCLEAR ENERGY LIABILITY SEE ATTACHED 01/01/2015 0J1/01/2016 SEE ATTACHED ACORD 101 DESCRIPTION OF OPERATIONS I LOCATIONS/IVEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It 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 ACCORDANCE WITH THE POLICY PROVISIONS.

AUTHORIZED REPRESENTATIVE of Marsh USA Inc.

Manashi Mukherjee K*&I.Le,*.AAd-e, ACORD 25 (2014101)

© 1988-2014 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORD

• ,00 I-

AGENCY CUSTOMER ID: 713170 LOC #: Atlanta ACORD ADDITIONAL REMARKS SCHEDULE Page 2 of 3

AGENCY NAMED INSURED MARSH USA, INC.

NEXTERA ENERGY, INC.

JACUMBA SOLAR, INC.

POLICY NUMBER 700 UNIVERSE BLVD P.O. BOX 14000 JUNO BEACH, FL 33408 CARRIER NAIC CODE L

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 dale of this Certificate a Nuclear Energy Liability Insurance Policy issued by members of American Nuclear Insurers as indicated (Companies), to the Insured~narned herein, with respect to the Nuclear Facility at the Location shown and/or with respect to the Insured's operations described herein, If such policy is cancelled or otherwise terminated prior to the end of December 31s1 of the calendar year in which the Effective Date ot 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 31sf..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 - (Fore~jn Suppliers & Transporters],:

COVERAGE FOR NUCLEAR FACILITIES:"'

1. SITE #1 - ST. LUClE LOCATION OF NUCLEAR FACILITY: St. Lucie Nuclear Power Plant on Hutchinson Island, St. Lucie County, Florida NAMED INSURED [LISTED ON POLICY[: Florida Power & Light Company, Florida Municipal Power Agency, and Orlando Utilities Commission of the City of Oriando POLICY NUMBER:

POLICY EFFECTIVE:

LIMIT OF LIABILITY:

NF-0227 06/01/1974

$375 Million NW-0604 06/01/1974

$375 Million'*

2. SITE #2 - TURKEY POINT LOCATION OF NUCLEAR FACILITY: Turkey Point Nuclear Power Plant in the Southeast part of Dade County, Florida NAMED INSURED [LISTED ON POLICY]: Florida Power & Light Company POLICY NUMBER:

POLICY EFFECTIVE:

LIMIT OF LIABILITY:

NF-0185 06/01/I1970

$375 Million NW-0570 06/01/1970

$375 Million**

3. SITE #3 -SEABROOK LOCATION OF NUCLEAR FACILITY: Seabrook Nuclear Power Plant in Seabrook Township, Rockingham County, New Hampshire NAMED INSURED [LISTED ON POLICY]: NextEra Energy Seabirook, LLC; Massachusetts Municipal Wholesale Electric company; Taunton Municipal Light Plant; and Hudson Light and Power Department POLICY NUMBER:

POLICY EFFECTIVE:

LIMIT OF LIABILITY:

NF-0296 12/15/1985

$375 Million NW-0647 12/15/1985

$375 Million"

4. SITE #4 - DUANE ARNOLD LOCATION OF NUCLEAR FACILITY: Duane Arnold Nuclear Power Plant on the Cedar River approx 2 and 1/3 Miles NNE of Palo, Iowa NAMED INSURED [LISTED ON POLICY]: NeutEra Eneigy Duane Arnold, LLC, Central Iowa Power Cooperative and Corn Belt Power Cooperative POLICY NUMBER:

POLICY EFFECTIVE:

LIMIT OF LIABILITY:

N F-0214 05115/1 973

$375 Million NW-0593 05/1 5/1 973

$375 Million *

5. SITE #5 - POINT BEACH LOCATION OP NUCLEAR FACILITY: Point Beach Nuclear Power Plant in the Town of Two Creeks, Manilowoc County, Wisconsin NAMED INSURED (LISTED ON POLICY]: NextEra Energy Point Beach, LLC POLICY NUMBER:

POLICY EFFECTIVE:

LIMIT OF LIABILITY:

NF-0178 08/12/1969

$375 Million NW-0565 08/12/1969

$375 Million'*

ACORD 101 (2008101)

© 2008 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORD

AGENCY CUSTOMER ID: 713170 LOC #:

Atlanta ACORD ADDITIONAL REMARKS SCHEDULE Page 3

of3 AGENCY NAMED INSURED MARSH USA, INC.

NEXTERA ENERGY, INC.

__________________________________________________JACUMBA SOLAR, INC.

POLICY NUMBER 700 UNIVERSE BLVD P.O. BOX 14000 JUNO BEACH, FL 33408 CARRIER NAIC CODE J.

EFFECTIVE DATE:

ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:

25 FORM TITLE: Certificate of Liability Insurance COVERAGE FOR SUPPLIER'S & TRANSPORTER'S:

6. US DOMESTIC S&T DESCRIPTION OF OPERATIONS; Furnishing of services, materials, parts or equipment in connection with the planning, construction, maintenance, involving the handling, storage, shipment, use or disposal of spec.ified types of nuclear materials.

'i'*

NAMED INSURED [LISTED ON POLICY]: NextEra Energy, Inc.

POLICY NUMBER:

POLICY EFFECTIVE:

LIMIT OF LIABILITY:"-'."

N S-0308 1011511975

$300 Million THiS CERTIFICATE iS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.

The insurance afforded by the peticylies) is nubjecl 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 aftorded 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 reterence thereto. Such limit may have been reduced by payment of claims or claims expenses.

ACORD 101 (2008101)

© 2008 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORD

0 0 03 209 SP 0422

-C01 -P03210-i Document Control Desk U.S. Nuclear Regulatory Commission Washington, DC 20555