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Text

Certificate of Liability Insurance
	ML16053A093
Person / Time
Site:	Oconee, Mcguire, Catawba, Harris, Brunswick, Crystal River, Robinson, McGuire, Levy County, Lee
Issue date:	02/01/2016
From:	Burke K A; Marsh USA
To:	; Document Control Desk, Office of New Reactors, Office of Nuclear Reactor Regulation
References
	Download: ML16053A093 (5)
	v • d • e

§bo-- qi!S 3Th 0 001 7 21 SP 0053 -C01-P01721-1 Document Control Desk U.S. Nuclear Regulatory Commission Washington, DC 20555-0001 Sip- f-Jt9 g5-Z--- )ob3L 5-z &(2 of?

ACO9RD CERTIFICATE OF LIABILITY INSURANCE S DATE (MM/DD/YYYY) 02101/2016 THIS CERTIFICATE IS 1SSUED 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 CONTACT Marsh USA Inc. NAME: PHONE FAX 100 North Tryon Street, Suite 3600 (AC, o Ext): (A/C, No): Charlotte, NC 28202 E-MA!L AFFORDING COVERAGE NAIC #22830 -0NE-1/1-16-17 INSURER A : American Nuclear Insurers INUEDuke Energy Corporation INSURER B : ATTN: Ed Adams INSURER C: ______ed.adams~duke-energy.com INSURER D : 550 S. Tryon Street DEC40-C INSURER E: :_____Charlotte, NC 28202 :INSURER F: _______COVERAGES CERTIFICATE NUMBER: ATL-003526555-06 REVISION NUMBER: 17 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 POLICY EXP LTR .TYPE OF INSURANCE INDWDPOLICY NUMBER 'MMIDD/YYYYI (MMIDDIYYYY)

LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE

$F7 DAMAGE TO RENTED SLAM-AE OCCUR PREMISES (Ea occurrencel

__________________________MED EXP (Any one person) $_____________________PERSONAL

& ADV INJURY ,$GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE

$POLICY JECT PRO LOC PRODUCTS -COMP/OP AGO $__OTHER: $AUTOMBILELIABLITYCOMBINED SINGLE LIMIT $AUOOIELIBLT Ea accident)

$____________

ANY AUTO BODILY INJURY (Per person) $--ALL OWNED BODILY INJURY (Per acciden) i$__AUTOS NON-OWNED PROPERTY DAMAGE $__HIRED AUTOS AUTOS (Per accidentl

$_________

$__UMBRELLA LIAB OCCUR EACH OCCURRENCE

$EXCESS LIAB ICLAIMS-MADE AGGREGATE

$DEDI RETENTIONs

$____ $WORKERS COMPENSATION IPERSTTT 0 TH-E AND EMPLOYERS' LIABILITY Y/N E _______ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $OFFICER/MEMBER EXCLUDED? /A (Mandatory in NH) E.L. DISEASE -EA EMPLOYEE $If yes, describe under DESCRIPTION OF OPERATIONS below ______E.L.

DISEASE -POLICY LIMIT $A Nuclear Energy Liability SEE ATTACHED 01/01/2016 01/01/2017 SEE ATTACHED DESCRIPTION OF OPERATIONS

/ LOCATIONS

/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)CERTIFICATE HOLDER CANCELLATION Document Control Desk SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE U.S. Nuclear Regulatory Commission THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Washington, DC 20555-0001 ACCORDANCE WITH THE POLICY PROVISIONS.

AGENCY CUSTOMER ID: 22830 LOC #: Charlotte ACORD ADDITIONAL REMARKS SCHEDULE Page 2 of4 AGENCY TNAMED I NSURED Marsh USA Inc. I Duke Energy Corporation

________________________________________________ATTN:

Ed Adams POLIY NUBERed.adams@duke-energy.com POLIY NUBER550 S. Tryon Street DEC40-C C3ARRIER NAIC CODE Charlotte, NC 28202 jEFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, SFORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance CERTIFICATE OF NUCLEAR ENERGY INSURANCE This is to certify that there is in force as of the ettective date of this Certificate a Nuclear Energy Liability Insurance Policy issued hy members of American Nuclear Insurers as indicated (Companies), to the Insured named herein, with respect to the Nuclear Facility at the Location shown and/or with respect to the Insured's operations described herein. If such policy is cancelled or otherwise terminated prior to the end of December 31st of the calendar year in which the Effective Date of this Certificate occurs, notice will be delivered in accordance with the policy provisions.

Otherwise this Certificate shall terminate as of the end of such December 31st. A Certificate mill NOT be issued for any subsequent calendar year unless requested in writing.Types of Insurance:

NF -[Facility Form], NW- [Master Worker Certificate], NS -[US Domestic Supplier's

& Transporters], FS -[Foreign Suppliers

& Transporters], N- [Secondary Financial Protection Certificate]

COVERAGE FOR NUCLEAR FACILITIES:

1. SITE #1 -CATAWBA LOCATION OF NUCLEAR FACILITY:

Catawba Nuclear Power Plant la the NE portion of York County, SC NAMED INSURED [LISTED ON POLICY]: Duke Energy Carolinas, LLC POLICY NUMBER: POLICY EFFECTIVE:

LIMIT OF LIABILITY:

NF-0281 12/01/1983

$375 Million NW-0637 12/01/1983

$375 Million**N-0097 07/18/1984 N-0106 12/01/1983**

2. SITE #2 -MCGUIRE LOCATION.OF NUCLEAR FACILITY:

McGuire Nuclear Power Plant located 17 ml N/NW of Charlotte, NC NAMED INSURED [LISTED ON POLICY]: Duke Energy Carolinas, LLC POLICY NUMBER: POLICY EFFECTIVE:

LIMIT OF LIABILITY:

NF-0248 05/01/1977

$375 Million NW-0615 05/01/1977

$375.Mitlion**

N-0069 01/23/1981**

N-0092 03/03/1 983**3. SITE #3 -OCONEE LOCATION OF NUCLEAR FACILITY:

Oconee Nuclear Power Plant in Oconee County, South Carolina NAMED INSURED [LISTED ON POLICY]: Duke Energy Carolinas, LLC POLICY NUMBER: POLICY EFFECTIVE:

LIMIT OF LIABILITY:

N F-0182 03/01/1970

$375 Million NW-0569 03/01/1970

$375 Million**N-0022 08/01/1977 N-0023 08/01/1977**

N-0024 08/01/1977

4. SITE #4- BRUNSWICK LOCATION OF NUCLEAR FACILITY:

Brunswick Nuclear Power Plant 2.5 MI N ot Southport, NC NAMED INSURED [LISTED ON POLICY]: Duke Energy Progress, LLC POLICY NUMBER: POLICY EFFECTIVE:

LIMIT OF LIABILITY:

NF-0218 10/25/'1973

$375 Million NW-0597 10/25/1973

$375 Million**N-0054 08/01/1977**

All rights reserved.The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 22830 LOC #: Charlotte ACORflD ADDITIONAL REMARKS SCHEDULE Page 3 of 4 AGENCY NAMED INSURED Marsh USA Inc. Duke Energy Corporation

_____________________________________________________ATTN:

Ed Adams POLICY NUMBER ed~adams@duke-energy.com 550 S. Tryon Street DEC40-C CARRIER /NAIC CODE Charlotte, NC 28202 EFFECTIVE DATE: ADDITIONAL REMARKS fTHIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability insurance 5. SITE #5 -CRYSTAL RIVER LOCATION OF NUCLEAR FACILITY:

Crystal Riser Nuclear Power Plant 7.5 MI NW of Crystal River, Citrus County, FL NAMED INSURED [LISTED ON POLICY]: Duke Energy Florida, Inc.; Seminole Electric Cooperative, Inc.; Orlando Utilities Commission and City of Orlando; City of Gainesville, Florida; City of Ocala; City of Leesburg, Florida; City of tKissimmee, Florida, A Municipal Corporation; City of New Smyrna Beach, Florida and Utilities Commission of New Smyrna Beach, Florida; City oftAlachua, Florida; The City of Bushnell; Florida Progress Corporation POLICY NUMBER: POLICY EFFECTIVE:

LIMIT OF LIABILITY:

NF-0195 07/01/1 971 $375 Million NW-057g 07/01/1 971 $375 MiIlion**6. SITE #6 -SHEARON HARRIS LOCATION OF NUCLEAR FACILITY:

Shearon Harris Nuclear Power Plant 20 Ml SW of Raleigh, NC NAMED INSURED [LISTED ON POLICY]: Duke Energy Progress, Inc.POLICY NUMBER: POLICY EFFECTIVE:

LIMIT OF LIABILITY:

NF-0288 06/01/1984

$375 Million NW-0642 06/01/1984

$375 Million**N-0112 10/24/1986**

7. SITE #7 -H. B. ROBINSON LOCATION OF NUCLEAR FACILITY:

H.B. Robinson Nuclear Power Plant 5 Ml WNW from Hartsville, SC NAMED INSURED [LISTED ON POLICY]: Duke Energy Progress, Inc.POLICY NUMBER: POLICY EFFECTIVE:

LIMIT OF LIABILITY:

N F-0180 10/1 5/1 969 $375 Million NW-0567 10/15/1969

$375 Million**N-0021 08/01/1977**

8. SITE #8 -LEVY LOCATION OF NUCLEAR FACILITY:

Levy Nuclear Plant 39 MI SW of Gainsville, FL NAMED iNSURED [LISTED ON POLICY]: Duke Energy Florida, Inc.POLICY NUMBER: POLICY EFFECTIVE:

NF -0354 01/01/2015 LIMIT OF LIABILITY:

$1 Million 9. SITE #9 -LEE LOCATION OF NUCLEAR FACILITY:

Lee Nuclear Site 6 MI S of Blacksburg, SC NAMED INSURED [LISTED ON POLICY]: Duke Energy Carolinas, LLC POLICY NUMBER: POLICY EFFECTIVE:

LIMIT OF LiABILITY:

NF-0355 1/1/12016

$1 Million THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.Thieinsurance afforded by the policy(ies) issubject to he exclusions, conditions and other provisionsof the policy(ies).

Neither this Certificate nor any contract or other document with respect to which it is issued shall amend, estend or alter the coverage afforded by the policy. The Umit of Liability shown above may have been reduced by payment of claims or claims expenses.COMMENTS/NOTES:

All rights reserved.The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 22830 LOC #: Charlotte ACO1RD ADDITIONAL REMARKS SCHEDULE Page 4 *of 4.AGENCY NAMED INSURED Marsh USA Inc. Duke Energy Corporation

_____________________________________________

ATTN: Ed Adams POLICY NUMBER ed.adams@duke-energy.com 550 S. Tryon Street DEC40-C CARRIER NAiC CODE Charlotte, NC 28202*EFFECTIVE DATE: ADDITIONAL REMARKS[THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CertifiCate of Liability Insurance**Master Worker Certifcate

-This limit is shared hy att 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 ot claims or claims expenses.**Secondary Financial Protection Certificate

-Financial protection available snder an industry retrospechive rating plan.9. SITE #9 -LEE LOCATION OF NUCLEAR FACILITY:

Lee Nuclear Site 6 MI S ot Blacksburg, SC NAMED INSURED [LISTED ON POLICY]: Duke Energy Carolinas, LLC POLICY NUMBER: POLICY EFFECTIVE: