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Agenda 05/12/2015 Item #16E2EXECUTIVE SUMMARY Recommendation to ratify Property, Casualty, Workers’ Compensation and Subrogation claim files settled and/or closed by the Risk Management Division Director pursuant to Resolution # 2004-15 for the second quarter of FY 15. OBJECTIVE : To gain approval from the Board of Commissioners for Property, Casualty, Workers’ Compensation and Subrogation claims settled and/or closed under the authority of the Risk Management Director during the second quarter of FY 15. CONSIDERATIONS : Resolution 04-15 grants limited authority to the Risk Management Director to settle certain damage claims against Collier County and to authorize the payment of investigation and adjustment expenses as presented to the County’s Risk Management Program. Authority is delegated as follows: Claim Type Delegated Authority Bodily Injury Liability- Premises, Auto, Operations Non-litigated claims less than $50,000 Property Damage Liability Claims- Premises, Auto, Operations Non-litigated claims less than $75,000. (Note- A $75,000 limit is sought due to high valued vehicles and the potential for multiple vehicle accidents.) Errors, Omissions, Professional Liability, Employment Practices Liability Non-litigated claims less than $50,000 Property Losses to County Owned Property Full authority Workers’ Compensation Full authority subject to the provisions of F.S. 440 and subject to approval by the Judge of Compensation as needed Employer’s Liability Non-litigated claims less than $50,000 Subrogation- Bodily Injury and Property Damage Full authority to pursue non-litigated subrogation recoveries. Subrogation- Workers’ Compensation Full authority to pursue non-litigated subrogation recoveries. Pursuant to the Resolution, claims are settled and paid according to the loss verification procedures contained in the Resolution which include the completion of claim forms, documentation of evidence, valuation, and the determination of a finding of liability where applicable. Closed claim files are also subject to review by the external auditor. A listing of claim files closed during the second quarter of FY 15 is attached. The report may include claims and/or settlements previously approved by the Board of Commissioners. Packet Page -956- 5/12/2015 16.E.2. A valid public purpose is served through the delegation of settlement authority to the Risk Management Director to settle routine, administrative and minor claim matters in order to promote the efficient use of resources; to promote the efficient administration of the program; and to allow for a timely response to claimants and/or their representatives. FISCAL IMPACT : Funds are budgeted and available in Fund 516-121650-645920 (Property and Casualty Self Insurance Fund) and 518-121630-645928 (Workers’ Compensation Fund) for the payment of covered claims and settlements. For the second quarter of FY 2015, 56 files were closed with total expenditures of $73,543.23. During the same period, 38 subrogation files were closed and the Division recovered $123,270.25. GROWTH MANAGEMENT IMPACT : There is no growth management impact associated with this item. LEGAL CONSIDERATIONS: This item has been approved as to form and legality and requires majority vote for approval. -CMG RECOMMENDATION: That the Board of County Commissioners accepts the attached Settlement Report and ratifies the actions taken therein. PREPARED BY: Jeff Walker CPCU, ARM, Division Director, Risk Management Division. Attachments: 1) All Lines Closed Claim Report 2nd QTR FY 2015 2) Subrogation Closed Claim Report 2nd QTR FY 2015 3) Resolution 2004-15 Packet Page -957- 5/12/2015 16.E.2. COLLIER COUNTY Board of County Commissioners Item Number: 16.16.E.16.E.2. Item Summary: Recommendation to ratify Property, Casualty, Workers’ Compensation and Subrogation claim files settled and/or closed by the Risk Management Division Director pursuant to Resolution # 2004-15 for the second quarter of FY 15. Meeting Date: 5/12/2015 Prepared By Name: WalkerJeff Title: Division Director - Risk Management, Risk Management 4/20/2015 2:55:19 PM Submitted by Title: Division Director - Risk Management, Risk Management Name: WalkerJeff 4/20/2015 2:55:20 PM Approved By Name: GreeneColleen Title: Assistant County Attorney, CAO General Services Date: 4/21/2015 8:33:35 AM Name: PriceLen Title: Department Head - Administrative Svc, Administrative Services Department Date: 4/24/2015 3:51:35 PM Name: KimbleSherry Title: Management/Budget Analyst, Senior, Office of Management & Budget Date: 4/27/2015 10:25:50 AM Name: KlatzkowJeff Title: County Attorney, Date: 4/30/2015 9:03:22 AM Packet Page -958- 5/12/2015 16.E.2. Name: CasalanguidaNick Title: Deputy County Manager, County Managers Office Date: 4/30/2015 10:00:38 AM Packet Page -959- 5/12/2015 16.E.2. Med/BI/Comp Expense Ind/PD/Coll Recovery Deductible Legal Other Total Inc Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Date of Loss Date Report to Risk Status Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total Coverage Cause 174.60 0.00 0.00 0.00 0.00 0.00 0.00 174.60 2/4/2015 2/4/2015 2/19/2015 174.60 0.00 0.00 0.00 0.00 0.00 0.00 174.60 10 12001 244.83 27.75 0.00 0.00 0.00 0.00 0.00 272.58 1/30/2015 1/30/2015 2/ 5/2015 244.83 27.75 0.00 0.00 0.00 0.00 0.00 272.58 10 15001 239.92 0.00 0.00 0.00 0.00 0.00 0.00 239.92 2/13/2015 2/13/2015 2/27/2015 239.92 0.00 0.00 0.00 0.00 0.00 0.00 239.92 10 13001 0.00 13.75 0.00 0.00 0.00 0.00 0.00 13.75 12/9/2014 12/11/2014 1/30/2015 0.00 13.75 0.00 0.00 0.00 0.00 0.00 13.75 10 14001 142.20 0.00 0.00 0.00 0.00 0.00 0.00 142.20 2/20/2015 2/23/2015 3/ 9/2015 142.20 0.00 0.00 0.00 0.00 0.00 0.00 142.20 10 14001 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1/30/2015 2/2/2015 2/ 2/2015 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 10 18001 1001301503849 138911 Investigator responded to a grow house to investigate code violations within the home. At approximately 1pm he began to experience itching, redness and white bumps around the head and back of the head. Redness and itching continued for another 24 hours. 122240 Employee was rear ended while stopped in traffic by 3 seperate vehicles (chain reaction). 1002201503889 122410 Employee was making a u-turn in Asset #CC2-710 and was struck by another vehicle that failed to stop at the red light. 1002131503874 233312 Employee stumbled forward and straight armed a light pole, injuring his right shoulder. 1012091403750 155410 Veterinary Technician was restraining a dog for an injection. After the injection was administered by the Veterinarian, the dog became aggitated & was able to break free of the Vet. Tech's hold & bit her hands. (puncture wounds right and left hands). 1001301503846 144612 Employee suffered a neck injury when the stretcher she was moving a patient on collapsed and she tried to catch it with her right arm. Cost Center Carrier Employer Acc Desc. Major Coverage: 10 - Workers' Compensation 1002041503855 Collier County Government Closed Claim Report- All Lines 2nd QTR FY 2015 Valued as of:4/20/2015 Claim Number Employee Name Page 1 Pa c k e t P a g e - 9 6 0 - 5 / 1 2 / 2 0 1 5 1 6 . E . 2 . 3,103.55 276.15 0.00 0.00 0.00 0.00 0.00 3,379.70 11/5/2014 11/21/2014 3/19/2015 3,103.55 276.15 0.00 0.00 0.00 0.00 0.00 3,379.70 10 15001 961.80 140.00 0.00 0.00 0.00 0.00 0.00 1,101.80 12/16/2014 12/18/2014 1/22/2015 961.80 140.00 0.00 0.00 0.00 0.00 0.00 1,101.80 10 11001 73.71 13.75 0.00 0.00 0.00 0.00 0.00 87.46 2/24/2015 2/25/2015 3/31/2015 73.71 13.75 0.00 0.00 0.00 0.00 0.00 87.46 10 11001 228.60 0.00 0.00 0.00 0.00 0.00 0.00 228.60 1/28/2015 1/28/2015 2/13/2015 228.60 0.00 0.00 0.00 0.00 0.00 0.00 228.60 10 14001 13,664.00 9,014.10 14,012.84 0.00 0.00 0.00 0.00 36,690.94 9/12/2014 9/16/2014 1/21/2015 13,664.00 9,014.10 14,012.84 0.00 0.00 0.00 0.00 36,690.94 10 15001 185.40 14.00 0.00 0.00 0.00 0.00 0.00 199.40 1/17/2015 1/19/2015 1/22/2015 185.40 14.00 0.00 0.00 0.00 0.00 0.00 199.40 10 19001 185.40 14.00 0.00 0.00 0.00 0.00 0.00 199.40 1/17/2015 1/19/2015 1/22/2015 185.40 14.00 0.00 0.00 0.00 0.00 0.00 199.40 10 19001 242.10 0.00 0.00 0.00 0.00 0.00 0.00 242.10 1/30/2015 1/30/2015 2/ 5/2015 242.10 0.00 0.00 0.00 0.00 0.00 0.00 242.10 10 15001 93.60 38.75 0.00 0.00 0.00 0.00 0.00 132.35 2/13/2015 2/13/2015 2/18/2015 93.60 38.75 0.00 0.00 0.00 0.00 0.00 132.35 10 14001 1002131503876 144610 Employee was responding to an emergency incident in County asset #CC2-901 when it was struck on the passenger side by a vehicle driven by Ramona Winger. 144610 NCH Hospital called to advise of possible pertusis exposure to employee. 1001301503845 144610 Employee sprained her low back when the stretcher she was moving a patient on awkwardly moved & tilted. Employee states his back began to hurt on scene of a cardiac arrest at medic 22 on the morning of the 12th 1001171503815 144610 Patient with possible Pertusis coughed while in presence of EMS crew prior to notification of patient condition at Urgent Care Center. 1001171503814 156380 Employee was involved in a vehicle accident and is experiencing back pain. 1009121403575 144610 1002241503896 138931 Employee was pinned between two rolling files. 1001281503840 157460 Employee was working with another employee moving the tables and chairs in the lecture hall when she felt something "pop" in her right elbow. It felt kind of like a guitar string being plucked. 1012161403762 138931 Employee's foot became caught in a shelve that was rolled out by another employee. 1011051403710 Page 2 Pa c k e t P a g e - 9 6 1 - 5 / 1 2 / 2 0 1 5 1 6 . E . 2 . 28.55 0.00 0.00 0.00 0.00 0.00 0.00 28.55 3/9/2015 3/9/2015 3/11/2015 28.55 0.00 0.00 0.00 0.00 0.00 0.00 28.55 10 12001 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 3/23/2015 3/24/2015 3/25/2015 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 10 12001 5,955.73 611.39 0.00 0.00 0.00 0.00 0.00 6,567.12 8/29/2014 9/3/2014 1/ 8/2015 5,955.73 611.39 0.00 0.00 0.00 0.00 0.00 6,567.12 10 13001 25,523.99 10,163.64 14,012.84 0.00 0.00 0.00 0.00 49,700.47 25,523.99 10,163.64 14,012.84 0.00 0.00 0.00 0.00 49,700.47 Employee's left index finger was stuck by a nail from the bottom of a chair he was moving. 1008291403543 105010 Employee fell while descending an outdoor stairway and dislocated his left ring finger. Total by Major Coverage 18 Claims 156343 Employee was accidentally stuck in the left lower leg with a trash pick by another employee. 1003231503965 144610 1003091503927 Page 3 Pa c k e t P a g e - 9 6 2 - 5 / 1 2 / 2 0 1 5 1 6 . E . 2 . 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 8/26/2014 1/8/2015 2/25/2015 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 22 0.00 0.00 1,724.95 0.00 0.00 0.00 0.00 1,724.95 11/12/2014 11/13/2014 1/29/2015 0.00 0.00 1,724.95 0.00 0.00 0.00 0.00 1,724.95 22 20001 0.00 0.00 399.00 0.00 0.00 0.00 0.00 399.00 2/3/2015 2/4/2015 3/23/2015 0.00 0.00 399.00 0.00 0.00 0.00 0.00 399.00 22 20001 0.00 0.00 92.73 0.00 0.00 0.00 0.00 92.73 11/10/2014 11/17/2014 1/22/2015 0.00 0.00 92.73 0.00 0.00 0.00 0.00 92.73 22 21501 0.00 0.00 2,618.10 0.00 0.00 0.00 0.00 2,618.10 12/17/2014 12/17/2014 3/ 6/2015 0.00 0.00 2,618.10 0.00 0.00 0.00 0.00 2,618.10 22 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 2/10/2015 2/23/2015 3/30/2015 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 22 5900 Customer called a plumber first to clear a blockage. Plumber got his snake stuck in the County lateral. Plumber unstuck his snake in the County line and C&V crew viewed our lateral and found no issues on our side. 233351 Wastewater Collections responded to a reported backup at 11190 Health Park Blvd (North Collier Hospital). The customer reported that an sewer backup occurred on the property. 2202101503886 Kinnery, Steve 210116 2211101403698 LICATO, JOAN LIBE Claimant parked in a handicapped spot and the cement bumper rods were sticking up which damaged the underside of the vehicle. 2212171403759 North Collier Hospital 121811 On November 12, 2014 at approx. 5:05pm, the claimant exited the exterior garage parking (west side) when the garage arm dropped down onto the hood of her vehicle. The garage arm did cause dents and scratches to her vehicle. 2202031503853 KAISER, SANDY RMSE While machette mowing in our easement, debris flew and struck the window of a manufactured home at 1533 Gulf Coast Dr. Major Coverage: 20 - General Liability 2208261403791 Wisniewski, John UOSD Customer called and stated someone had run over their backflow device. They requested someone respond to the location. 2211121403693 Murray, Hollie Page 4 Pa c k e t P a g e - 9 6 3 - 5 / 1 2 / 2 0 1 5 1 6 . E . 2 . 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 10/16/2014 11/18/2014 2/ 5/2015 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 22 5100 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 9/1/2014 10/1/2014 3/13/2015 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 21 20501 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 12/22/2011 1/20/2012 2/ 5/2015 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 21 20001 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 7/14/2014 10/14/2014 1/27/2015 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 22 20001 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 7/11/2014 10/13/2014 1/23/2015 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 22 163620 Century Link alleges that Road Maintenance damaged a 100 pair buried cable & pedestal while mowing grass in the storm/drainage swale area of Jung Blvd. 8th St NE. Claimant (correctional officer) was driving a County vehicle & towing a chipper when he stopped for a traffic light and was rear- ended by another vehicle. 2207141403638 CENTURY LINK 163620 Century Link alleges Road Maintenance employees damaged a 600 pair copper cable and a 24 pair fiber optic cable while placing culverts in the area of Jung Blvd. off 8th and Randall. 2207111403636 CENTURY, LINK 163620 Sheryl Conway alleges that while riding her bicycle, the tires became caught between the storm drain and the sidewalk causing her to fall off the bike. 2112221101145 BRUCH, WALTER 163620 Customer called a plumber first to clear a blockage. Plumber got his snake stuck in the County lateral. Plumber unstuck his snake in the County line and C&V crew viewed our lateral and found no issues on our side. 2210161403701 SCHULTZ, EVERETT 182602 Customer had a line break and called a plumber. Plumber and customer were unable to find a shut off valve. They called and requested we come out. Crews responded and customer requested to reschedule. *Plumbing charges during our response time. 2109011403613 CONWAY, SHERYL Page 5 Pa c k e t P a g e - 9 6 4 - 5 / 1 2 / 2 0 1 5 1 6 . E . 2 . 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 9/19/2014 9/24/2014 1/15/2015 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 21 20501 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4/13/2014 11/18/2014 3/25/2015 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 21 20001 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 11/12/2014 12/9/2014 1/ 5/2015 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 22 5900 0.00 0.00 678.30 0.00 0.00 0.00 0.00 678.30 1/16/2015 1/16/2015 3/30/2015 0.00 0.00 678.30 0.00 0.00 0.00 0.00 678.30 22 20001 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 12/21/2013 12/27/2013 3/ 9/2015 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 21 20001 0.00 0.00 5,513.08 0.00 0.00 0.00 0.00 5,513.08 0.00 0.00 5,513.08 0.00 0.00 0.00 0.00 5,513.08 2112211302925 WALKER, DON 156314 Claimant was holding onto the new grab bar over the entrance to the slides that was installed by the company contracted to do repairs. The bar broke as he was using it and he hit his head on the ground when he fell. Total by Major Coverage 16 Claims 156390 Patron drove his car onto and over entrance median. Popping driver's side front and rear tires. 2201161503812 Roman, Samantha 156381 As employee was pulling into a parking space (in her private vehicle) she struck a large boulder in the space, scratching her lower spoiler on the right side. 2104131403702 OLIVER (ANDERSON), KRISTI 156393 Claimant sustained injuries after using a rope swing to jump into the water and allegedly struck a large rock under the water. 2211121403745 MAYER, JOHN 2109191403594 SOLIZ, YADIRA 156398 Claimant states she was walking at Eagle Lakes Park when she was frightened upon seeing a snake; tripped and fell, striking her head on the sidewalk. Page 6 Pa c k e t P a g e - 9 6 5 - 5 / 1 2 / 2 0 1 5 1 6 . E . 2 . 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 10/9/2014 11/5/2014 3/27/2015 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 32 0.00 0.00 1,187.36 0.00 0.00 0.00 0.00 1,187.36 12/3/2014 12/3/2014 3/27/2015 0.00 0.00 1,187.36 0.00 0.00 0.00 0.00 1,187.36 32 21501 0.00 0.00 1,476.00 0.00 0.00 0.00 0.00 1,476.00 11/29/2014 11/29/2014 3/19/2015 0.00 0.00 1,476.00 0.00 0.00 0.00 0.00 1,476.00 32 20001 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 2/27/2014 6/3/2014 1/15/2015 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 31 24501 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 11/21/2014 12/8/2014 2/17/2015 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 32 30004 0.00 0.00 2,663.36 0.00 0.00 0.00 0.00 2,663.36 0.00 0.00 2,663.36 0.00 0.00 0.00 0.00 2,663.36 138915 County employee was backing asset #CC2- 094 and the tailpipe scraped the front of the claimant's vehicle. Total by Major Coverage 5 Claims 3102271403300 VASQUEZ-ACOSTA, DAVID 144610 Claimant was involved in a multi-vehicle accident that included EMS Medic 70, Truck 18. Claimant's vehicle with damage to the rear and passenger side and was pushed into another vehicle in front. Claims bodily injury. 3211211403739 CALVERT, ROSELLA 155410 Employee was backing into a parking space & caught the bumper of asset #CC2-128 on a parked rental car, ripping off the bumper from the vehicle. 3211291403721 North Naples Fire Department 144610 While attempting to park the EMS Truck 28, Medic 46 struck an open compartment door on NNFD Squad 40. This resulted in damage to the fiberglass compartment door on NNFD Squad 40 and a long scratch on the passenger side of EMS Truck 28. 3210091403675 CHIDSEY, ANNE 253212 Claimant was in the right turn lane at Napa Blvd. and was rear-ended by a County vehicle. 3212031403729 ANDERSON, THOMAS Major Coverage: 30 - Auto Liability Page 7 Pa c k e t P a g e - 9 6 6 - 5 / 1 2 / 2 0 1 5 1 6 . E . 2 . 0.00 0.00 503.10 0.00 0.00 0.00 0.00 503.10 12/19/2014 12/19/2014 1/22/2015 0.00 0.00 503.10 0.00 0.00 0.00 0.00 503.10 42 5900 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 2/13/2015 2/13/2015 2/26/2015 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 41 20001 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 3/25/2015 3/26/2015 3/27/2015 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 41 0.00 0.00 1,452.31 0.00 0.00 0.00 0.00 1,452.31 1/6/2015 1/6/2015 2/10/2015 0.00 0.00 1,452.31 0.00 0.00 0.00 0.00 1,452.31 42 5500 0.00 696.26 0.00 0.00 0.00 0.00 0.00 696.26 11/13/2014 12/9/2014 2/17/2015 0.00 696.26 0.00 0.00 0.00 0.00 0.00 696.26 42 5900 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 12/21/2014 12/24/2014 1/13/2015 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 41 32001 Minor crack on driver side front windshield. 4112211403771 EMS EMSE Tk29 sustained damage to the right-side passenger step light to the point it fell off. The driver; Isles of Capri Firefighter Kofsky ran over unseen debris on the roadway. The broken equipment was collected and dropped-off with the truck at Motorpool. 155110 It was discovered today that the mirrors on the Ford Truck (CC2-304) were missing and the interior dome lights had been tampered with as the plastic covers for the lights had been thrown in the back seat of the truck. 4211131403742 Clerk of Courts 311111 4103251503970 Traffic Operations Division 163630 While attempting to make room for an incoming vehicle with a trailer to come in the intersection, employee did not see the guardrail nose and ended up striking it with his vehicle passenger side rear door and side panel. 4201061503784 University Extension Services Department 163630 A chip in a windshield of CC2-910 now has become a crack 4102131503873 EMS EMSE While leaving patient address, the patient compartment on the drivers side scraped the garage siding. The reflector, rubber fender guard, and an emegency light were damaged. See AR#17705 Major Coverage: 40 - Auto Physical Damage 4212191403764 Traffic Operations Department Page 8 Pa c k e t P a g e - 9 6 7 - 5 / 1 2 / 2 0 1 5 1 6 . E . 2 . 0.00 0.00 523.44 0.00 0.00 0.00 0.00 523.44 1/15/2015 1/15/2015 3/20/2015 0.00 0.00 523.44 0.00 0.00 0.00 0.00 523.44 41 30004 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 2/20/2015 3/18/2015 3/20/2015 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 41 30004 0.00 1,446.29 0.00 0.00 0.00 0.00 0.00 1,446.29 10/8/2014 10/9/2014 1/14/2015 0.00 1,446.29 0.00 0.00 0.00 0.00 0.00 1,446.29 42 20001 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 10/28/2014 10/29/2014 2/17/2015 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 41 20001 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1/9/2015 1/9/2015 1/14/2015 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 41 30004 0.00 2,142.55 2,478.85 0.00 0.00 0.00 0.00 4,621.40 0.00 2,142.55 2,478.85 0.00 0.00 0.00 0.00 4,621.40 Total by Major Coverage 11 Claims EMSE As directed by hotel staff, EMS parked under an overpass. Firefighters thought the antenna on the EMS vehicle may have clipped the structure. No damage was noted. Sent for assessment. 4101091503793 EMS EMSE EMS ambulance #19 driver backed into a McDonald's sign causing slight damage to driver's side bumper of ambulance #19. No damage to sign confirmed by the store manager. 4210081403630 Parks & Recreation Department 157710 While picking up aluminum barricades, the driver attempted to turn around. The turn was too sharp, resulting in the crank on the trailer making contact with the top of the tailgate. 4110281403665 EMS 163620 Sweeper truck #CC2-899 struck dump truck #980032 while dumping debris into it. Struck the side of truck while backing away from it. 4102201503949 HEALTH DEPARTMENT 155810 Upon backing asset #CC2-432, the right rear bumper brushed the site manager's truck parked just off the drive behind/near #CC2-432. Tk29 sustained damage to the right-side passenger step light to the point it fell off. The driver; Isles of Capri Firefighter Kofsky ran over unseen debris on the roadway. The broken equipment was collected and dropped-off with the truck at Motorpool. 4101151503805 Road Maintenance Department Page 9 Pa c k e t P a g e - 9 6 8 - 5 / 1 2 / 2 0 1 5 1 6 . E . 2 . 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 8/15/2014 8/15/2014 1/27/2015 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 52 23501 0.00 0.00 1,150.00 0.00 0.00 0.00 0.00 1,150.00 11/17/2014 11/17/2014 1/ 9/2015 0.00 0.00 1,150.00 0.00 0.00 0.00 0.00 1,150.00 52 5500 5,635.46 0.00 0.00 0.00 0.00 0.00 0.00 5,635.46 7/5/2014 7/7/2014 1/26/2015 5,635.46 0.00 0.00 0.00 0.00 0.00 0.00 5,635.46 52 5400 0.00 0.00 4,184.46 0.00 0.00 0.00 0.00 4,184.46 12/11/2014 1/23/2015 3/27/2015 0.00 0.00 4,184.46 0.00 0.00 0.00 0.00 4,184.46 53 30004 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1/5/2015 3/10/2015 3/25/2015 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 53 24001 5,635.46 0.00 5,334.46 0.00 0.00 0.00 0.00 10,969.92 5,635.46 0.00 5,334.46 0.00 0.00 0.00 0.00 10,969.92 5301051503930 Waste Management, Inc. 156332 A Waste Management, Inc. truck oil drain plug came lose and fell out causing 11 gallons of oil on driveway and parking lot near maintenance facility. Total by Major Coverage 5 Claims 122240 Lightening struck the panel, gate and terminals in the Administration Building. It now fails to communicate. It appears the gate board needs replacing. 5312111403826 Traffic Operations Department 163630 Light pole #94 at Golden Gate Parkway and Freedom Park was leaning heavily to one side, apparently struck by a vehicle which had fled the scene. 5211171403699 Solid & Hazardous Waste Management Department 210130 Employee was performing locates, he left the Ground Penetrating Radar (GPR) in front of a house, walked to his truck 4 houses away to get the truck closer to his work site and when he turned around to move, the GPR was gone. 5207051403381 Facilities Management Major Coverage: 50 - Property 5208151403502 Parks & Recreation Department 156313 Person(s) unknown entered the fenced in parking area on Recreation Lane and broke into three (3) trailers and a maintenance shed by cutting locks off of all. Subject(s) then forcibly entered the west door of the maintenance building. Page 10 Pa c k e t P a g e - 9 6 9 - 5 / 1 2 / 2 0 1 5 1 6 . E . 2 . 0.00 75.00 0.00 0.00 0.00 0.00 0.00 75.00 5/8/2013 5/9/2013 1/13/2015 0.00 75.00 0.00 0.00 0.00 0.00 0.00 75.00 67 0.00 75.00 0.00 0.00 0.00 0.00 0.00 75.00 0.00 75.00 0.00 0.00 0.00 0.00 0.00 75.00 31,159.45 12,381.19 30,002.59 0.00 0.00 0.00 0.00 73,543.23 31,159.45 12,381.19 30,002.59 0.00 0.00 0.00 0.00 73,543.23 Grand Totals: 56 Claims 4/20/2015 1:11:05 PM Major Coverage: 60 - Public Officials Errors and Ommissions 6705081302379 The Lamar Company, LLC 163620 The Lamar Company alleges FDOT (as part of a 6-lane improvement to SR84) constructed a noise attenuation barrier within the r-o-w causing a substantial loss of access to Lamar's property. Total by Major Coverage 1 Claim Page 11 Pa c k e t P a g e - 9 7 0 - 5 / 1 2 / 2 0 1 5 1 6 . E . 2 . Packet Page -971- 5/12/2015 16.E.2. Packet Page -972- 5/12/2015 16.E.2. Packet Page -973- 5/12/2015 16.E.2. Packet Page -974- 5/12/2015 16.E.2. Packet Page -975- 5/12/2015 16.E.2. Packet Page -976- 5/12/2015 16.E.2. Med/BI/Comp Expense Ind/PD/Coll Recovery Deductible Legal Other Total Inc Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Date of Loss Date Report to Risk Status Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total Coverage Cause 0.00 0.00 0.00 3,700.00 0.00 0.00 0.00 0.00 7/14/2014 2/26/2015 3/18/2015 0.00 0.00 0.00 3,700.00 0.00 0.00 0.00 0.00 59 0.00 12,804.03 0.00 11,400.00 0.00 0.00 0.00 12,804.03 5/9/2014 5/14/2014 1/ 8/2015 0.00 12,804.03 0.00 11,400.00 0.00 0.00 0.00 12,804.03 53 30004 0.00 0.00 45,803.35 10,000.00 0.00 0.00 0.00 45,803.35 6/18/2014 6/19/2014 3/12/2015 0.00 0.00 45,803.35 10,000.00 0.00 0.00 0.00 45,803.35 41 24501 0.00 0.00 1,488.01 1,488.01 0.00 0.00 0.00 1,488.01 1/28/2015 1/28/2015 3/24/2015 0.00 0.00 1,488.01 1,488.01 0.00 0.00 0.00 1,488.01 41 24501 144360 Isles of Capri Engine 91 (asset #050724) was responding to a vehicle accident at 11163 Tamiami Trail East. As they came up on scene and attempted to pull to left, a vehicle driven by third party attempted to pass the fire engine and struck it. 4101281503839 CC v. HIRSCH, JACK 156380 Employee was driving Asset #010015 west on Vanderbilt Beach Road when Mr. Hirsch struck his vehicle on the passenger side rear quarter panel. The Collier County Sheriff's Office was called to make a report. The operator of the vessel lost engine power then subsequently abandoned the vessel. Due to strong westerly winds that day, the vessel beached onto Kice island. The vessel was eventually removed by Collier County. 5305091403267 CC v. Seidler, Ashley (CA) 138336 Ashley Seidler was traveling east on Naples Blvd. and did not stop for the flashing red light & caused a collision which resulted in damage to a CAT bus shelter. 4106181403332 CC v. Orilin Duperrier, Gislaine (CA) Cost Center Carrier Employer Acc Desc. 5907141403899 CC v. Hollenbach, Kenneth 110409 Collier County Government Subrogation Closed Claim Report 2nd QTR 2015 Valued as of:4/20/2015 Claim Number Employee Name Page 1 Pa c k e t P a g e - 9 7 7 - 5 / 1 2 / 2 0 1 5 1 6 . E . 2 . 0.00 0.00 0.00 72.63 0.00 0.00 0.00 0.00 10/17/2014 10/17/2014 1/ 8/2015 0.00 0.00 0.00 72.63 0.00 0.00 0.00 0.00 41 30004 0.00 0.00 0.00 95.68 0.00 0.00 0.00 0.00 5/17/2014 5/27/2014 1/ 8/2015 0.00 0.00 0.00 95.68 0.00 0.00 0.00 0.00 59 30004 0.00 0.00 0.00 3,458.04 0.00 0.00 0.00 0.00 2/17/2012 3/12/2012 1/ 8/2015 0.00 0.00 0.00 3,458.04 0.00 0.00 0.00 0.00 53 30004 0.00 0.00 0.00 177.27 0.00 0.00 0.00 0.00 12/18/2014 1/5/2015 1/22/2015 0.00 0.00 0.00 177.27 0.00 0.00 0.00 0.00 59 31001 0.00 0.00 0.00 424.86 0.00 0.00 0.00 0.00 11/9/2014 11/25/2014 1/29/2015 0.00 0.00 0.00 424.86 0.00 0.00 0.00 0.00 53 30004 0.00 0.00 0.00 463.12 0.00 0.00 0.00 0.00 9/16/2014 10/3/2014 2/ 6/2015 0.00 0.00 0.00 463.12 0.00 0.00 0.00 0.00 53 32001 0.00 0.00 3,014.22 0.00 0.00 0.00 0.00 3,014.22 2/6/2014 2/19/2014 2/17/2015 0.00 0.00 3,014.22 0.00 0.00 0.00 0.00 3,014.22 53 30004 5302061403043 CC v. Rootes, Evan (PC) 163620 Evan Rootes was traveling north on Airport Road when he looked down to text on his phone; the vehicle left the roadway and struck a guardrail. 163620 Ernestina Valdes was traveling east on Vanderbilt Beach Road and when she turned left onto Collier Blvd., she lost control of the vehicle and struck a guardrail. 5309161403618 CC v. Dolan, Shirley 163620 County workers were called to remove a tree that had fallen from a residents property and landed on the road, blocking traffic. 5912181403780 CC v. Preferred Materials, Inc. 163620 An employee working on bahalf of Preferred Materials, Inc. spilled rock on the road, requiring clean- up by County personnel. 5311091403716 CC v. Valdes, Ernestina 163620 County employees cleaned up the roadway following a vehicle accident. 5302171201258 CC v. Pineda-Lopez, Viviana 163620 Viviana Pineda-Lopez was traveling west on Golden Gate Blvd. when a dog allegedly ran out in front of her vehicle. She steered to the left to avoid striking the dog & lost control of the vehicle, rotated clockwise & collided with a guardrail. 4110171403644 CC v. ALDRIGE, WADE 163620 Driver #1 backed out of a parking space into the side of County Vehicle #030015 as County vehicle was driving through parking lot. 5905171403290 CC v. Eastburn, Gregory Page 2 Pa c k e t P a g e - 9 7 8 - 5 / 1 2 / 2 0 1 5 1 6 . E . 2 . 0.00 0.00 0.00 285.71 0.00 0.00 0.00 0.00 1/8/2015 1/22/2015 2/27/2015 0.00 0.00 0.00 285.71 0.00 0.00 0.00 0.00 59 31001 0.00 0.00 0.00 757.61 0.00 0.00 0.00 0.00 1/14/2015 2/25/2015 3/ 4/2015 0.00 0.00 0.00 757.61 0.00 0.00 0.00 0.00 53 30004 0.00 0.00 0.00 1,147.20 0.00 0.00 0.00 0.00 1/27/2015 2/19/2015 3/ 4/2015 0.00 0.00 0.00 1,147.20 0.00 0.00 0.00 0.00 59 31001 0.00 0.00 0.00 219.10 0.00 0.00 0.00 0.00 2/2/2015 3/4/2015 3/24/2015 0.00 0.00 0.00 219.10 0.00 0.00 0.00 0.00 59 31001 0.00 0.00 0.00 252.53 0.00 0.00 0.00 0.00 11/7/2014 11/20/2014 1/ 8/2015 0.00 0.00 0.00 252.53 0.00 0.00 0.00 0.00 53 30004 0.00 0.00 0.00 210.27 0.00 0.00 0.00 0.00 12/3/2014 12/11/2014 1/ 9/2015 0.00 0.00 0.00 210.27 0.00 0.00 0.00 0.00 53 30004 5312031403751 CC v. Eisenhower, Joseph 163630 Joseph Eisenhower was in the left hand turn lane to turn from Airport Road onto Westview Drive & upon turning left, crossed over 3 lanes of traffic, struck another vehicle which was forced onto the sidewalk, striking a stop sign. 163620 Rock was spilled on the northwest corner of Golden Gate Blvd. and 5th Street NW by a driver working on behalf of Preferred Materials, requiring clean-up by County personnel. 5311071403704 CC v. Chavez, Nory 163630 Karla Chavez was stopped on westbound 60th Avenue NE before Everglades Blvd. when she began to turn left & drove into the path of an oncoming vehicle, causing a collision. The other vehicle left the roadway and struck a stop sign and post. 5901271503880 CC v. American Farms LTD 163620 County workers were called to clean up debris in the roadway following a traffic accident on Immokalee Road. 5902021503912 CC v. Preferred Materials 163620 An employee working on behalf of Preferred Materials, Inc. spilled rock at the corner of Golden Gate Blvd. and 5th Street NW requiring clean-up by County personnel. 5301141503895 CC v. Macias, Juan 163620 Martha Macias was traveling north on Everglades Blvd. N. when she fell asleep and traveled off the roadway and struck a concrete storm drain. 5901081503825 CC v. Preferred Materials, Inc. Page 3 Pa c k e t P a g e - 9 7 9 - 5 / 1 2 / 2 0 1 5 1 6 . E . 2 . 0.00 0.00 0.00 103.85 0.00 0.00 0.00 0.00 7/16/2014 8/20/2014 1/29/2015 0.00 0.00 0.00 103.85 0.00 0.00 0.00 0.00 53 30004 0.00 0.00 0.00 232.88 0.00 0.00 0.00 0.00 9/14/2014 9/25/2014 2/ 3/2015 0.00 0.00 0.00 232.88 0.00 0.00 0.00 0.00 53 30004 0.00 0.00 0.00 4,073.23 0.00 0.00 0.00 0.00 8/26/2014 1/27/2015 2/ 4/2015 0.00 0.00 0.00 4,073.23 0.00 0.00 0.00 0.00 53 0.00 0.00 0.00 74.42 0.00 0.00 0.00 0.00 9/22/2014 9/25/2014 2/20/2015 0.00 0.00 0.00 74.42 0.00 0.00 0.00 0.00 53 30004 0.00 0.00 0.00 1,278.64 0.00 0.00 0.00 0.00 6/27/2014 7/2/2014 2/20/2015 0.00 0.00 0.00 1,278.64 0.00 0.00 0.00 0.00 53 30004 0.00 0.00 0.00 597.52 0.00 0.00 0.00 0.00 10/10/2014 10/21/2014 2/27/2015 0.00 0.00 0.00 597.52 0.00 0.00 0.00 0.00 53 30004 0.00 0.00 0.00 1,619.71 0.00 0.00 0.00 0.00 10/2/2014 10/20/2014 3/ 2/2015 0.00 0.00 0.00 1,619.71 0.00 0.00 0.00 0.00 53 30004 163630 A vehicle owned by Maria Martina Mateo Antonio was traveling north on Livingston Road when it traveled over the curb and collided with light pole #90. 5310101403651 CC v. Speer, David (CA) 163630 David Speer was making a u-turn at Tamiami Trail North & Vanderbilt Beach Road and struck a traffic signal mast arm. 5310021403648 CC v. Mateo Antonio, Maria Martina 163630 A Waste Management truck struck a speed limit sign at Orchard Lane & Thomasson Drive. 536271403372 CC v. Bedell, Lisa 163630 Katlyn Bedell was traveling east on Immokalee Road when she began to change lanes and lost control of the vehicle and struck a light pole. 5308261403834 CC v. Accurate Drilling 163630 Employees working on behalf of Accurate Drilling damaged a light pole at Goodlette-Frank Road and Vanderbilt Beach Road. 5309221403595 CC v. Waste Management 163630 Kaitlin Goldstone was traveling south on Santa Barbara approaching Coronado Pakway when she turned left into the path of an oncoming vehicle, they collided, then she struck a traffic sign. 5309141403600 CC v. Roblero, Isaias 163630 Byron Roblero had just turned west on Golden Gate Pkwy from 44th Street SW when he lost control of the vehicle and struck a street sign, then a tree. 5307161403511 CC v. Goldstone, Howard Page 4 Pa c k e t P a g e - 9 8 0 - 5 / 1 2 / 2 0 1 5 1 6 . E . 2 . 0.00 0.00 0.00 80.34 0.00 0.00 0.00 0.00 2/1/2015 3/12/2015 3/16/2015 0.00 0.00 0.00 80.34 0.00 0.00 0.00 0.00 53 30004 0.00 0.00 3,664.13 3,670.71 0.00 0.00 0.00 3,664.13 12/19/2014 12/19/2014 3/16/2015 0.00 0.00 3,664.13 3,670.71 0.00 0.00 0.00 3,664.13 41 30004 0.00 0.00 0.00 68.38 0.00 0.00 0.00 0.00 12/22/2014 1/22/2015 3/17/2015 0.00 0.00 0.00 68.38 0.00 0.00 0.00 0.00 53 30004 0.00 0.00 0.00 46.77 0.00 0.00 0.00 0.00 11/27/2014 12/17/2014 3/20/2015 0.00 0.00 0.00 46.77 0.00 0.00 0.00 0.00 53 30004 0.00 0.00 0.00 26,800.00 0.00 0.00 0.00 0.00 10/29/2013 11/12/2013 3/24/2015 0.00 0.00 0.00 26,800.00 0.00 0.00 0.00 0.00 53 30004 0.00 0.00 0.00 2,592.00 0.00 0.00 0.00 0.00 4/17/2014 6/11/2014 1/ 2/2015 0.00 0.00 0.00 2,592.00 0.00 0.00 0.00 0.00 54 30004 163652 Jean Laguerre was traveling south on Goodlette Road north during a rainstorm when her vehicle allegedly hydroplaned into the median, damaging landscaping. 5310291302838 CC v. Vineyards Development Corp./Sosa (CA) 163630 Debra Gogan was making a u- turn on Pine Ridge Road at the intersection of Whipporwill Lane & collided with another vehicle, then struck the curb & a traffic control box. 5404171403318 CC v. Laguerre, Jean 163630 Yamilet Diaz Gonzalez was stopped at the westbound sign on 23rd Place SW at 43rd Lane SW when she entered the right-of-way in front of another vehicle, causing a collision, then striking a street sign. 5311271403758 CC v. Kerstein, Jonathan 163630 Jonathan Kerstein was traveling south on Santa Barbara Blvd. and alleges an approaching vehicle had their high beams on & he reacted by turning to the right to avoid the light & jumped the curb, drove across a sidewalk & struck a traffic sign. 4112191403765 CC v. Basha, Altin 163630 Driving on Balboa Circle E. doing my rountine sign inspection. Drove around the cul-de-sac, driver pulled out in reverse from his driveway & struck my County vehicle. 5312221403824 CC v. Gonzalez, Yamilet 5302011503936 CC v. Cricien, Freddy 163630 Freddy Cricien was traveling east on Oil Well Road before a left turning curve. He entered the curve, but failed to negotiate it, driving onto the grass shoulder and ditch, then striking a road sign. Page 5 Pa c k e t P a g e - 9 8 1 - 5 / 1 2 / 2 0 1 5 1 6 . E . 2 . 0.00 0.00 0.00 1,050.00 0.00 0.00 0.00 0.00 8/18/2014 9/10/2014 1/26/2015 0.00 0.00 0.00 1,050.00 0.00 0.00 0.00 0.00 54 30004 0.00 0.00 0.00 5,724.00 0.00 0.00 0.00 0.00 12/31/2014 1/20/2015 2/ 4/2015 0.00 0.00 0.00 5,724.00 0.00 0.00 0.00 0.00 53 30004 0.00 0.00 0.00 1,050.00 0.00 0.00 0.00 0.00 7/16/2014 8/13/2014 2/20/2015 0.00 0.00 0.00 1,050.00 0.00 0.00 0.00 0.00 54 30004 0.00 0.00 0.00 500.00 0.00 0.00 0.00 0.00 12/12/2014 1/14/2015 2/27/2015 0.00 0.00 0.00 500.00 0.00 0.00 0.00 0.00 54 31001 0.00 0.00 0.00 3,883.00 0.00 0.00 0.00 0.00 11/1/2014 12/3/2014 1/26/2015 0.00 0.00 0.00 3,883.00 0.00 0.00 0.00 0.00 53 30004 0.00 0.00 0.00 33,333.33 0.00 0.00 0.00 0.00 9/21/2012 9/26/2012 1/13/2015 0.00 0.00 0.00 33,333.33 0.00 0.00 0.00 0.00 53 5900 233351 Las Brisas had an irrigation line break on thier property which let sand in through the County's lateral causing our gravity system to back up. Wastewater had to hire and emergency contractor to make emergency repairs to our lateral and to remove sand. 5311011403728 CC v. Kurkjian, Tiffany 173412 William Harris was traveling north on South 1st Street when he struck the median, then a light pole. 5309211201845 CC v. Las Brisas HOA/Kirk Family Trust (CA) 163652 Juan Manuel Maciel pulled out of West Crown Point Blvd. and upon accelerating, lost control of the vehicle and struck a Sabal palm and landscaping. 5412121403802 CC v. Lipinski, Wladyslaw 163652 Geico Insurance reported that a vehicle driven by Emilia Lipinska damged landscaping on a median on Pine Ridge Road east of Airport Road. The policy holder is Wladyslaw Lipinski. 5312311403817 CC v. Hopper, Martha 163652 Martha Hopper was traveling south on Livingston Road when the front right wheel struck a curb. She then steered to the left & the vehicle went out of control & rotated in a clockwise direction before striking a water fountain control box. 5407161403489 CC v. Maciel, Juan 5408181403561 CC v. Herrera, Leeann 163652 Leeann Herrera was traveling north on CR 851 when she lost control of the vehicle and traveled off the roadway, into the median, striking a palm tree. Page 6 Pa c k e t P a g e - 9 8 2 - 5 / 1 2 / 2 0 1 5 1 6 . E . 2 . 0.00 0.00 0.00 552.43 0.00 0.00 0.00 0.00 12/18/2014 1/2/2015 3/24/2015 0.00 0.00 0.00 552.43 0.00 0.00 0.00 0.00 53 0.00 0.00 1,787.01 1,787.01 0.00 0.00 0.00 1,787.01 11/10/2014 11/10/2014 1/ 8/2015 0.00 0.00 1,787.01 1,787.01 0.00 0.00 0.00 1,787.01 41 30004 0.00 12,804.03 55,756.72 123,270.25 0.00 0.00 0.00 68,560.75 0.00 12,804.03 55,756.72 123,270.25 0.00 0.00 0.00 68,560.75 4/20/2015 1:13:10 PM 4111101403687 CC v. White, Paul DASE Paul White came out of Market Street, entered the intersection and attempted to turn left and struck a County vehicle. Grand Totals: 38 Claims Las Brisas had an irrigation line break on thier property which let sand in through the County's lateral causing our gravity system to back up. Wastewater had to hire and emergency contractor to make emergency repairs to our lateral and to remove sand. 5312181403777 CC v. Keolis Transit America, Inc. ATMS Keolis employee backed into the gate controller box. Page 7 Pa c k e t P a g e - 9 8 3 - 5 / 1 2 / 2 0 1 5 1 6 . E . 2 .