Agenda 10/08/2019 Item #16E 2 (Ratify Property, Casualty, & Workers Comp Claims)10/08/2019
EXECUTIVE 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 third quarter of FY 19.
OBJECTIVE: To settle routine, administrative and minor claims matters which promotes the efficient
use of resources and the efficient administration of the program; and allows for a timely response to
claimants and/or their representatives.
CONSIDERATIONS: Resolution 04-15 grants limited authority to the Risk Management Division
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:
• 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
• 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 third quarter of FY 19
is attached. The report may include claims and/or settlements previously approved by the Board of
Commissioners as well as litigated files with a final court determination.
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 claims and settlements. For the third quarter of FY 19, 144 files were closed with total expenditures of
$10,280,832.79. Reinsurance recoveries for the third quarter of FY 19 were $7,887,519.03. During the
same period, 46 subrogation files were closed, and the Risk Management Division recovered $211,713.29
in funds owed the County.
GROWTH MANAGEMENT IMPACT: There is no growth management impact associated with this
item.
LEGAL CONSIDERATIONS: This item has been reviewed by the County Attorney, is approved as
to form and legality, and requires majority vote for approval. -JAK
RECOMMENDATION: That the Board of County Commissioners accepts the attached Settlement
16.E.2
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10/08/2019
Report and ratifies the actions taken therein.
PREPARED BY: Jeff Walker CPCU, ARM, Division Director, Risk Management Division.
ATTACHMENT(S)
1. All Lines Closed Claim Report 3rd QTR FY 19 (PDF)
2. Subrogation Closed Claim Report 3rd QTR FY 19 (PDF)
3. Resolution 2004-15 PDF0001 (PDF)
16.E.2
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10/08/2019
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.E.2
Doc ID: 10114
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 third quarter of FY 19.
Meeting Date: 10/08/2019
Prepared by:
Title: Division Director - Risk Management – Risk Management
Name: Jeff Walker
09/12/2019 8:05 AM
Submitted by:
Title: Division Director - Risk Management – Risk Management
Name: Jeff Walker
09/12/2019 8:05 AM
Approved By:
Review:
Administrative Services Department Michael Cox Level 1 Division Reviewer Completed 09/12/2019 10:47 AM
Administrative Services Department Len Price Level 2 Division Administrator Review Completed 09/23/2019 5:06 PM
Office of Management and Budget Laura Wells Level 3 OMB Gatekeeper Review Completed 09/24/2019 2:46 PM
Budget and Management Office Mark Isackson Additional Reviewer Completed 09/25/2019 10:33 AM
County Attorney's Office Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Completed 09/25/2019 3:23 PM
County Manager's Office Nick Casalanguida Level 4 County Manager Review Completed 09/29/2019 5:54 PM
Board of County Commissioners MaryJo Brock Meeting Pending 10/08/2019 9:00 AM
16.E.2
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Collier County Government
Closed Claim Report- All Lines
3rd QTR FY 2019
Med/BI/Comp Expense Ind/PD/Coll Recovery Deductible Legal Other Total Inc
Claim Number Employee Name Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total
Division 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 Employer Acc Desc.
Major Coverage: 10 - Workers' Compensation
1006051909218 687.31 82.20 0.00 0.00 0.00 0.00 0.00 769.51
ASAE 6/5/2019 6/5/2019 6/17/2019 687.31 82.20 0.00 0.00 0.00 0.00 0.00 769.51
10 1200 Employee pinched left pinky finger with
pliers while adding wheel weights to rim.
155368 139,915.20 13,800.79 18,472.09 0.00 0.00 0.00 0.00 172,188.08
WWTE 6/2/1994 6/2/1994 4/1/2019 139,915.20 13,800.79 18,472.09 0.00 0.00 0.00 0.00 172,188.08
10 1700 Employee was working on Vactor truck
when machinery exploded and he was
struck in head.
1006171909268 417.86 17.85 0.00 0.00 0.00 0.00 0.00 435.71
BPRI 6/17/2019 6/17/2019 6/30/2019 417.86 17.85 0.00 0.00 0.00 0.00 0.00 435.71
10 1300 Employee was walking at job site when
he tripped and fell. Left pinky finger hit
metal stud.
1004121909025 3,493.48 33.10 0.00 0.00 0.00 0.00 0.00 3,526.58
ASAE 4/12/2019 4/12/2019 4/15/2019 3,493.48 33.10 0.00 0.00 0.00 0.00 0.00 3,526.58
10 1600 Employee hit head on metal crossbar
when running on treadmill and is
complaining of dizziness and confusion.
1004121909026 305.45 11.90 0.00 0.00 0.00 0.00 0.00 317.35
BPRI 4/12/2019 4/12/2019 4/17/2019 305.45 11.90 0.00 0.00 0.00 0.00 0.00 317.35
10 1300 Employee fell from ladder while
performing an inspection and is
complaining of left ankle pain.
1005171909163 273.70 11.90 0.00 0.00 0.00 0.00 0.00 285.60
BPRI 5/17/2019 5/17/2019 5/24/2019 273.70 11.90 0.00 0.00 0.00 0.00 0.00 285.60
10 1200 Employee punctured back of head while
climbing into attic of residence during
inspection.
1004111909035 303.66 14.05 0.00 0.00 0.00 0.00 0.00 317.71
EMSE 4/11/2019 4/15/2019 4/30/2019 303.66 14.05 0.00 0.00 0.00 0.00 0.00 317.71
10 1900 Employee was exposed to inmate who's
autopsy showed lesions. Confirmed
diagnosis of pneumonia MRSA.
1004111909034 380.16 20.00 0.00 0.00 0.00 0.00 0.00 400.16
EMSE 4/11/2019 4/15/2019 4/29/2019 380.16 20.00 0.00 0.00 0.00 0.00 0.00 400.16
10 1900 Employee was exposed to inmate who's
autopsy showed lesions. Confirmed
diagnosis of pneumona MRSA.
1006201909285 1,208.13 67.65 857.10 0.00 0.00 0.00 0.00 2,132.88
HHVS 6/20/2019 6/21/2019 6/30/2019 1,208.13 67.65 857.10 0.00 0.00 0.00 0.00 2,132.88
10 1100 Employee twisted right ankle on outside
steps of a client home that were uneven
as she stepped down.
1
16.E.2.a
Packet Pg. 1038 Attachment: All Lines Closed Claim Report 3rd QTR FY 19 (10114 : Ratification of Claims Closed by the
1004271909084 424.67 26.80 0.00 0.00 0.00 0.00 0.00 451.47
LIBE 4/27/2019 4/27/2019 5/22/2019 424.67 26.80 0.00 0.00 0.00 0.00 0.00 451.47
10 1500 Employee injured left lower rib cage
while gathering books from the floor in
the outside book drop room.
1004221909059 361.51 23.80 0.00 0.00 0.00 0.00 0.00 385.31
PSVE 4/22/2019 4/22/2019 4/30/2019 361.51 23.80 0.00 0.00 0.00 0.00 0.00 385.31
10 1200 Cat lunged and scratched the employee
on the left forearm.
1006031909205 343.40 31.60 0.00 0.00 0.00 0.00 0.00 375.00
TECM 6/3/2019 6/3/2019 6/25/2019 343.40 31.60 0.00 0.00 0.00 0.00 0.00 375.00
10 1300 Employee slipped off step of bucket
truck when he went to step down and is
feeling discomfort in groin area.
1004191909081 805.38 42.77 0.00 0.00 0.00 0.00 0.00 848.15
WATE 4/19/2019 4/26/2019 6/18/2019 805.38 42.77 0.00 0.00 0.00 0.00 0.00 848.15
10 1300 Employee sprained right ankle within the
past week on the job.
1005161909153 599.15 43.35 0.00 0.00 0.00 0.00 0.00 642.50
WWTE 5/16/2019 5/16/2019 5/21/2019 599.15 43.35 0.00 0.00 0.00 0.00 0.00 642.50
10 1200 Employee jammed right index finger
when he lost grip on valve handle.
1002211908826 WALLACE, MATTHEW 303.96 19.05 1,249.84 0.00 0.00 0.00 0.00 1,572.85
ASAE 2/21/2019 2/21/2019 4/30/2019 303.96 19.05 1,249.84 0.00 0.00 0.00 0.00 1,572.85
10 1500 Employee felt pressure in lower back
and right leg while lifting patient.
1005031909111 432.47 26.70 0.00 0.00 0.00 0.00 0.00 459.17
COCE 5/3/2019 5/6/2019 5/14/2019 432.47 26.70 0.00 0.00 0.00 0.00 0.00 459.17
10 1300 Employee fell over water bottles and
bruised left leg. She is complaining of
sore back pain.
1005301909201 231.00 5.95 0.00 0.00 0.00 0.00 0.00 236.95
DASE 5/30/2019 5/31/2019 6/30/2019 231.00 5.95 0.00 0.00 0.00 0.00 0.00 236.95
10 1200 Employee was scratched by cat on left
forearm when she went to break up cat
fight.
1005151909150 333.50 11.90 0.00 0.00 0.00 0.00 0.00 345.40
EMSE 5/15/2019 5/16/2019 5/30/2019 333.50 11.90 0.00 0.00 0.00 0.00 0.00 345.40
10 1500 Employee rolled right ankle while
assisting someone out of Ambulance.
1005071909118 358.57 37.55 0.00 0.00 0.00 0.00 0.00 396.12
WATE 5/7/2019 5/7/2019 5/31/2019 358.57 37.55 0.00 0.00 0.00 0.00 0.00 396.12
10 1500 Employee felt pain in back area while
operating valves.
1003281908971 162.35 5.95 0.00 0.00 0.00 0.00 0.00 168.30
LIBE 3/28/2019 3/28/2019 4/8/2019 162.35 5.95 0.00 0.00 0.00 0.00 0.00 168.30
10 1700 Employee was shelving books when the
shelf collapsed forward, which caused
bruising to right eyelid and right side of
face.
1004241909073 337.90 36.60 0.00 0.00 0.00 0.00 0.00 374.50
MHCP 4/24/2019 4/25/2019 4/30/2019 337.90 36.60 0.00 0.00 0.00 0.00 0.00 374.50
10 1300 Employee fell on ankle due to uneven
pavement.
2
16.E.2.a
Packet Pg. 1039 Attachment: All Lines Closed Claim Report 3rd QTR FY 19 (10114 : Ratification of Claims Closed by the
1002151908832 3,566.54 182.51 0.00 0.00 0.00 0.00 0.00 3,749.05
MHCP 2/15/2019 2/22/2019 4/30/2019 3,566.54 182.51 0.00 0.00 0.00 0.00 0.00 3,749.05
10 1300 Employee was standing on 5 gallon
bucket trying to fix meter and the bucket
slipped out from underneath and
jammed right lower leg.
1005211909173 826.28 64.49 0.00 0.00 0.00 0.00 0.00 890.77
TECM 5/21/2019 5/21/2019 6/21/2019 826.28 64.49 0.00 0.00 0.00 0.00 0.00 890.77
10 1500 Employee was digging hole to install
dead end sign and felt pinch in lower
back.
1005011909100 399.48 38.09 0.00 0.00 0.00 0.00 0.00 437.57
PSVE 5/1/2019 5/1/2019 6/30/2019 399.48 38.09 0.00 0.00 0.00 0.00 0.00 437.57
10 1900 Employee was infected with ringworms
while fostering kittens.
1006181909269 518.93 11.90 0.00 0.00 0.00 0.00 0.00 530.83
WATE 6/18/2019 6/18/2019 6/30/2019 518.93 11.90 0.00 0.00 0.00 0.00 0.00 530.83
10 1200 Employee was cutting water pipe with
circular saw when saw kicked back and
hit left shin.
1003141908924 1,194.81 58.07 0.00 0.00 0.00 0.00 0.00 1,252.88
WWTE 3/14/2019 3/14/2019 5/31/2019 1,194.81 58.07 0.00 0.00 0.00 0.00 0.00 1,252.88
10 1300 Employee twisted left ankle when foot
fell in hole while picking up trash.
1010311605573 362.98 0.00 0.00 0.00 0.00 0.00 0.00 362.98
RMSE 10/31/2016 10/31/2016 5/31/2019 362.98 0.00 0.00 0.00 0.00 0.00 0.00 362.98
10 1300 Employee slipped while exiting sweeper
truck and fell backwards onto the
sidewalk.
1003111908900 863.33 47.79 0.00 0.00 0.00 0.00 0.00 911.12
TECM 3/11/2019 3/11/2019 4/30/2019 863.33 47.79 0.00 0.00 0.00 0.00 0.00 911.12
10 1900 Employee clenched his teeth after being
shocked while changing out a traffic
signal head mount and is complaining of
bottom teeth loose.
1004111909020 355.81 17.85 0.00 0.00 0.00 0.00 0.00 373.66
WWTE 4/11/2019 4/11/2019 4/16/2019 355.81 17.85 0.00 0.00 0.00 0.00 0.00 373.66
10 1200 Employee was opening the fence at
Master Station 102 when a loose
barbwire snagged his left arm and
punctured his skin
1001281908731 4,495.08 152.26 0.00 0.00 0.00 0.00 0.00 4,647.34
CTCE 1/28/2019 1/29/2019 6/28/2019 4,495.08 152.26 0.00 0.00 0.00 0.00 0.00 4,647.34
10 1300 Employee tripped and fell walking to the
elevator on the 3rd floor of the
Courthouse.
1002071908772 585.21 5.95 0.00 0.00 0.00 0.00 0.00 591.16
EMSE 2/7/2019 2/7/2019 4/29/2019 585.21 5.95 0.00 0.00 0.00 0.00 0.00 591.16
10 1900 Crew examined for possible exposure to
meningitis.
1002071908771 661.57 17.85 0.00 0.00 0.00 0.00 0.00 679.42
EMSE 2/7/2019 2/7/2019 4/29/2019 661.57 17.85 0.00 0.00 0.00 0.00 0.00 679.42
10 1900 Crew examined for possible exposure to
meningitis.
1001121807381 31,292.94 4,947.23 38,801.30 0.00 0.00 0.00 0.00 75,041.47
EMSE 1/12/2018 1/12/2018 6/30/2019 31,292.94 4,947.23 38,801.30 0.00 0.00 0.00 0.00 75,041.47
10 1500 EE felt a pop in his lower back while
lifting a manual stretcher.
1006251909300 373.71 51.61 0.00 0.00 0.00 0.00 0.00 425.32
GMAO 6/25/2019 6/26/2019 6/28/2019 373.71 51.61 0.00 0.00 0.00 0.00 0.00 425.32
10 1900 Employee vomited on jobsite from
complications of heat.
3
16.E.2.a
Packet Pg. 1040 Attachment: All Lines Closed Claim Report 3rd QTR FY 19 (10114 : Ratification of Claims Closed by the
1006271909315 168.30 0.00 0.00 0.00 0.00 0.00 0.00 168.30
WATE 6/27/2019 6/27/2019 6/30/2019 168.30 0.00 0.00 0.00 0.00 0.00 0.00 168.30
10 1900 Employee was nauseated from
complications of heat exhaustion.
1006111808043 8,764.14 3,057.94 750.06 0.00 0.00 0.00 0.00 12,572.14
CICE 6/11/2018 6/12/2018 6/21/2019 8,764.14 3,057.94 750.06 0.00 0.00 0.00 0.00 12,572.14
10 1300 Employee went to sit down and missed
chair hitting tailbone and head
1001231908700 394.97 39.69 0.00 0.00 0.00 0.00 0.00 434.66
HURE 1/23/2019 1/24/2019 6/30/2019 394.97 39.69 0.00 0.00 0.00 0.00 0.00 434.66
10 1300 Employee fell out of chair when chair
slipped out from under her causing pain
to buttocks.
1012111808556 4,006.76 621.09 2,558.96 0.00 0.00 0.00 0.00 7,186.81
ORMD 12/11/2018 12/12/2018 5/31/2019 4,006.76 621.09 2,558.96 0.00 0.00 0.00 0.00 7,186.81
10 1700 Employee was struck by vehicle and is
complaining of neck pain
1009061808283 20,829.77 917.81 515.05 0.00 0.00 0.00 0.00 22,262.63
RMSE 9/6/2018 9/13/2018 6/30/2019 20,829.77 917.81 515.05 0.00 0.00 0.00 0.00 22,262.63
10 1300 Employee slipped and fell on ditch slope
and injured right shoulder.
1011151808475 13,892.81 3,200.70 8,185.64 0.00 0.00 0.00 0.00 25,279.15
MHCP 11/15/2018 11/15/2018 6/30/2019 13,892.81 3,200.70 8,185.64 0.00 0.00 0.00 0.00 25,279.15
10 1000 Employee complained of being exposed
in the last two weeks to black mold and
is complaning of not being able to
breathe.
1010221808387 22,696.95 268.89 3,817.60 0.00 0.00 0.00 0.00 26,783.44
WATE 10/22/2018 10/23/2018 6/30/2019 22,696.95 268.89 3,817.60 0.00 0.00 0.00 0.00 26,783.44
10 1500 As operator picked up the hose and took
a couple steps so it could drain
completely his footing gave way in a
steep swale and twisted his knee.
1004011908982 273.70 11.90 0.00 0.00 0.00 0.00 0.00 285.60
ASAE 4/1/2019 4/1/2019 4/29/2019 273.70 11.90 0.00 0.00 0.00 0.00 0.00 285.60
10 1700 Employee bumped head on cabinet of
Ambulance causing a laceration to head.
268,202.88 28,085.08 75,207.64 0.00 0.00 0.00 0.00 371,495.60
Total by Major Coverage 42 Claims 268,202.88 28,085.08 75,207.64 0.00 0.00 0.00 0.00 371,495.60
Major Coverage: 20 - General Liability
2103051908968 EADIE, ASCHLIMAN 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
RMSE 3/5/2019 3/27/2019 5/24/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
21 2050 Eadie Aschliman was walking on the
sidewalk outside of Panera Bread and
tripped breaking her right arm in two
places. She was taken to Physician
Hospital on Collier Blvd where she was
admitted and had surgery for 5 hours on
March 6 to repair.
4
16.E.2.a
Packet Pg. 1041 Attachment: All Lines Closed Claim Report 3rd QTR FY 19 (10114 : Ratification of Claims Closed by the
2101061807877 HABITAT FOR HUMANITY of Collier
County, Inc.
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
RMSE 1/6/2018 4/16/2018 4/12/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
21 2150 LeDarian Robinson and two of her
children, Ra'Layah Johnson, 3, and
Ra'Majesty Johnson, 5, died after a
minivan LeDarian Robinson was driving
veered onto the shoulder of the road
and into a pond and became
submerged.
2203221908953 Alliance Management 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
VSCE 3/22/2019 3/22/2019 4/30/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
22 Collier County Asset#-CC2-823 ran over
a concrete parking stop and fled the
scene.
2112041609010 CISNERO, ANTHONY 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
COL 12/4/2016 4/10/2019 4/10/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
21 2150 Mr. Cisnero received an injury when a
machine used at the technical school
malfunctioned.
2103031908977 WIENCLAW, NATALIE 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
GMAO 3/3/2019 4/1/2019 4/5/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
21 2050 Received notice of claim from Morgan
and Morgan. Natalie Wienclaw was
walking down the street when she
tripped and fell on an uneven sidewalk.
2204251909185 LOKAY, RENEE 0.00 0.00 4,150.00 0.00 0.00 0.00 0.00 4,150.00
RMSE 4/25/2019 5/28/2019 6/30/2019 0.00 0.00 4,150.00 0.00 0.00 0.00 0.00 4,150.00
22 5900 Per notes by field staff the driveway at
this address was damaged by the
removal of roots by county road
maintenance staff.
2203201908941 LCEC 0.00 0.00 730.07 0.00 0.00 0.00 0.00 730.07
RMSE 3/20/2019 3/20/2019 6/30/2019 0.00 0.00 730.07 0.00 0.00 0.00 0.00 730.07
22 5900 Frank Franklin HEO operating longreach
CC2-217 hit a overhead line crossing
SR-29 while performing canal work.
2206071509132 MCCARTHY, JOHN 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
WWTE 6/7/2015 5/13/2019 5/13/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
22 5900 Subrogation adjuster for John McCarthy
called in to file a sewer back up at 8363
Ibis Cove Circle Naples, FL 34119.
2203261909098 MCCORD, JAMES 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
GMAO 3/26/2019 5/1/2019 5/14/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
22 L105 My truck measuring @ 6'-9" was
damaged on numerous occasions
(scratches on roof) by the second 7'
clearance sign due to it is placed where
a sloped plane and the entry meet,
when entering the slope, the vehicle
geometry changes and the 6' 9" scrapes
2202201908810 DOUGHTY, COREY 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
MHCP 2/20/2019 2/20/2019 5/8/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
22 5900 3rd party vehicle(2011 Ford Explorer)
was driving down the road behind a
county truck that was carrying rocks.
The rocks were falling out of the county
vehicle and hit the 3rd party vehicle
multiple times.
5
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Packet Pg. 1042 Attachment: All Lines Closed Claim Report 3rd QTR FY 19 (10114 : Ratification of Claims Closed by the
2204111909022 FLEMING, RICHARD MICHAEL 0.00 0.00 2,128.83 0.00 0.00 0.00 0.00 2,128.83
MHCP 4/11/2019 4/11/2019 4/30/2019 0.00 0.00 2,128.83 0.00 0.00 0.00 0.00 2,128.83
22 2150 Oversize van scraped its roof as it drove
onto second floor of Vanderbilt Beach
Garage.
2205091909126 Barefoot Beach Club Condominium
Associations
0.00 0.00 1,262.60 0.00 0.00 0.00 0.00 1,262.60
WWTE 5/9/2019 5/9/2019 5/31/2019 0.00 0.00 1,262.60 0.00 0.00 0.00 0.00 1,262.60
22 L105 CC2-1655 struck a foam address sign
while backing up.
2112171808567 SPARKS, ALEXIS 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
DASE 12/17/2018 12/17/2018 6/7/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
21 2200 Woman was standing near the animal
that was unprovoked and bit her in the
face.
2111191808768 WILL, CLOEY 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
PTNE 11/19/2018 2/7/2019 6/7/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
21 Received letter in the mail from Shiner
Law Group representing
Cloey(daughter) Will in connection with
an incident at Collier County Bus
number 618.
2109171808320 YVONNE, MINARD 6,637.50 0.00 0.00 0.00 0.00 0.00 0.00 6,637.50
MHCP 9/17/2018 9/25/2018 4/30/2019 6,637.50 0.00 0.00 0.00 0.00 0.00 0.00 6,637.50
21 Life Fitness Abdominal Crunch seat
(reportedly) dropped while individual was
seated. Injury was reported by husband.
2204231909071 SULLIVAN, KEVIN 0.00 0.00 1,153.00 0.00 0.00 0.00 0.00 1,153.00
WATE 4/23/2019 4/24/2019 5/21/2019 0.00 0.00 1,153.00 0.00 0.00 0.00 0.00 1,153.00
22 L352 Collier County Water Distribution in
conjunction with Haskins Inc were
performing work on the water main that
serves the customers near Saint
Andrews Blvd. and Lely Ct. The
customer at 601 Saint Andrews Blvd.
claims that their hot water heater burst.
6,637.50 0.00 9,424.50 0.00 0.00 0.00 0.00 16,062.00
Total by Major Coverage 16 Claims 6,637.50 0.00 9,424.50 0.00 0.00 0.00 0.00 16,062.00
Major Coverage: 30 - Auto Liability
3203181908931 CLOUTIER, TOBY 0.00 0.00 2,897.98 0.00 0.00 0.00 0.00 2,897.98
BPRI 3/18/2019 3/19/2019 6/19/2019 0.00 0.00 2,897.98 0.00 0.00 0.00 0.00 2,897.98
32 3000 A car swerved towards the employee's
vehicle and the employee swerved to
avoid the car, causing him to come into
contact with another vehicle. No
physical injuries and some minimal
damage to the citizen's vehicle and the
county vehicle.
3212031808520 MATTICE, SAMANTHA 0.00 0.00 1,141.65 0.00 0.00 0.00 0.00 1,141.65
ORMD 12/3/2018 12/4/2018 4/12/2019 0.00 0.00 1,141.65 0.00 0.00 0.00 0.00 1,141.65
32 3000 Sitting at a red light, traffic started to
move, employee tapped the back of the
car in front.
6
16.E.2.a
Packet Pg. 1043 Attachment: All Lines Closed Claim Report 3rd QTR FY 19 (10114 : Ratification of Claims Closed by the
3212101809036 Sixt Rent a Car 0.00 0.00 4,549.23 0.00 0.00 0.00 0.00 4,549.23
FMGE 12/10/2018 12/10/2018 6/30/2019 0.00 0.00 4,549.23 0.00 0.00 0.00 0.00 4,549.23
32 3000 Car1 on Pine Ridge crossed over
intersection running a red light. On
Goodlette-Frank Car2 slammed on
brakes and avoided Car 1. Car3 also
slammed on brakes but hit Car2 from
behind. Car3 was county vehicle.
3205121909137 CLARKSON, KENT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
MHCP 5/12/2019 5/13/2019 5/31/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
32 3000 While performing official duties on Marco
Island, Park Ranger Kavan's county
Ford F150 was struck on left rear
quarter panel by Mr. Clarkson's vehicle.
No injuries. Both vehicles sustained
minor damage.
3203281908970 Pro Lime 0.00 0.00 921.27 0.00 0.00 0.00 0.00 921.27
WATE 3/28/2019 3/28/2019 5/21/2019 0.00 0.00 921.27 0.00 0.00 0.00 0.00 921.27
32 3000 County employee was driving County
asset #CC2-785, and moving a large
Pro Lime trailers within the SCRWTP.
He was backing the trailer when he
struck the wheels of the trailer on a
raised concrete platform; this resulted in
the damage to the tire and rim.
4103021908874 Building Plan Review And Inspection
Division
0.00 0.00 779.42 0.00 0.00 0.00 0.00 779.42
BPRI 3/2/2019 3/4/2019 4/4/2019 0.00 0.00 779.42 0.00 0.00 0.00 0.00 779.42
30 3000 Stopped at a red light and employee's
foot slipped off the brake and bumped
the car in front of him.
3204231909068 Keren Julissa Arita 0.00 0.00 1,534.90 0.00 0.00 0.00 0.00 1,534.90
CENE 4/23/2019 4/23/2019 6/30/2019 0.00 0.00 1,534.90 0.00 0.00 0.00 0.00 1,534.90
32 3000 Employee was traveling northbound on
Airport Rd. The vehicle in front of her
unexpectedly slammed on the brakes,
and county vehicle rear ended the
vehicle in front of her.
3204081909009 OSSA, TERESA 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
WATE 4/8/2019 4/8/2019 4/17/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
32 3000 While backing out of parking spot struck
another vehicle in parking lot.
3202271908854 MISENA, SPAHIU 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
WWTE 2/27/2019 2/27/2019 5/13/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
32 3000 Collier county Vehicle CC2-617 Driver
was making right onto J&C Blvd from
Airport Pulling Rd. While making turn
reached for water bottle and rolled into
vehicle#2 rear bumper. Causing damage
to bumper.
3201111908742 ADODEO, AGNES 0.00 0.00 2,508.96 0.00 0.00 0.00 0.00 2,508.96
FLME 1/11/2019 2/1/2019 5/23/2019 0.00 0.00 2,508.96 0.00 0.00 0.00 0.00 2,508.96
32 3000 Fleet vehicle CC2-1070 (White F-150)
operated by employee, rear ended
Agnes Adodeos vehicle(blue BMW) at
the intersection of Countybarn Rd and
Davis Blvd.
3202071908773 FOX, GLENDA 0.00 0.00 3,523.32 0.00 0.00 0.00 0.00 3,523.32
PSVE 2/7/2019 2/8/2019 5/24/2019 0.00 0.00 3,523.32 0.00 0.00 0.00 0.00 3,523.32
7
16.E.2.a
Packet Pg. 1044 Attachment: All Lines Closed Claim Report 3rd QTR FY 19 (10114 : Ratification of Claims Closed by the
32 3000 County employee was driving down 951
in the middle lane and tried to get over
into the left lane, but didn't see the third
party vehicle in the left lane and struck
the third party vehicle.
3212211808585 Herard, Odilia 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
ORMD 12/21/2018 12/21/2018 4/19/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
32 3000 Employee(Vehicle 1) ran a red light
causing vehicle 2 to hit the side of the
county vehicle. Employee found at fault
for running red light.
3212181808570 SLOVA, ALMA 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
WATE 12/18/2018 12/18/2018 5/21/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
32 3000 Vehicle CC2-1840 was backing out of
parking space at 8855 Immokalee Rd
(Cameron Commons), without a spotter,
as a burgundy Honda Civic was passing
the vise on the F450 scrapped the right
front bumper and headlight of the
Honda.
3201141908649 CRONIN, ROSEMARY 0.00 0.00 12,468.00 0.00 0.00 0.00 0.00 12,468.00
TECM 1/14/2019 1/15/2019 4/30/2019 0.00 0.00 12,468.00 0.00 0.00 0.00 0.00 12,468.00
32 3000 Car accident on Livingston and Pine
Ridge Rd.
3103301706055 SEVERE, GARRY 20,000.00 2,355.80 3,784.75 0.00 0.00 0.00 0.00 26,140.55
TECM 3/30/2017 4/19/2017 5/31/2019 20,000.00 2,355.80 3,784.75 0.00 0.00 0.00 0.00 26,140.55
31 2450 Employee was traveling east on Davis
Blvd. when he failed to observe stopped
traffic and struck the vehicle in front of
him then pushing that vehicle into the
one in front of it.
3201221908697 PROLIME, STEVE 0.00 0.00 1,907.65 0.00 0.00 0.00 0.00 1,907.65
WATE 1/22/2019 1/23/2019 5/23/2019 0.00 0.00 1,907.65 0.00 0.00 0.00 0.00 1,907.65
32 3000 Steve from ProLime contacted plant staff
claiming one of our drivers backed into
one of his trailers into the second trailer.
The time and date of the incident is
unknown and both trailers were moved.
3203021908875 VOLCY, GEORGINA 0.00 0.00 1,947.07 0.00 0.00 0.00 0.00 1,947.07
BPRI 3/2/2019 3/4/2019 6/30/2019 0.00 0.00 1,947.07 0.00 0.00 0.00 0.00 1,947.07
32 3000 Stopped at a red light, employee's foot
slipped off the brake and truck bumped
the car in front.
20,000.00 2,355.80 37,964.20 0.00 0.00 0.00 0.00 60,320.00
Total by Major Coverage 17 Claims 20,000.00 2,355.80 37,964.20 0.00 0.00 0.00 0.00 60,320.00
Major Coverage: 40 - Auto Physical Damage
4103211908949 EMS 0.00 0.00 1,894.45 0.00 0.00 0.00 0.00 1,894.45
ASAE 3/21/2019 3/21/2019 6/12/2019 0.00 0.00 1,894.45 0.00 0.00 0.00 0.00 1,894.45
41 3000 EMS Tk21 was attempting to pass
through an intersection while responding
(emergency) to the hospital. When
passing a large truck, it moved and the
ambulance lightly struck it. The
ambulance continued and the truck left
the scene.
8
16.E.2.a
Packet Pg. 1045 Attachment: All Lines Closed Claim Report 3rd QTR FY 19 (10114 : Ratification of Claims Closed by the
4103181908930 Building Plan Review and Inspection
Division
0.00 0.00 484.11 0.00 0.00 0.00 0.00 484.11
BPRI 3/18/2019 3/19/2019 4/30/2019 0.00 0.00 484.11 0.00 0.00 0.00 0.00 484.11
41 3000 A car swerved towards the employee's
vehicle and the employee swerved to
avoid the car, causing him to come into
contact with another vehicle. No
physical injuries and some minimal
damage to the citizen's vehicle and the
county vehicle.
4103061908881 Utilities Planning And Project
Management Division
0.00 0.00 925.22 0.00 0.00 0.00 0.00 925.22
PAPM 3/6/2019 3/6/2019 5/31/2019 0.00 0.00 925.22 0.00 0.00 0.00 0.00 925.22
41 3000 Employee was attempting to pull into a
parking spot when they hit a parked
Trailer. The trailer was parked in the
travel lane and the employee assumed
he had enough room to go around. The
front bumber hit the corner of the trailer.
4104271909083 Water Division 0.00 0.00 438.45 0.00 0.00 0.00 0.00 438.45
WATE 4/27/2019 4/27/2019 6/12/2019 0.00 0.00 438.45 0.00 0.00 0.00 0.00 438.45
41 3000 Employee was driving on Airport Road
when semi truck struck passenger side
of vehicle causing damage to vehicle.
4104231909069 Code Enforcement Division 0.00 0.00 1,731.00 0.00 0.00 0.00 0.00 1,731.00
CENE 4/23/2019 4/24/2019 5/31/2019 0.00 0.00 1,731.00 0.00 0.00 0.00 0.00 1,731.00
41 3000 Employee was traveling northbound on
Airport Rd. The vehicle in front of her
unexpectedly slammed on the brakes,
and county vehicle rear ended the
vehicle in front of her.
4209101709092 Building Plan Review & Inspection
Division
1,749.18 0.00 0.00 0.00 0.00 0.00 0.00 1,749.18
BPRI 9/10/2017 4/30/2019 6/25/2019 1,749.18 0.00 0.00 0.00 0.00 0.00 0.00 1,749.18
42 5400 Damage to truck tailgate due to
Hurricane Irma.
4104171909046 EMS 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
ASAE 4/17/2019 4/17/2019 4/30/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
41 3000 While responding to an emergency call,
the community security gate came down
and struck the ambulance - minor
damage to truck. None to gate. Gate
STARS Report #3004171909045.
4104041908995 Building Plan Review And Inspection
Division
0.00 0.00 2,069.91 0.00 0.00 0.00 0.00 2,069.91
BPRI 4/4/2019 4/4/2019 5/30/2019 0.00 0.00 2,069.91 0.00 0.00 0.00 0.00 2,069.91
41 3000 Employee was backing up on the main
street and a lady backed out of her
driveway into the county vehicle.
4104101909012 Building Plan Review And Inspection
Division
0.00 0.00 503.22 500.00 0.00 0.00 0.00 503.22
BPRI 4/10/2019 4/10/2019 6/14/2019 0.00 0.00 503.22 500.00 0.00 0.00 0.00 503.22
41 5900 Employee does not know how it
happened. There is a dent in the
tailgate of the truck. It was reported
today.
4105271909194 Domestic Animal Services 0.00 0.00 1,124.45 0.00 0.00 0.00 0.00 1,124.45
DASE 5/27/2019 5/28/2019 6/30/2019 0.00 0.00 1,124.45 0.00 0.00 0.00 0.00 1,124.45
41 2150 I got stuck in sugar sand on Inez. I called
the fleet on call and he decided it’d be
best to pull me out backwards. While he
was pulling me out, a piece of PVC that
was hidden in the sand caught the front
bumper and ripped it off.
9
16.E.2.a
Packet Pg. 1046 Attachment: All Lines Closed Claim Report 3rd QTR FY 19 (10114 : Ratification of Claims Closed by the
4105171909158 Building Plan Review And Inspection
Division
0.00 0.00 749.26 500.00 0.00 0.00 0.00 749.26
BPRI 5/17/2019 5/17/2019 6/14/2019 0.00 0.00 749.26 500.00 0.00 0.00 0.00 749.26
41 3000 Construction moved his mailbox and he
hit the box with the side of the truck.
4105011909101 Project Planning, Impact Fees and
Program Management Division
0.00 0.00 748.62 0.00 0.00 0.00 0.00 748.62
CPPM 5/1/2019 5/1/2019 6/12/2019 0.00 0.00 748.62 0.00 0.00 0.00 0.00 748.62
41 3000 Mirror blinker cover made contact with
branch or pole while driving and
cracked.
4105131909135 Utilities Planning and Project
Management Division.
0.00 0.00 3,740.33 0.00 0.00 0.00 0.00 3,740.33
PAPM 5/13/2019 5/13/2019 6/14/2019 0.00 0.00 3,740.33 0.00 0.00 0.00 0.00 3,740.33
41 3000 While exiting the SCRWTP the
employee struck the exit gate with the
passenger side mirror. The employee
was distracted by construction activities
happening by the gate and moved
forward too quickly. There was no
damage to the Gate or Employee.
4104221909060 Water Division 0.00 0.00 1,243.74 0.00 0.00 0.00 0.00 1,243.74
WATE 4/22/2019 4/22/2019 5/30/2019 0.00 0.00 1,243.74 0.00 0.00 0.00 0.00 1,243.74
41 3000 While installing rock at driveway that
needed additional fill material, team
member struck the back of CC-1745 with
the backhoe.
4104221909065 Wastewater Division 0.00 0.00 1,609.16 0.00 0.00 0.00 0.00 1,609.16
WWTE 4/22/2019 4/23/2019 6/30/2019 0.00 0.00 1,609.16 0.00 0.00 0.00 0.00 1,609.16
41 3000 Driver ran over a stump with crew truck
CC2-845.
4203181909007 Facilities Management Division 429.28 0.00 0.00 0.00 0.00 0.00 0.00 429.28
FMGE 3/18/2019 4/8/2019 4/19/2019 429.28 0.00 0.00 0.00 0.00 0.00 0.00 429.28
42 5900 Crack in windshield.
4103181908927 Health Department 0.00 0.00 685.46 0.00 0.00 0.00 0.00 685.46
HDPE 3/18/2019 3/18/2019 4/4/2019 0.00 0.00 685.46 0.00 0.00 0.00 0.00 685.46
41 3000 While a Health Department employee
was backing out, skirting of rear bumper
got stuck on chain located on parking
garage 5th floor at Health Department
premises.
4104021908984 Parks and Recreation 0.00 0.00 1,126.64 0.00 0.00 0.00 0.00 1,126.64
MHCP 4/2/2019 4/2/2019 5/23/2019 0.00 0.00 1,126.64 0.00 0.00 0.00 0.00 1,126.64
41 3000 I was loading equipment when the trailer
hit the tailgate.
4102271908852 Wastewater Division 0.00 154.75 2,324.91 0.00 0.00 0.00 0.00 2,479.66
WWTE 2/27/2019 2/27/2019 5/31/2019 0.00 154.75 2,324.91 0.00 0.00 0.00 0.00 2,479.66
41 3000 Collier county Vehicle CC2-617 was
making a right onto J&C blvd from
Airport pulling Rd. While making the turn
he reached for water a bottle and rolled
into vehicle#2 rear bumper.
4102071908774 Public Services Administration Offices
Division
0.00 0.00 2,086.40 0.00 0.00 0.00 0.00 2,086.40
PSVE 2/7/2019 2/8/2019 4/30/2019 0.00 0.00 2,086.40 0.00 0.00 0.00 0.00 2,086.40
41 3000 County employee was driving down 951
in the middle lane and tried to get over
into the left lane, but didnt see the third
party vehicle in the left lane and struck
the third party vehicle.
10
16.E.2.a
Packet Pg. 1047 Attachment: All Lines Closed Claim Report 3rd QTR FY 19 (10114 : Ratification of Claims Closed by the
4101191908693 Solid Waste 0.00 0.00 2,440.77 0.00 0.00 0.00 0.00 2,440.77
SOWE 1/19/2019 1/23/2019 6/3/2019 0.00 0.00 2,440.77 0.00 0.00 0.00 0.00 2,440.77
41 3000 CC2-803 was hit by an unknown vehicle
as it backed up causing damage to the
front plastic grill, plastic bumper cap,
and front 2 strobe lights after hours. No
employee or contractor was involved.
No camera footage is avaiable to review.
4102041908749 Stake & Locate 0.00 0.00 1,015.88 0.00 0.00 0.00 0.00 1,015.88
SOWE 2/4/2019 2/4/2019 4/30/2019 0.00 0.00 1,015.88 0.00 0.00 0.00 0.00 1,015.88
41 3000 County vehicle was rear ended while
stuck in traffic. No bodily injuries. Minor
damage to rear bumper of CC2-1773.
No apparent damage to other vehicle.
4102041908748 Collection 0.00 0.00 1,273.00 0.00 0.00 0.00 0.00 1,273.00
WWTE 2/4/2019 2/4/2019 6/30/2019 0.00 0.00 1,273.00 0.00 0.00 0.00 0.00 1,273.00
41 3000 While county vehicle CC2 1874 was
pulling forward vehicle CC2 845 side bin
door was open . The open bin door
hooked on to the side of the moving
vehicle causing damage to both bin
doors
4102041908747 Collection 0.00 0.00 715.00 0.00 0.00 0.00 0.00 715.00
WWTE 2/4/2019 2/4/2019 5/14/2019 0.00 0.00 715.00 0.00 0.00 0.00 0.00 715.00
41 3000 While county vehicle CC2 1874 was
pulling forward vehicle CC2 845 side bin
door was open . The open bin door
hooked on to the side of the moving
vehicle causing damage to both vehicles
bin doors.
4110011808337 Traffic Operations 0.00 0.00 468.00 0.00 0.00 0.00 0.00 468.00
TECM 10/1/2018 10/2/2018 5/21/2019 0.00 0.00 468.00 0.00 0.00 0.00 0.00 468.00
41 3000 CC2-1382 scratched CC2-1681 while
backing into parking slot.
4101091908625 Parks and Recreation 0.00 0.00 882.09 0.00 0.00 0.00 0.00 882.09
MHCP 1/9/2019 1/9/2019 4/16/2019 0.00 0.00 882.09 0.00 0.00 0.00 0.00 882.09
41 3000 While parked, an unattended Patrol Unit
CC2-1273 was apparently struck by
unknown vehicle/object. The front
bumper sustained minor damage,
reported to supervisor upon discovery.
Due to the minor nature no further action
was taken.
4101021908597 Solid Waste 1,440.69 0.00 0.00 0.00 0.00 0.00 0.00 1,440.69
SOWE 1/2/2019 1/2/2019 5/21/2019 1,440.69 0.00 0.00 0.00 0.00 0.00 0.00 1,440.69
41 3200 Employee was driving vehicle CC2-1100
on Golden Gate Blvd, and came upon
road debris (metal) in the right lane. He
could not change lanes to avoid the
debris. The right front light cover was
damaged along with the right fender.
11
16.E.2.a
Packet Pg. 1048 Attachment: All Lines Closed Claim Report 3rd QTR FY 19 (10114 : Ratification of Claims Closed by the
4110101808359 BLDG Review and Permitting-Inspection 0.00 0.00 1,074.44 0.00 0.00 0.00 0.00 1,074.44
ORMD 10/10/2018 10/10/2018 5/30/2019 0.00 0.00 1,074.44 0.00 0.00 0.00 0.00 1,074.44
41 3000 Inspector was parked and backed out of
parking spot and hit a fire hydrant. Front
bumper sustained damage. No damage
to the hydrant.
4109201808305 EMS 0.00 0.00 950.69 0.00 0.00 0.00 0.00 950.69
EMSE 9/20/2018 9/20/2018 5/20/2019 0.00 0.00 950.69 0.00 0.00 0.00 0.00 950.69
41 3000 Driver Paramedic Kelli Renten pulled
onto Immokalee Rd southbound from
EMS 10 and was struck by a vehicle
travelling southbound on Immokalee Rd
causing minor damage to both vehs. No
persons were injured as result of the
incident. See attached IR.
4109181808297 Wastewater 0.00 0.00 1,000.00 0.00 0.00 0.00 0.00 1,000.00
WWTE 9/18/2018 9/18/2018 5/30/2019 0.00 0.00 1,000.00 0.00 0.00 0.00 0.00 1,000.00
41 3000 The driver was pulling into one of our
Well sites off of Immokalee Rd. The pull
off area is pretty tight. After pulling off
Immokalee, the driver then began to
back up to the Well when he struck the
light pole.
3,619.15 154.75 33,305.20 1,000.00 0.00 0.00 0.00 37,079.10
Total by Major Coverage 30 Claims 3,619.15 154.75 33,305.20 1,000.00 0.00 0.00 0.00 37,079.10
Major Coverage: 50 - Property
5203071908958 EMS 0.00 0.00 2,669.54 0.00 0.00 0.00 0.00 2,669.54
EMSE 3/7/2019 3/25/2019 6/12/2019 0.00 0.00 2,669.54 0.00 0.00 0.00 0.00 2,669.54
52 5500 Medic 30, placed thier toughbook
computer on the rear bumper of the
ambulance. They did not remember to
pick it up. Enroute to the hospital they
realized the computer was left on the
bumper. When they pulled over it was
not there.
5309101707556 Public Utilities Department, Wastewater
Collections, PS 300.35
223.00 60.00 0.00 0.00 0.00 0.00 0.00 283.00
WWTE 9/10/2017 2/9/2018 5/28/2019 223.00 60.00 0.00 0.00 0.00 0.00 0.00 283.00
53 5400 Fence damage resulting from IRMA.
5309101707550 Public Utilities Department, Wastewater
Collections, PS 300.20
408.00 60.00 0.00 0.00 0.00 0.00 0.00 468.00
WWTE 9/10/2017 2/8/2018 5/28/2019 408.00 60.00 0.00 0.00 0.00 0.00 0.00 468.00
53 5400 Fence damage resulting from IRMA.
5303251909272 Road Maintenance 6,670.43 0.00 0.00 0.00 0.00 0.00 0.00 6,670.43
RMSE 3/25/2019 6/19/2019 6/25/2019 6,670.43 0.00 0.00 0.00 0.00 0.00 0.00 6,670.43
53 3000 The guardrail along Immokalee Rd near
9850 Immokalee Road was destroyed.
No police report was found.
5304011909276 Road Maintenance 766.57 0.00 0.00 0.00 0.00 0.00 0.00 766.57
RMSE 4/1/2019 6/19/2019 6/25/2019 766.57 0.00 0.00 0.00 0.00 0.00 0.00 766.57
53 3000 Guardrail damage from traffic accident.
No police report found.
12
16.E.2.a
Packet Pg. 1049 Attachment: All Lines Closed Claim Report 3rd QTR FY 19 (10114 : Ratification of Claims Closed by the
5105111909152 North Collier Regional Park RecPlex 4,119.89 0.00 0.00 0.00 0.00 0.00 0.00 4,119.89
MHCP 5/11/2019 5/16/2019 5/31/2019 4,119.89 0.00 0.00 0.00 0.00 0.00 0.00 4,119.89
51 5300 The toilet in the spin room at the
RecPlex was continuously running and
flooded the entire spin room.
5302051808948 Library 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
LIBE 2/5/2018 3/21/2019 6/11/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
50 5900 When the Library reopened on 2/5/2018.
Roberta Stone noticed that the AED was
missing.
5305091809023 Traffic Operations 7,319.37 0.00 0.00 0.00 0.00 0.00 0.00 7,319.37
TECM 5/9/2018 4/12/2019 4/24/2019 7,319.37 0.00 0.00 0.00 0.00 0.00 0.00 7,319.37
53 3000 Staff found street light down.
5309051808921 CRA 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
CRAE 9/5/2018 3/14/2019 4/17/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
53 3000 A car knocked down a 40' light pole in
front of the "Bee Hive" store near the
intersection of 15th and Santa Rosa
Ave. in Immokalee Fl. There was no
witness and no police report filed.
5303121909279 Road Maintenance 7,264.00 0.00 0.00 0.00 0.00 0.00 0.00 7,264.00
RMSE 3/12/2019 6/19/2019 6/30/2019 7,264.00 0.00 0.00 0.00 0.00 0.00 0.00 7,264.00
53 3000 Guardrail damaged due to traffic
accident.
5304081909277 Road Maintenance 2,303.00 0.00 0.00 0.00 0.00 0.00 0.00 2,303.00
RMSE 4/8/2019 6/19/2019 6/30/2019 2,303.00 0.00 0.00 0.00 0.00 0.00 0.00 2,303.00
53 3000 Damage to guardrail from vehicle
accident.
5303151909273 Road Maintenance 1,825.00 0.00 0.00 0.00 0.00 0.00 0.00 1,825.00
RMSE 3/15/2019 6/19/2019 6/25/2019 1,825.00 0.00 0.00 0.00 0.00 0.00 0.00 1,825.00
53 3000 Traffic Accident caused guardrail
damage.
5301311909245 Traffic Operations 5,751.06 0.00 0.00 0.00 0.00 0.00 0.00 5,751.06
TECM 1/31/2019 6/12/2019 6/19/2019 5,751.06 0.00 0.00 0.00 0.00 0.00 0.00 5,751.06
53 3000 Street light down.
5105071909115 Transportation Engineering Division 14,846.40 0.00 0.00 0.00 0.00 0.00 0.00 14,846.40
TECM 5/7/2019 5/7/2019 5/31/2019 14,846.40 0.00 0.00 0.00 0.00 0.00 0.00 14,846.40
51 5100 Fire sprinkler were being tested at GMD
2885 South Horseshoe Dr. Employees
heard loud sound about 9:00 am.Water
came in to office ruined ceiling carpart
and walls. Large amount of H20 in
Traffic.
5104201909074 Tax Collector 51.88 0.00 0.00 0.00 0.00 0.00 0.00 51.88
TXCE 4/20/2019 4/25/2019 5/31/2019 51.88 0.00 0.00 0.00 0.00 0.00 0.00 51.88
51 5900 Over the weekend, something hit the
glass on the side door of the main DL
building, and the door is now cracked.
5309101709188 Wastewater Division (PS 300.34)0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
WWTE 9/10/2017 5/28/2019 5/30/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
53 5400 PS 300.34 Double panel gate damaged
and wooden gate needs reattachment
and needs reallignment to chain link
fence.
5309101709187 Wastewater Divison (PS 300.32)0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
WWTE 9/10/2017 5/28/2019 5/30/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
53 5400 PS 300.32 Front Gate damage and
fencing needs re-allignment.
13
16.E.2.a
Packet Pg. 1050 Attachment: All Lines Closed Claim Report 3rd QTR FY 19 (10114 : Ratification of Claims Closed by the
5309101709186 Wastewater Division (PS 300.36)0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
WWTE 9/10/2017 5/28/2019 5/30/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
50 5400 Fencing Damage at PS300.36, re-
allignment needed of ~10lf of black
coated chain link fence.
5111111808737 Naples Jail Center 475.00 0.00 0.00 0.00 0.00 0.00 0.00 475.00
FMGE 11/11/2018 1/31/2019 6/12/2019 475.00 0.00 0.00 0.00 0.00 0.00 0.00 475.00
51 5900 Inmate Paul Michael Furey kicked in the
bottom window of the cell door.
5106251909308 Eagle Lakes Community Park 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
MHCP 6/25/2019 6/26/2019 6/30/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
51 5900 Sometime after 7pm on 6/25/19 Eagle
Lakes Community Park experienced
some severe weather. There is damage
to the softball field backstop and
bleachers. Field house soffit, Soccer
bleachers where blown against the
soccer fence. Aquatics has fence
damage.
5406251909306 Eagle Lakes Community Park 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
MHCP 6/25/2019 6/26/2019 6/30/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
54 5900 Sometime after 7pm on 6/25/19 Eagle
Lakes Community Park experienced
some severe weather. There is damage
to the softball field backstop and
bleachers. Field house soffit, Soccer
bleachers where blown against the
soccer fence. Aquatics has fence
damage.
5209101706999 Clam Pass Park 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
MHCP 9/10/2017 10/19/2017 5/21/2019 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
52 5400 Kayaks thrown about Clam Pass Park
during Hurricane Irma.
1309101706987 Wastewater Collections 0.00 8,148,460.03 0.00 6,834,630.36 0.00 0.00 0.00 8,148,460.03
WWTE 9/10/2017 10/18/2017 5/21/2019 0.00 8,148,460.03 0.00 6,834,630.36 0.00 0.00 0.00 8,148,460.03
130 5400 Post Hurricane Irma Wastewater
contracted force pumper trucks and
force generators to keep the lift stations
working and prevent overflows.
5111301808509 North Collier Regional Park 10,362.20 2.00 0.00 0.00 0.00 0.00 0.00 10,364.20
PSVE 11/30/2018 11/30/2018 6/21/2019 10,362.20 2.00 0.00 0.00 0.00 0.00 0.00 10,364.20
51 5900 Sewage Backup.
5309101706758 Traffic Operations (Light Poles)424,875.87 60.00 0.00 319,199.33 0.00 0.00 0.00 424,935.87
TECM 9/10/2017 10/4/2017 5/21/2019 424,875.87 60.00 0.00 319,199.33 0.00 0.00 0.00 424,935.87
53 5400 During Hurricane Irma the county-owned
street lighting sustained significant
damage.
5311251707190 Parks & Recreation Division 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
MHCP 11/25/2017 11/28/2017 6/7/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
53 5900 A piece of the playground slide was
found on the ground Saturday morning.
Caution tape was wrapped around the
slide for no public use.. Need replaced
asap because of Department of Children
and Families will be coming out in 1st
week in December.
14
16.E.2.a
Packet Pg. 1051 Attachment: All Lines Closed Claim Report 3rd QTR FY 19 (10114 : Ratification of Claims Closed by the
5309101706602 CAT (Bus Stop ID 193)0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
PTNE 9/10/2017 9/26/2017 5/23/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
53 5400 Decorative light pole broken.
5312071808545 Collection 4,473.47 0.00 0.00 0.00 0.00 0.00 0.00 4,473.47
WWTE 12/7/2018 12/7/2018 6/12/2019 4,473.47 0.00 0.00 0.00 0.00 0.00 0.00 4,473.47
53 2350 Upon field crew station inspection they
found main entry doors were damaged
like a crow bar tried to pull open the
doors.
5111111808459 Natural Resources building 87,021.41 0.00 0.00 14,490.84 0.00 0.00 0.00 87,021.41
FMGE 11/11/2018 11/13/2018 6/21/2019 87,021.41 0.00 0.00 14,490.84 0.00 0.00 0.00 87,021.41
51 2400 Water Main Pipe Broken. Caused
flooding of building.
5211251808496 Parks and Other Property 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
MHCP 11/25/2018 11/26/2018 6/3/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
52 Noticed all the equipment was gone this
morning when I came into back of pump
house and notice gates were cut. and
called cops when I notice that.
5109101706641 Facilities Management (ISS Trailer)0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
FMGE 9/10/2017 9/27/2017 5/21/2019 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
51 5400 Roof leak by east end roof vent of the
trailer.
5309101707081 Redroot Preserve Land-CC 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
MHCP 9/10/2017 10/31/2017 5/21/2019 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400 Damage to the Entrance Sign.
1359101707069 IFAS - University Extension 0.00 86,610.46 0.00 0.00 0.00 0.00 0.00 86,610.46
UESE 9/10/2017 10/27/2017 4/30/2019 0.00 86,610.46 0.00 0.00 0.00 0.00 0.00 86,610.46
135 5400 Hurricane Irma caused significant
damage to the building requiring the
temporary relocation of staff and
operations.
5309101706550 Airport Authority (Immokalee Aiport
Terminal)
15,063.23 60.00 0.00 0.00 0.00 0.00 0.00 15,123.23
OPRS 9/10/2017 9/21/2017 4/30/2019 15,063.23 60.00 0.00 0.00 0.00 0.00 0.00 15,123.23
53 5400 Multiple traffic signs destroyed. Both
windsock frames & pole for runway 9/27
destroyed. One ramp security light pole
bent forward.
5309101707130 Stormwater Management (Water Level
Monitors)
16,317.60 60.00 0.00 0.00 0.00 0.00 0.00 16,377.60
RMSE 9/10/2017 11/13/2017 5/21/2019 16,317.60 60.00 0.00 0.00 0.00 0.00 0.00 16,377.60
53 5400 Durring Irma high winds and high tide
damaged water monitoring equipment.
5309101706762 Traffic Operations (Roadway Signs)912,896.68 60.00 0.00 718,198.50 0.00 0.00 0.00 912,956.68
TECM 9/10/2017 10/5/2017 5/21/2019 912,896.68 60.00 0.00 718,198.50 0.00 0.00 0.00 912,956.68
53 5400 During Hurricane Irma the county's
roadway signs sustained significant
damages.
5309101707838 Public Utilities Department, Wellfield
Division, Tamiami Well 18
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
WATE 9/10/2017 3/30/2018 5/31/2019 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400 Large Generator Damaged.
1,523,034.06 8,235,672.49 2,669.54 7,886,519.03 0.00 0.00 0.00 9,761,376.09
Total by Major Coverage 37 Claims 1,523,034.06 8,235,672.49 2,669.54 7,886,519.03 0.00 0.00 0.00 9,761,376.09
15
16.E.2.a
Packet Pg. 1052 Attachment: All Lines Closed Claim Report 3rd QTR FY 19 (10114 : Ratification of Claims Closed by the
Major Coverage: 60 - Public Officials Errors and
6712141808680 Collier County Clerks Office 25,000.00 0.00 0.00 0.00 0.00 0.00 0.00 25,000.00
CLAE 12/14/2018 1/18/2019 4/19/2019 25,000.00 0.00 0.00 0.00 0.00 0.00 0.00 25,000.00
67 Funds remitted to a fraudulent bank
account. Fraudulent banking information
provided to the COC for a BCC vendor
(Quality Enterprises). BCC Procurement
updated master vendor data using this
fraudulent information. Payment reflects
only the deductible portion of the claim.
6703011909258 GIL CARLOS, JUAN 0.00 0.00 9,500.00 0.00 0.00 0.00 0.00 9,500.00
COL 3/1/2019 6/13/2019 6/30/2019 0.00 0.00 9,500.00 0.00 0.00 0.00 0.00 9,500.00
67 New ADA Complaint/2:19-cv-372 Juan
Carlos Gil v Collier County, Florida/ADA
Website Accessibility Blind Visually
Impaired.
25,000.00 0.00 9,500.00 0.00 0.00 0.00 0.00 34,500.00
Total by Major Coverage 2 Claims 25,000.00 0.00 9,500.00 0.00 0.00 0.00 0.00 34,500.00
1,846,493.59 8,266,268.12 168,071.08 7,887,519.03 0.00 0.00 0.00 10,280,832.79
Grand Totals: 144 Claims 1,846,493.59 8,266,268.12 168,071.08 7,887,519.03 0.00 0.00 0.00 10,280,832.79
9/4/2019
10:03:44 AM
16
16.E.2.a
Packet Pg. 1053 Attachment: All Lines Closed Claim Report 3rd QTR FY 19 (10114 : Ratification of Claims Closed by the
Collier County Government
Subrogation Closed Claim Report
3rd QTR FY 2019
Valued as of:9/5/2019
Total Inc Ind/PD/CollExpense RecoveryMed/BI/Comp Deductible Legal Other
Claim Number Employee Name Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total
Coverage Carrier
Division
Cause
Date of Loss
Employer Acc Desc.
Date Report to RiskStatus Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total
12,487.81 0.00 0.00 0.00 24,584.76 12,487.81 0.00 0.00CC v. Joe Giannone4105101807957
5/14/20195/10/2018 5/10/2018 0.00 12,487.81 0.00 24,584.76 12,487.81 0.00 0.00 0.00CENE
41 While driving northbound on
Livingston Rd, employee had a
rear end collision with a Nissan
that was slowing down due to a
broken down vehicle (Chevrolet).
The Nissan rear ended the
Chevy and then the County veh
rear ended the Nissan.
3000
3,879.23 0.00 0.00 0.00 7,758.46 3,879.23 0.00 0.00Bureau of Emergency Division v.
State Farm
4112061808538
5/24/201912/6/2018 12/6/2018 0.00 3,879.23 0.00 7,758.46 3,879.23 0.00 0.00 0.00EMSE
41 Vehicle 1 was traveling south on
Rattle Snake Hammock Rd
entering the intersection on a red
traffic signal(witness confirmed).
County vehicle WB on 41
lights/sirens on entering the
intersection and Veh 1 struck the
right front area of County Veh
3000
3,149.93 0.00 0.00 0.00 10,244.23 3,149.93 0.00 0.00Landscape operations v. Brian
Chorman(Progressive
Insurance)
5410201808510
5/10/201910/20/2018 11/30/2018 0.00 3,149.93 0.00 10,244.23 3,149.93 0.00 0.00 0.00RMSE
54 Employee on his own personal
time( in his own car) driving 110
mph tried to make a right turn
onto Golden Gate went off the
road struck multiple poles,
passed over multiple medians
striking multiple shrubs.
3000
0.00 0.00 0.00 0.00 6,590.96 0.00 0.00 0.00Transportation Engineering
Division v. (Brian
Chorman)Progressive Insurance
5310201808850
5/10/201910/20/2018 2/27/2019 0.00 0.00 0.00 6,590.96 0.00 0.00 0.00 0.00TECM
53 Cost center 163630 Traffic
Car hit sign, ped pole, and street
light.
3000
-1-
8:41:21AM
9/5/2019
16.E.2.b
Packet Pg. 1054 Attachment: Subrogation Closed Claim Report 3rd QTR FY 19 (10114 : Ratification of Claims Closed by
Collier County Government
Subrogation Closed Claim Report
3rd QTR FY 2019
Valued as of:9/5/2019
Total Inc Ind/PD/CollExpense RecoveryMed/BI/Comp Deductible Legal Other
Claim Number Employee Name Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total
Coverage Carrier
Division
Cause
Date of Loss
Employer Acc Desc.
Date Report to RiskStatus Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total
0.00 0.00 0.00 0.00 216.48 0.00 0.00 0.00Transportation Engineering
Division v. Joseph Okuniewicz
5304041807856
4/9/20194/4/2018 4/5/2018 0.00 0.00 0.00 216.48 0.00 0.00 0.00 0.00TECM
53 Car hit traffic Signal boxL105
0.00 0.00 0.00 0.00 8,239.75 0.00 0.00 0.00Traffic Operations v. Progressive
Insurance
5311181809006
6/6/201911/18/2018 4/8/2019 0.00 0.00 0.00 8,239.75 0.00 0.00 0.00 0.00TECM
53 Street light down due to car
accident.
3000
908.07 0.00 0.00 0.00 1,816.14 908.07 0.00 0.00EMS V. Greater Naples Fire
District
4110041808344
4/30/201910/4/2018 10/4/2018 0.00 908.07 0.00 1,816.14 908.07 0.00 0.00 0.00EMSE
41 While our crew was in the
patient treatment area of the
ambulance, they heard a
scraping sound from the exterior
of the ambulance. GNFD
informed them that while
attempting to pass the
ambulance, their fire engine
swipped the rear drivers side.
3000
0.00 0.00 0.00 0.00 754.56 0.00 0.00 0.00Traffic Operations v. Granada
Insurance
5310061808370
6/21/201910/6/2018 10/15/2018 0.00 0.00 0.00 754.56 0.00 0.00 0.00 0.00TECM
53 Truck making a turn lost a load
and damaged the ped pole.
3000
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00Road Maintenance Division v.
Progressive Insurance
5302281908878
6/25/20192/28/2019 3/5/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00RMSE
53 Private vehicle hit railing on
bridge.
3000
0.00 0.00 0.00 0.00 4,248.15 0.00 0.00 0.00Landscape operations v. Safe
Co
5408171808722
6/21/20198/17/2018 1/28/2019 0.00 0.00 0.00 4,248.15 0.00 0.00 0.00 0.00RMSE
54 There was a car accident which
damaged landscape materials
per police report.
3000
0.00 0.00 0.00 0.00 9,021.83 0.00 0.00 0.00Traffic Opeations v. Safe Co5308171808664
6/21/20198/17/2018 1/16/2019 0.00 0.00 0.00 9,021.83 0.00 0.00 0.00 0.00TECM
53 Street light down3000
-2-
8:41:21AM
9/5/2019
16.E.2.b
Packet Pg. 1055 Attachment: Subrogation Closed Claim Report 3rd QTR FY 19 (10114 : Ratification of Claims Closed by
Collier County Government
Subrogation Closed Claim Report
3rd QTR FY 2019
Valued as of:9/5/2019
Total Inc Ind/PD/CollExpense RecoveryMed/BI/Comp Deductible Legal Other
Claim Number Employee Name Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total
Coverage Carrier
Division
Cause
Date of Loss
Employer Acc Desc.
Date Report to RiskStatus Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total
0.00 0.00 0.00 0.00 479.00 0.00 0.00 0.00Parks and Recreation v.
Progressive Insurance
5402261908848
6/4/20192/26/2019 2/27/2019 0.00 0.00 0.00 479.00 0.00 0.00 0.00 0.00MHCP
54 Single vehicle accident - vehicle
exiting NCRP. Happened upon
scene after operator transported
to hospital, according to
on-scene CCSO deputies.
Damage to vehicle, several Park
trees/shrubs and grass median.
3000
9,705.11 0.00 0.00 0.00 20,000.00 9,705.11 0.00 0.00BLDG REVIEW &
PERMITTING-INSPECTION v.
Esurance
4112111808555
6/7/201912/11/2018 12/12/2018 0.00 9,705.11 0.00 20,000.00 9,705.11 0.00 0.00 0.00ORMD
41 Employee driving in his lane on
white blvd, a car came into
employees lane, and he swerved
right to miss head on collision,
and claimant hit county vehicle
on left side and pushed him into
the ditch.
3000
448.87 0.00 0.00 0.00 490.04 448.87 0.00 0.00Utilities Engineering v.
Progressive Insurance
4102061908760
5/30/20192/6/2019 2/6/2019 0.00 448.87 0.00 490.04 448.87 0.00 0.00 0.00PAPM
41 Vehicle was traveling south on
Airport Pulling Road when a
vehicle exiting Trade Center Way
clipped the rear bumper of the
vehicle. Little damage done to
rear bumper.
3000
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00Road Maintenance v.
Progressive Insurance
5012171808686
5/31/201912/17/2018 1/22/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00RMSE
50 Vehicle fire caused damage to
roadway.
0.00 0.00 0.00 0.00 74.65 0.00 0.00 0.00Transportation Engineering
Division v. Allstate
5302051908914
5/6/20192/5/2019 3/13/2019 0.00 0.00 0.00 74.65 0.00 0.00 0.00 0.00TECM
53 Sign and curb hit by car3000
-3-
8:41:21AM
9/5/2019
16.E.2.b
Packet Pg. 1056 Attachment: Subrogation Closed Claim Report 3rd QTR FY 19 (10114 : Ratification of Claims Closed by
Collier County Government
Subrogation Closed Claim Report
3rd QTR FY 2019
Valued as of:9/5/2019
Total Inc Ind/PD/CollExpense RecoveryMed/BI/Comp Deductible Legal Other
Claim Number Employee Name Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total
Coverage Carrier
Division
Cause
Date of Loss
Employer Acc Desc.
Date Report to RiskStatus Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total
0.00 0.00 0.00 0.00 10,479.42 0.00 0.00 0.00Landscape operations v.
Gallagher Bassett
5408221808723
4/15/20198/22/2018 1/28/2019 0.00 0.00 0.00 10,479.42 0.00 0.00 0.00 0.00RMSE
54 There was a car accident which
damaged landscape materials
per police report.
3000
0.00 0.00 0.00 0.00 1,710.63 0.00 0.00 0.00Landscape operations v.
Progressive Insurance
5412271808730
4/9/201912/27/2018 1/29/2019 0.00 0.00 0.00 1,710.63 0.00 0.00 0.00 0.00RMSE
54 There was a car accident which
caused damage to landscape
materials (see attached report).
3000
0.00 0.00 0.00 0.00 1,437.62 0.00 0.00 0.00Transportation Engineering
Division v. Geico
5301191908901
4/9/20191/19/2019 3/11/2019 0.00 0.00 0.00 1,437.62 0.00 0.00 0.00 0.00TECM
53 Big sign hit by auto accident.3000
0.00 0.00 0.00 0.00 5,943.44 0.00 0.00 0.00Transportation Engineering
Division v. Jordi Aviles Lopez
5304071807955
4/9/20194/7/2018 5/10/2018 0.00 0.00 0.00 5,943.44 0.00 0.00 0.00 0.00TECM
53 Jordi Avile Lopez was driving
East on Pine Ridge, went off the
road on the south side, jumped
the curb and struck two road
directional signs, and then struck
a street light pole.
0.00 0.00 0.00 0.00 6,488.09 0.00 0.00 0.00Cat Transit v. Safeco5311061808441
6/24/201911/6/2018 11/8/2018 0.00 0.00 0.00 6,488.09 0.00 0.00 0.00 0.00PTNE
53 Bus shelter hit due to a car
accident.
3000
0.00 0.00 0.00 0.00 2,300.00 0.00 0.00 0.00Road Maintenance Division v.
Geico
5412291605859
6/24/201912/29/2016 2/15/2017 0.00 0.00 0.00 2,300.00 0.00 0.00 0.00 0.00RMSE
54 Russell Brockwell was turning
right onto Tamiami Trail from
Lely Resort Blvd. and lost control
of the vehicle. He ran off the
roadway and struck a palm tree.
3000
-4-
8:41:21AM
9/5/2019
16.E.2.b
Packet Pg. 1057 Attachment: Subrogation Closed Claim Report 3rd QTR FY 19 (10114 : Ratification of Claims Closed by
Collier County Government
Subrogation Closed Claim Report
3rd QTR FY 2019
Valued as of:9/5/2019
Total Inc Ind/PD/CollExpense RecoveryMed/BI/Comp Deductible Legal Other
Claim Number Employee Name Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total
Coverage Carrier
Division
Cause
Date of Loss
Employer Acc Desc.
Date Report to RiskStatus Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total
0.00 0.00 0.00 0.00 6,311.46 0.00 0.00 0.00Traffic Operations v. Ocean
Harbor Insurance
5306171808624
6/24/20196/17/2018 1/9/2019 0.00 0.00 0.00 6,311.46 0.00 0.00 0.00 0.00TECM
53 Street light hit by car.3000
0.00 0.00 0.00 0.00 3,333.99 0.00 0.00 0.00CC v. Bonard, Rodney (CA)5312270802658
5/15/201912/27/2008 1/29/2009 0.00 0.00 0.00 3,333.99 0.00 0.00 0.00 0.00RMSE
53 JE Rodney Bonard was traveling
west on US41 and became
fatigued, as he had been up for
21 hours, and failed to negotiate
a curve to the left and struck a
guardrail.
1400
0.00 0.00 0.00 0.00 2,015.20 0.00 0.00 0.00Road Maintenance Division v.
Windhaven Insurance
5303191909011
5/20/20193/19/2019 4/10/2019 0.00 0.00 0.00 2,015.20 0.00 0.00 0.00 0.00RMSE
53 V2 traveled up onto the median,
V2 struck a street sign and then
continued into oncoming traffic in
the west bound lanes. V2's front
center bumper struck the
guardrail on the north side of
lmmokalee Rd. V2 finally came
to point of rest. V1
3000
0.00 0.00 0.00 0.00 1,211.08 0.00 0.00 0.00Traffic Operations v. Security
National Insurance
5304101909031
5/20/20194/10/2019 4/15/2019 0.00 0.00 0.00 1,211.08 0.00 0.00 0.00 0.00TECM
53 Street light hit by car.3000
0.00 0.00 0.00 0.00 25,719.29 0.00 0.00 0.00Traffic Operations v. State Farm5312031809033
5/20/201912/3/2018 4/15/2019 0.00 0.00 0.00 25,719.29 0.00 0.00 0.00 0.00TECM
53 Signal and UPS cabinet hit by
car
3000
0.00 0.00 0.00 0.00 5,660.80 0.00 0.00 0.00Road Maintenance Division v.
Federated Mutual
5303111909016
5/13/20193/11/2019 4/10/2019 0.00 0.00 0.00 5,660.80 0.00 0.00 0.00 0.00RMSE
53 V1 failed to slow and collided
with V2. V1 then swerved to its
right and collided with a
guardrail.
3000
-5-
8:41:21AM
9/5/2019
16.E.2.b
Packet Pg. 1058 Attachment: Subrogation Closed Claim Report 3rd QTR FY 19 (10114 : Ratification of Claims Closed by
Collier County Government
Subrogation Closed Claim Report
3rd QTR FY 2019
Valued as of:9/5/2019
Total Inc Ind/PD/CollExpense RecoveryMed/BI/Comp Deductible Legal Other
Claim Number Employee Name Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total
Coverage Carrier
Division
Cause
Date of Loss
Employer Acc Desc.
Date Report to RiskStatus Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total
0.00 0.00 0.00 0.00 1,034.37 0.00 0.00 0.00Transportation Engineering
Division v. Geico
5302271908892
5/13/20192/27/2019 3/8/2019 0.00 0.00 0.00 1,034.37 0.00 0.00 0.00 0.00TECM
53 Street light down due to car
accident.
3000
0.00 0.00 0.00 0.00 1,017.66 0.00 0.00 0.00Landscape operations v. Geico5402251908908
5/7/20192/25/2019 3/13/2019 0.00 0.00 0.00 1,017.66 0.00 0.00 0.00 0.00RMSE
54 There was a traffic accident
where the vehicle went up onto
the median crushing the bushes
and breaking a sprinkler system
lid.
3000
0.00 0.00 0.00 0.00 692.92 0.00 0.00 0.00Landscape Operations v.
Federal Insurance
5403041908928
4/2/20193/4/2019 3/18/2019 0.00 0.00 0.00 692.92 0.00 0.00 0.00 0.00RMSE
54 V2 was stopped in wb traffic on
CR 886 (Golden Gate Pkwy) in
the inside lane just east of 70th
ST SW. V1 was traveling wb on
Golden Gate Pkwy in the inside
lane. V1 collided into V2 ended
up in the median.
3000
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00Solid Waste Division4104011908981
4/1/20194/1/2019 4/1/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00SOWE
41 Heading down Santa Barbra
east bound, county driver
completely stopped at
intersecting light on davis with
cars in front of him. Car behind
him rear ended his county truck.
3000
0.00 0.00 0.00 0.00 6,841.36 0.00 0.00 0.00Traffic Operations v. Geico5302231908962
6/28/20192/23/2019 3/26/2019 0.00 0.00 0.00 6,841.36 0.00 0.00 0.00 0.00TECM
50 Light pole down due to accident.3000
0.00 0.00 0.00 0.00 4,558.67 0.00 0.00 0.00Landscape Operations v.
Century-National Ins.
5405221808652
4/15/20195/22/2018 1/15/2019 0.00 0.00 0.00 4,558.67 0.00 0.00 0.00 0.00RMSE
54 There was a car accident which
caused damage to landscape
materials per police report.
3000
-6-
8:41:21AM
9/5/2019
16.E.2.b
Packet Pg. 1059 Attachment: Subrogation Closed Claim Report 3rd QTR FY 19 (10114 : Ratification of Claims Closed by
Collier County Government
Subrogation Closed Claim Report
3rd QTR FY 2019
Valued as of:9/5/2019
Total Inc Ind/PD/CollExpense RecoveryMed/BI/Comp Deductible Legal Other
Claim Number Employee Name Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total
Coverage Carrier
Division
Cause
Date of Loss
Employer Acc Desc.
Date Report to RiskStatus Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total
0.00 0.00 0.00 0.00 3,208.71 0.00 0.00 0.00Landscape operations v. Geico5408241808661
4/2/20198/24/2018 1/16/2019 0.00 0.00 0.00 3,208.71 0.00 0.00 0.00 0.00RMSE
54 There was a car accident which
adamaged landscape materials
per the police report.
3000
0.00 0.00 0.00 0.00 750.00 0.00 0.00 0.00Landscape Operations v. Ocean
Harbor Insurance
5404281808651
4/2/20194/28/2018 1/15/2019 0.00 0.00 0.00 750.00 0.00 0.00 0.00 0.00RMSE
54 There was a car accident that
damaged landscape materials
per the police report.
3000
0.00 0.00 0.00 0.00 930.00 0.00 0.00 0.00Road Maintenance v.
Progressive Insurance
5410191606070
4/2/201910/19/2016 4/21/2017 0.00 0.00 0.00 930.00 0.00 0.00 0.00 0.00RMSE
54 Anthony Sealy was traveling
east on Orange Blossom Drive
turning onto Airport Road when
he lost control of the vehicle and
stuck the curb then collided with
a tree.
3000
0.00 0.00 0.00 0.00 1,695.22 0.00 0.00 0.00Transportation Engineering
Division v. Geico
5312291707790
6/19/201912/29/2017 3/22/2018 0.00 0.00 0.00 1,695.22 0.00 0.00 0.00 0.00TECM
53 Automobile hit a pedestrian ped
pole see crash report for more
info.
2450
0.00 0.00 0.00 0.00 5,587.95 0.00 0.00 0.00Traffic Operations v. Progressive
Insurance
5304251808980
6/18/20194/25/2018 4/1/2019 0.00 0.00 0.00 5,587.95 0.00 0.00 0.00 0.00TECM
53 Street light down due to car
accident.
3000
0.00 0.00 0.00 0.00 7,392.04 0.00 0.00 0.00Traffic Operations v. Windhaven
Insurance
5307171808656
5/20/20197/17/2018 1/15/2019 0.00 0.00 0.00 7,392.04 0.00 0.00 0.00 0.00TECM
53 Vehicle 1 left the right side of
livingston road going north
driving over the curb crashing
into a utility light pole before
re-entering the roadway coming
to a stop in the middle of the
roadway.
3000
-7-
8:41:21AM
9/5/2019
16.E.2.b
Packet Pg. 1060 Attachment: Subrogation Closed Claim Report 3rd QTR FY 19 (10114 : Ratification of Claims Closed by
Collier County Government
Subrogation Closed Claim Report
3rd QTR FY 2019
Valued as of:9/5/2019
Total Inc Ind/PD/CollExpense RecoveryMed/BI/Comp Deductible Legal Other
Claim Number Employee Name Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total
Coverage Carrier
Division
Cause
Date of Loss
Employer Acc Desc.
Date Report to RiskStatus Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total
0.00 0.00 0.00 0.00 1,976.03 0.00 0.00 0.00Traffic Operations v. Geico5303191908952
4/23/20193/19/2019 3/22/2019 0.00 0.00 0.00 1,976.03 0.00 0.00 0.00 0.00TECM
53 Street light down from car
accident.
3000
1,128.69 0.00 0.00 0.00 1,169.86 1,128.69 0.00 0.00Wastewater Division v. Geico4104101909018
5/31/20194/10/2019 4/11/2019 0.00 1,128.69 0.00 1,169.86 1,128.69 0.00 0.00 0.00WWTE
41 Vehicle #CC2-1624 was hit by
another vehicle while pulling out
of a parking space. The other
vehicle was traveling the wrong
direction in a one way lane.
3000
0.00 0.00 0.00 0.00 5,240.61 0.00 0.00 0.00Traffic Operations v. Ocean
Harbor Insurance
5304081808472
4/15/20194/8/2018 11/14/2018 0.00 0.00 0.00 5,240.61 0.00 0.00 0.00 0.00TECM
53 Driver 1 traveling North in the
inside lane of Airport Pulling Rd ,
when he fell asleep, next thing
he recalls he went over a
elevated median across all south
bound lanes of Airport Pulling Rd
and into a street light pole.
3000
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00Water Division v. State Farm4105211909175
5/23/20195/21/2019 5/22/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00WATE
41 Cecil Spangler was driving on
Progress Ave when a vehicle ran
a stop sign in front of Cecil and
was struck in the left rear of the
car by Cecil.
3000
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00Traffic Operations v. Peak
Property and Casualty
5306071808213
5/10/20196/7/2018 8/14/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00TECM
53 Stop sign was hit by accident.3000
0.00 0.00 0.00 0.00 2,487.86 0.00 0.00 0.00Traffic Operations v. Windhaven5310271809109
5/24/201910/27/2018 5/3/2019 0.00 0.00 0.00 2,487.86 0.00 0.00 0.00 0.00TECM
53 Pedestrian pole down due to
accident.
3000
0.00
0.00
0.00
0.00
31,707.71
31,707.71
211,713.29
211,713.29 0.00
0.00 0.00
0.00
0.00
0.00
31,707.71
31,707.71Grand Totals: 46 Claims
-8-
8:41:21AM
9/5/2019
16.E.2.b
Packet Pg. 1061 Attachment: Subrogation Closed Claim Report 3rd QTR FY 19 (10114 : Ratification of Claims Closed by
16.E.2.c
Packet Pg. 1062 Attachment: Resolution 2004-15 PDF0001 (10114 : Ratification of Claims Closed by the Risk Management Director for the Third Quarter FY 19)
16.E.2.c
Packet Pg. 1063 Attachment: Resolution 2004-15 PDF0001 (10114 : Ratification of Claims Closed by the Risk Management Director for the Third Quarter FY 19)
16.E.2.c
Packet Pg. 1064 Attachment: Resolution 2004-15 PDF0001 (10114 : Ratification of Claims Closed by the Risk Management Director for the Third Quarter FY 19)
16.E.2.c
Packet Pg. 1065 Attachment: Resolution 2004-15 PDF0001 (10114 : Ratification of Claims Closed by the Risk Management Director for the Third Quarter FY 19)
16.E.2.c
Packet Pg. 1066 Attachment: Resolution 2004-15 PDF0001 (10114 : Ratification of Claims Closed by the Risk Management Director for the Third Quarter FY 19)
16.E.2.c
Packet Pg. 1067 Attachment: Resolution 2004-15 PDF0001 (10114 : Ratification of Claims Closed by the Risk Management Director for the Third Quarter FY 19)