Agenda 02/25/2020 Item #16E 4 (Property, Casualty & Workers' Comp Claims Filed)02/25/2020
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 first quarter of FY20.
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 first quarter of FY 20
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 first quarter of FY 20, 163 files were closed with total expenditures of
$3,207,356.85. Reinsurance recoveries for the first quarter of FY 20 were $2,716,529.36. Both
expenditures and recoveries were primarily related to Hurricane Irma. During the same period, 27
subrogation files were closed, and the Risk Management Division recovered $296,755.47 in funds owed
to 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, raises no legal
issues, and requires majority vote for approval. -JAK
16.E.4
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02/25/2020
RECOMMENDATION: To accept the attached Settlement Report and ratify the actions taken therein.
Prepared by: Jeff Walker CPCU, ARM, Division Director, Risk Management Division.
ATTACHMENT(S)
1. All Lines Closed Claim Report 1st QTR FY 20 (PDF)
2. Subrogation Closed Claim Report 1st QTR FY 20 (PDF)
3. Resolution 2004-15 PDF0001 (PDF)
16.E.4
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02/25/2020
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.E.4
Doc ID: 11519
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 first quarter of FY20.
Meeting Date: 02/25/2020
Prepared by:
Title: – Risk Management
Name: Heidi Dareus
01/30/2020 9:15 AM
Submitted by:
Title: Division Director - Risk Management – Risk Management
Name: Jeff Walker
01/30/2020 9:15 AM
Approved By:
Review:
Risk Management Jeff Walker Additional Reviewer Completed 01/30/2020 9:27 AM
Administrative Services Department Paula Brethauer Level 1 Division Reviewer Completed 01/30/2020 2:59 PM
Administrative Services Department Len Price Level 2 Division Administrator Review Completed 02/10/2020 5:44 PM
County Attorney's Office Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Completed 02/11/2020 8:05 AM
Office of Management and Budget Debra Windsor Level 3 OMB Gatekeeper Review Completed 02/11/2020 8:27 AM
Office of Management and Budget Laura Wells Additional Reviewer Completed 02/13/2020 10:09 AM
County Manager's Office Leo E. Ochs Level 4 County Manager Review Completed 02/13/2020 12:23 PM
Board of County Commissioners MaryJo Brock Meeting Pending 02/25/2020 9:00 AM
16.E.4
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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
2,724.89 232.15 3,181.09 0.00 0.00 0.00 0.00 6,138.13
6/14/2019 6/14/2019 10/15/2019 2,724.89 232.15 3,181.09 0.00 0.00 0.00 0.00 6,138.13
10 1500
2,870.14 200.47 0.00 0.00 0.00 0.00 0.00 3,070.61
8/10/2019 8/21/2019 10/31/2019 2,870.14 200.47 0.00 0.00 0.00 0.00 0.00 3,070.61
10 1500
653.46 238.45 0.00 0.00 0.00 0.00 0.00 891.91
8/8/2019 8/8/2019 10/31/2019 653.46 238.45 0.00 0.00 0.00 0.00 0.00 891.91
10 1900
207.64 13.75 0.00 0.00 0.00 0.00 0.00 221.39
11/14/2019 11/14/2019 11/30/2019 207.64 13.75 0.00 0.00 0.00 0.00 0.00 221.39
10 1700
803.15 92.68 0.00 0.00 0.00 0.00 0.00 895.83
9/11/2019 9/11/2019 10/31/2019 803.15 92.68 0.00 0.00 0.00 0.00 0.00 895.83
10 1300
1,220.32 150.03 0.00 0.00 0.00 0.00 0.00 1,370.35
5/11/2019 5/13/2019 10/31/2019 1,220.32 150.03 0.00 0.00 0.00 0.00 0.00 1,370.35
10 1900
5,204.06 49.63 817.83 0.00 0.00 0.00 0.00 6,071.52
6/12/2019 7/12/2019 10/31/2019 5,204.06 49.63 817.83 0.00 0.00 0.00 0.00 6,071.52
10 1300
Collier County Government
Closed Claim Report- All Lines
1st QTR FY 2020
Claim Number Employee Name
Division
Employer Acc Desc.
Major Coverage: 10 - Workers' Compensation
1006141909264
ASAE
Employee turned left ankle stepping down
from Ambulance causing ankle to twist.
1008101909490
WWTE
Employee injured right shoulder when he
turned off valve on top of water plant.
1008081909453
ASAE
Employee came in contact with blood during
a cardiac arrest call.
1011141909802
ASAE
Employee was hit mutiple times in the head
with a metal ceiling fan when he walked into a
patient home.
1009111909575
DASE
Employee tripped and fell over tree root in
pasture area while feeding a pig.
1005111909134
EMSE
Employee was exposed to bodily fluid in right
eye when patient he was treating vomited.
1006121909361
FMGE
Employee fell when he was replacing a
wooden ramp that goes into the building and
the ramp was moved away for adjustments.
Employee is complaining of back and knee
pain.
2
16.E.4.a
Packet Pg. 2208 Attachment: All Lines Closed Claim Report 1st QTR FY 20 (11519 : Ratification of Claim FIles Closed by
0.00 13.75 0.00 0.00 0.00 0.00 0.00 13.75
12/1/2019 12/2/2019 12/31/2019 0.00 13.75 0.00 0.00 0.00 0.00 0.00 13.75
10 1300
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
12/10/2019 12/11/2019 12/31/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
10 1100
462.80 13.75 0.00 0.00 0.00 0.00 0.00 476.55
11/11/2019 11/12/2019 11/30/2019 462.80 13.75 0.00 0.00 0.00 0.00 0.00 476.55
10 1500
339.75 0.00 0.00 0.00 0.00 0.00 0.00 339.75
11/6/2019 11/6/2019 11/30/2019 339.75 0.00 0.00 0.00 0.00 0.00 0.00 339.75
10 1200
270.30 0.00 0.00 0.00 0.00 0.00 0.00 270.30
11/4/2019 11/4/2019 12/31/2019 270.30 0.00 0.00 0.00 0.00 0.00 0.00 270.30
10 1100
568.54 0.00 0.00 0.00 0.00 0.00 0.00 568.54
10/29/2019 11/12/2019 11/12/2019 568.54 0.00 0.00 0.00 0.00 0.00 0.00 568.54
10 1900
382.74 48.64 0.00 0.00 0.00 0.00 0.00 431.38
10/4/2019 10/7/2019 10/16/2019 382.74 48.64 0.00 0.00 0.00 0.00 0.00 431.38
10 1300
384.27 0.00 0.00 0.00 0.00 0.00 0.00 384.27
10/31/2019 10/31/2019 11/12/2019 384.27 0.00 0.00 0.00 0.00 0.00 0.00 384.27
10 1300
653.44 51.20 0.00 0.00 0.00 0.00 0.00 704.64
9/18/2019 9/26/2019 10/9/2019 653.44 51.20 0.00 0.00 0.00 0.00 0.00 704.64
10 1900
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
11/25/2019 11/26/2019 12/18/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
10 1600
1012011909849
MHCP
Employee was administering wrist bands to
patrons entering the pool when she took a
stumble and fell on her knee.
1012101909877
TXCE
Employee was cleaning eye tester machine
when her chair rolled back and hit her right
rib and breast.
1011111909793
ASAE
Employee injured lower back while lifting a
patient.
1011061909781
DASE
Employee was attempting to intake when cat
flipped over and bit left hand.
1011041909770
HURE
Employee was moving a file cabinet and
smashed left second finger.
1010291909795
RMSE
Employee felt dizzy while getting up from a
break.
1010041909683
FMGE
Employee fell off ladder injuring left knee and
right hand.
1010311909767
COCE
Employee fell on sidewalk while walking into
work.
1009181909653
RMSE
Employee observed a rash on his upper
extremities after work in the field.
1011251909833
COCE
Due to the employee turning her back to the
door while opening it, this caused her lower
back to hit the door handle, brusing her lower
back.
3
16.E.4.a
Packet Pg. 2209 Attachment: All Lines Closed Claim Report 1st QTR FY 20 (11519 : Ratification of Claim FIles Closed by
792.14 62.61 0.00 0.00 0.00 0.00 0.00 854.75
8/23/2019 8/30/2019 10/31/2019 792.14 62.61 0.00 0.00 0.00 0.00 0.00 854.75
10 1900
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
8/29/2019 10/10/2019 10/10/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
10 1500
1,485.60 143.30 0.00 0.00 0.00 0.00 0.00 1,628.90
8/29/2019 8/30/2019 10/18/2019 1,485.60 143.30 0.00 0.00 0.00 0.00 0.00 1,628.90
10 1500
429.71 122.09 0.00 0.00 0.00 0.00 0.00 551.80
10/29/2019 10/30/2019 10/31/2019 429.71 122.09 0.00 0.00 0.00 0.00 0.00 551.80
10 1700
289.16 0.00 0.00 0.00 0.00 0.00 0.00 289.16
11/19/2019 11/20/2019 12/2/2019 289.16 0.00 0.00 0.00 0.00 0.00 0.00 289.16
10 1500
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
12/7/2019 12/7/2019 12/26/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
10 1100
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
12/26/2019 12/26/2019 12/31/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
10 1200
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
12/16/2019 12/16/2019 12/31/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
10 1500
608.49 50.81 0.00 0.00 0.00 0.00 0.00 659.30
10/24/2019 10/24/2019 10/31/2019 608.49 50.81 0.00 0.00 0.00 0.00 0.00 659.30
10 1200
1,315.32 55.44 0.00 0.00 0.00 0.00 0.00 1,370.76
9/6/2019 9/20/2019 10/31/2019 1,315.32 55.44 0.00 0.00 0.00 0.00 0.00 1,370.76
10 1500
1008231909515
EMSE
Employee was exposed to TB while patient
was being treated for an assault.
1008291909704
FLME
Employee pulled muscle in right arm working
on a heavy machinery equipment
1008291909514
MHCP
Employee pulled muscle in left thigh when he
went to close the trailer tailgate.
1010291909761
PTNE
Employee was struck in the head with a
paper cutter when he went to remove it from
a file cabinet.
1011191909815
RMSE
Employee was moving trees and twisted his
hand, which caused it to become swollen the
following day.
1012071909866
CENE
Employee pinched left index finger when he
attempt to move/place a metal bed frame
into dumpster.
1012261909911
DASE
Employee was doing intake on a feral cat and
was bitten, scratched and punctured to right
middle finger.
1012161909886
MHCP
Employee was opening a hole for an
irrigation leak, and when he went to pick up
the dirt with the shovel,he felt a pop in
abdominal area.
1010241909737
WATE
Employee cut inner forearm while turning a
valve.
1009061909628
WATE
Employee was loading a piece of equipment
back on the truck and injured his shoulder
and neck.
4
16.E.4.a
Packet Pg. 2210 Attachment: All Lines Closed Claim Report 1st QTR FY 20 (11519 : Ratification of Claim FIles Closed by
6/21/2019 6/21/2019 10/29/2019 5,235.95 347.33 2,459.82 0.00 0.00 0.00 0.00 8,043.10
10 1500
192.10 0.00 0.00 0.00 0.00 0.00 0.00 192.10
11/17/2019 11/18/2019 11/30/2019 192.10 0.00 0.00 0.00 0.00 0.00 0.00 192.10
10 1700
67.03 0.00 388.28 0.00 0.00 0.00 0.00 455.31
12/2/2019 12/2/2019 12/16/2019 67.03 0.00 388.28 0.00 0.00 0.00 0.00 455.31
10 1600
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
12/19/2019 12/20/2019 12/26/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
10 1900
11,014.26 469.95 0.00 0.00 0.00 0.00 0.00 11,484.21
5/21/2019 5/22/2019 12/31/2019 11,014.26 469.95 0.00 0.00 0.00 0.00 0.00 11,484.21
10 1300
526.50 68.20 0.00 0.00 0.00 0.00 0.00 594.70
10/17/2019 10/17/2019 10/24/2019 526.50 68.20 0.00 0.00 0.00 0.00 0.00 594.70
10 1900
223.98 5.95 0.00 0.00 0.00 0.00 0.00 229.93
9/17/2019 9/17/2019 10/31/2019 223.98 5.95 0.00 0.00 0.00 0.00 0.00 229.93
10 1500
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
12/2/2019 12/2/2019 12/11/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
10 1100
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
12/3/2019 12/3/2019 12/12/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
10 1200
740.90 186.97 0.00 0.00 0.00 0.00 0.00 927.87
9/25/2019 9/26/2019 12/31/2019 740.90 186.97 0.00 0.00 0.00 0.00 0.00 927.87
10 1100
39,666.64 2,617.15 6,847.02 0.00 0.00 0.00 0.00 49,130.81
39,666.64 2,617.15 6,847.02 0.00 0.00 0.00 0.00 49,130.81
ASAE
Employee pulled lower back muscle while
moving patient on stretcher.
1011171909807
WATE
Employee was cleaning a slaker, and the
door fell on his finger.
1012021909848
WATE
Employee was removing a saddle around a
water main and a bolt popped off striking left
shin.
1012191909902
WATE
Employee was walking between Plant
Buildings and started feeling discomfort in left
eye.
1005211909174
WATE
Employee was working at jobsite repairing a
broken water line and stepped backwards
around a hole; and fell to the ground on right
hand and thumb.
1010171909726
WWTE
Employee was probing in-line valve when he
was stung by wasp on right hand.
1009171909620
WWTE
Employee strained right arm while pulling
carpet up and taking down shelving.
1012021909851
WWTE
Employee was performing maintenance on
station backflushing check valves station
308.04. When the check valve pulled out, he
felt pain to right shoulder, arm and fingers.
1012031909855
WWTE
Employee cut left thumb with razor knife
while working on equipment.
1009251909651
WWTE
Employee was pressure washing the
stairwell, and the trigger on the wand caught
right ring finger, causing finger to swell up.
Total by Major Coverage 37 Claims
5
16.E.4.a
Packet Pg. 2211 Attachment: All Lines Closed Claim Report 1st QTR FY 20 (11519 : Ratification of Claim FIles Closed by
0.00 0.00 0.00 80,186.71 0.00 0.00 0.00 0.00
9/15/2017 9/20/2017 10/31/2019 0.00 0.00 0.00 80,186.71 0.00 0.00 0.00 0.00
120
0.00 0.00 0.00 80,186.71 0.00 0.00 0.00 0.00
0.00 0.00 0.00 80,186.71 0.00 0.00 0.00 0.00
0.00 0.00 75.91 0.00 0.00 0.00 0.00 75.91
8/20/2019 8/20/2019 10/24/2019 0.00 0.00 75.91 0.00 0.00 0.00 0.00 75.91
22 3000
0.00 0.00 3,365.67 0.00 0.00 0.00 0.00 3,365.67
8/12/2019 8/29/2019 11/30/2019 0.00 0.00 3,365.67 0.00 0.00 0.00 0.00 3,365.67
22 5900
0.00 0.00 4,720.90 0.00 0.00 0.00 0.00 4,720.90
9/11/2019 9/11/2019 11/30/2019 0.00 0.00 4,720.90 0.00 0.00 0.00 0.00 4,720.90
22 3000
0.00 0.00 219.00 0.00 0.00 0.00 0.00 219.00
11/19/2019 11/19/2019 11/26/2019 0.00 0.00 219.00 0.00 0.00 0.00 0.00 219.00
22 3000
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
11/20/2019 11/20/2019 12/31/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
22 3000
Major Coverage: 120 - Pollution Liability
1209151706528 Water Division
WATE
Fuel was spilled when generator was being
refueled due to no power from FPL.
Total by Major Coverage 1 Claim
Major Coverage: 20 - General Liability
2208201909698 Marianne Varney
PAPM
While county employee was parked at a
customers home, the vehicle was left in
driveway and rolled away, damaging pieces
of homeowner's property that were propped
up against the garage.
2208121909509 BANOUB, ASHRAF
RMSE
8/16/2019, Jet-Vac went to location and
jetted the pipes. After they had left, the
citizen called to complain that the pipe had
collapsed under his driveway and he thought
the county should be responsible for
replacing it. (cont.)
2209111909592 North Collier Fire Station 40 Bay Door
ASAE
Truck 11 was accidentally backed into the
bay door at Station 40 when the driver put the
vehicle in reverse instead of park. This
caused damage to the bay door and the
truck.
2211191909812 LUONGO, PHILLIP
RMSE
Collier County Jet Vac Truck moved right to
allow oncoming vehicle (UPS), resulting in
the County vehicle striking the mailbox at 16
Cannes Dr. and damaging it.
2211201909817 CIRILLO, ERICA
RMSE
3rd party claimant vehicle was at the light on
Rattlesnake turning left onto Collier Blvd and
ran into a white cinder block in the middle of
the road.
6
16.E.4.a
Packet Pg. 2212 Attachment: All Lines Closed Claim Report 1st QTR FY 20 (11519 : Ratification of Claim FIles Closed by
0.00 821.28 0.00 0.00 0.00 0.00 0.00 821.28
12/5/2019 12/5/2019 12/20/2019 0.00 821.28 0.00 0.00 0.00 0.00 0.00 821.28
22 5100
0.00 0.00 150.00 0.00 0.00 0.00 0.00 150.00
12/5/2019 12/16/2019 12/30/2019 0.00 0.00 150.00 0.00 0.00 0.00 0.00 150.00
22 2000
0.00 395.00 0.00 0.00 0.00 0.00 0.00 395.00
9/18/2017 10/19/2017 11/25/2019 0.00 395.00 0.00 0.00 0.00 0.00 0.00 395.00
22 5400
836.50 0.00 0.00 0.00 0.00 0.00 0.00 836.50
11/1/2018 11/2/2018 10/1/2019 836.50 0.00 0.00 0.00 0.00 0.00 0.00 836.50
20 2050
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
11/19/2019 11/19/2019 12/31/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
22 2150
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
1/31/2019 6/18/2019 12/30/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
21 3000
836.50 1,216.28 8,531.48 0.00 0.00 0.00 0.00 10,584.26
836.50 1,216.28 8,531.48 0.00 0.00 0.00 0.00 10,584.26
2212051909860 MANNING, KIM
WWTE
While cleaning a wastewater gravity line in
Summit Place the resident came out and told
the Vac Truck operator that wastewater had
splashed out of her toilet and onto the walls
and floor.
2212051909888 JANE, BEISLER
RMSE
Crew trimming tree in the premeiter ditch with
Menzi-Muck exevator . 6 inch piece of wood
hit pool cage making small hole.
2209181706996 LANE, JEFFREY
RMSE
The 18" storm line collapsed and has a root
ball in it. Claimant alleges his home is
collapsing into the easement which has zero
set back. Settlement was approved by the
BCC.
2111011808425 DIAZ , SHERRY
LIBE
Sherry was on a ladder hanging her student
art for a monthly display. She works at Gulf
Coast Charter Academy South. She regularly
installs student art in the library. She missed
the last step and fell down on the floor. The
ladder fell away from her.
2211191909808 SELIGSON, ZAK
TXCE
Pulled into parking space at the Collier
County main campus and lower front bumper
ran into parking stop that was out of place.
2101311909271 HUMMER, CYNTHEA
RMSE
Received notice of claim from Law Offices
Fred Land Fulmer. Allegedly Cynthea
Hummer suffered bodily injury damages and
Brian Hummer, her husband, sustained loss
of consortium damages. Attorney alleging
Collier County was negligent in operation.
Total by Major Coverage 11 Claims
7
16.E.4.a
Packet Pg. 2213 Attachment: All Lines Closed Claim Report 1st QTR FY 20 (11519 : Ratification of Claim FIles Closed by
0.00 0.00 488.36 0.00 0.00 0.00 0.00 488.36
7/8/2019 7/8/2019 12/31/2019 0.00 0.00 488.36 0.00 0.00 0.00 0.00 488.36
32 3000
0.00 0.00 1,254.75 0.00 0.00 0.00 0.00 1,254.75
11/29/2019 11/29/2019 12/6/2019 0.00 0.00 1,254.75 0.00 0.00 0.00 0.00 1,254.75
32 3000
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
9/29/2017 1/3/2018 12/12/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
31 3000
0.00 0.00 967.92 0.00 0.00 0.00 0.00 967.92
11/25/2019 11/26/2019 12/20/2019 0.00 0.00 967.92 0.00 0.00 0.00 0.00 967.92
32 3000
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
4/3/2019 4/3/2019 10/31/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
31 3000
0.00 155.90 0.00 0.00 0.00 0.00 0.00 155.90
12/11/2018 12/12/2018 12/13/2019 0.00 155.90 0.00 0.00 0.00 0.00 0.00 155.90
31 3000
0.00 0.00 6,024.48 0.00 0.00 0.00 0.00 6,024.48
10/28/2019 10/29/2019 12/31/2019 0.00 0.00 6,024.48 0.00 0.00 0.00 0.00 6,024.48
32 3000
0.00 0.00 904.24 0.00 0.00 0.00 0.00 904.24
10/28/2019 10/28/2019 12/31/2019 0.00 0.00 904.24 0.00 0.00 0.00 0.00 904.24
32 3000
Major Coverage: 30 - Auto Liability
3207081909343 LOIACONO, ANTHONY
BPRI
Employee was traveling on Vanderbilt Beach
Road turning to Winn Dixie Plaza, pavement
was wet and he rear ended the vehicle in
front of him driven by 3rd party claimant.
3211291909844 Marco Island Fire
ASAE
EMS Tk19 struck the MIFD Squad 50 on the
left rear bumper.
3109291707346 SOTO YORKA, JULIO
CENE
Claimant was traveling south on Airport Road
when a County vehicle violated the right-of-
way and turned in front of him, causing him to
strike the right rear of the County vehicle.
3211251909830 Michel, Jean Philistin
HDPE
Trying to park in between two parked cars,
and county vehicle hit parked car.
3104031904020 GRIMES, GRACE
SOWE
County employee was heading west bound
on Pine Ridge Rd getting ready to turn north
onto Airport Pulling Rd when the vehicle
turning in front of him abruptly stopped
instead of merging onto Airport Pulling Rd.
causing employee to rear end her vehicle.
311211180855401 Pinero, Elvis
UOSD
County staff was exiting a parking spot going
left and 3rd party driver made contact with
front right bumper.
3210281909757 Francisco Javier Irarragorri
TECM
County vehicle rear ended third party
claimant vehicle.
3210281909783 Callahan Daniel
TECM
South bound on Fowler by Canal Ave in Fort
Myers, truck made a right turn into the lane
next to me. His extended mirror came into
my lane, caught edge of my mirror and
damaged passenger turn signal cover.
8
16.E.4.a
Packet Pg. 2214 Attachment: All Lines Closed Claim Report 1st QTR FY 20 (11519 : Ratification of Claim FIles Closed by
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
6/12/2018 6/13/2018 12/13/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
31 3000
0.00 427.80 6,264.01 0.00 0.00 0.00 0.00 6,691.81
11/13/2018 11/13/2018 10/25/2019 0.00 427.80 6,264.01 0.00 0.00 0.00 0.00 6,691.81
32 3000
0.00 147.70 0.00 0.00 0.00 0.00 0.00 147.70
4/3/2019 4/3/2019 10/31/2019 0.00 147.70 0.00 0.00 0.00 0.00 0.00 147.70
32 3000
0.00 731.40 15,903.76 0.00 0.00 0.00 0.00 16,635.16
0.00 731.40 15,903.76 0.00 0.00 0.00 0.00 16,635.16
916.79 0.00 0.00 0.00 0.00 0.00 0.00 916.79
9/26/2019 9/26/2019 10/11/2019 916.79 0.00 0.00 0.00 0.00 0.00 0.00 916.79
42 629
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
8/6/2019 8/7/2019 12/31/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
42 5900
0.00 0.00 967.30 0.00 0.00 0.00 0.00 967.30
6/27/2019 7/2/2019 10/23/2019 0.00 0.00 967.30 0.00 0.00 0.00 0.00 967.30
41 3000
310612180806301 SUCEL, RODRIGUEZ
RMSE
County vehicle impacted private vehicle in
passenger rear bumper area.
3211131808468 POWELL, LINETTE
GMAO
Traveling in the left lane at least 3 car lengths
from the hit vehicle. The hit vehicle veered to
the left as if to get into the turning lane but
abruptly came back into the left lane. Then
the collision occurred.
3204031908988 GRIMES, GRACE
SOWE
County employee was heading west bound
on Pine Ridge Rd getting ready to turn north
onto Airport Pulling Rd where the vehicle
turning in front of him abruptly stopped
instead of merging onto Airport Pulling Rd.
causing employee to rear end her vehicle.
Total by Major Coverage 11 Claims
Major Coverage: 40 - Auto Physical Damage
4209261909655 EMS
ASAE
Medic unit was transporting a patient to
Lehigh Regional Hospital. While traveling on
SR82, a rock flew off the back of a dump
truck and struck the ambulance windshield.
4208061909445 Water Division
WATE
When management team was exiting the
garage for the day, they noticed one of the
management team vehicles had a broken
windshield that had not been that way a few
hours before when we had returned from the
field.
4106271909328 Bayshore CRA
CRAE
Vehicle parked in Leased Office Building
space parking lot, public parking no assigned
spots. CRA Director noticed there was a dent
in rear drivers side above the rear tire, paint
scratched off unsure of exact date of
damage. Noticed on 6/27/19.
9
16.E.4.a
Packet Pg. 2215 Attachment: All Lines Closed Claim Report 1st QTR FY 20 (11519 : Ratification of Claim FIles Closed by
0.00 0.00 1,050.00 0.00 0.00 0.00 0.00 1,050.00
6/26/2019 6/26/2019 12/19/2019 0.00 0.00 1,050.00 0.00 0.00 0.00 0.00 1,050.00
41 3000
545.12 0.00 0.00 0.00 0.00 0.00 0.00 545.12
10/24/2019 10/28/2019 11/15/2019 545.12 0.00 0.00 0.00 0.00 0.00 0.00 545.12
42 5900
1,040.99 0.00 0.00 0.00 0.00 0.00 0.00 1,040.99
10/25/2019 10/28/2019 11/15/2019 1,040.99 0.00 0.00 0.00 0.00 0.00 0.00 1,040.99
42 5900
0.00 0.00 1,708.98 0.00 0.00 0.00 0.00 1,708.98
9/13/2019 9/13/2019 11/7/2019 0.00 0.00 1,708.98 0.00 0.00 0.00 0.00 1,708.98
42 3000
884.59 0.00 0.00 0.00 0.00 0.00 0.00 884.59
10/4/2019 10/8/2019 10/31/2019 884.59 0.00 0.00 0.00 0.00 0.00 0.00 884.59
42 5900
0.00 0.00 1,040.99 0.00 0.00 0.00 0.00 1,040.99
11/22/2019 11/25/2019 12/31/2019 0.00 0.00 1,040.99 0.00 0.00 0.00 0.00 1,040.99
42 5900
0.00 0.00 2,141.73 0.00 0.00 0.00 0.00 2,141.73
10/5/2019 10/15/2019 12/13/2019 0.00 0.00 2,141.73 0.00 0.00 0.00 0.00 2,141.73
41 3000
1,199.27 0.00 0.00 0.00 0.00 0.00 0.00 1,199.27
10/2/2019 10/3/2019 10/31/2019 1,199.27 0.00 0.00 0.00 0.00 0.00 0.00 1,199.27
42 5900
4106261909314 EMS
EMSE
Tk 24 failed negotiate a horseshoe driveway
at the Regional Cancer Center on 4th Ave
North in Naples. The box of the amblance
scraped a decorative pillar. Damage was
noted on the top edge on driver's side.
4210241909753 Parks And Recreation
MHCP
CC2-050 cracked windshield.
4210251909749 Parks And Recreation
MHCP
Noticed damage when parking the truck at
Golden Gate Community Park (maintenance
area).
4209131909604 Solid Waste Division
SOWE
Employee was driving west along Davis
Road when a deer jumped in front of the F-
150 and damaged the vehicle front grill.
4210041909691 Traffic Operations
TECM
An object hit and cracked my windshield
while I was driving.
4211221909826 Building Plan Review And Inspection Division
BPRI
While vehicle CC2-1860 was at Fleet for a
PM service, a small crack was found in the
windshield.
4110051909719 Health Department
HDPE
Health Department employee was driving
and hit a phone pedestal.
4210021909670 Public Services Administration Offices
Division
PSVE
Got in the county SUV CC2-985 to drive
downtown to a meeting and while driving
noticed the front window had a crack
approximately 3" long near the bottom of the
window near the hood.
10
16.E.4.a
Packet Pg. 2216 Attachment: All Lines Closed Claim Report 1st QTR FY 20 (11519 : Ratification of Claim FIles Closed by
0.00 0.00 1,992.48 0.00 0.00 0.00 0.00 1,992.48
3/13/2019 3/13/2019 12/17/2019 0.00 0.00 1,992.48 0.00 0.00 0.00 0.00 1,992.48
41 3000
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
10/21/2019 10/23/2019 11/22/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
41 3000
0.00 0.00 2,648.49 0.00 0.00 0.00 0.00 2,648.49
7/3/2019 8/19/2019 10/23/2019 0.00 0.00 2,648.49 0.00 0.00 0.00 0.00 2,648.49
41 3000
0.00 0.00 1,040.33 0.00 0.00 0.00 0.00 1,040.33
9/13/2019 9/13/2019 11/13/2019 0.00 0.00 1,040.33 0.00 0.00 0.00 0.00 1,040.33
41 3000
1,052.40 0.00 0.00 0.00 0.00 0.00 0.00 1,052.40
9/10/2017 12/20/2018 10/21/2019 1,052.40 0.00 0.00 0.00 0.00 0.00 0.00 1,052.40
42 5400
0.00 0.00 1,307.82 0.00 0.00 0.00 0.00 1,307.82
8/1/2018 8/1/2018 12/12/2019 0.00 0.00 1,307.82 0.00 0.00 0.00 0.00 1,307.82
41 3000
0.00 0.00 905.38 0.00 0.00 0.00 0.00 905.38
7/5/2019 7/5/2019 10/29/2019 0.00 0.00 905.38 0.00 0.00 0.00 0.00 905.38
41 3000
4103131908915 EMS
EMSE
Car tried to merge into the same space that
the ambulance occupied. There is no
damage to the civilian vehicle, there were no
injuries to anyone, the ambulance sustained
some damage detailed in the incident
reports.
4110211909735 Fleet Management
FLME
Employee was putting CC2-1537 on the lift 2
post 9k lift North side of shop. Lift arms and
feet were not set up correctly, vehicle shifted
and fell partially causing damages to both
running boards driver side lower cab/ door
and pass side.
4107031909479 Health Department
HDPE
Health Department employee noticed the
rear bumper has been cracked. They are not
sure when or where this happened.
4109131909602 Solid Waste Division
SOWE
Discovered by fleet addressing a different
issue.
4209101708582 GMD Building Review & Permitting
ORMD
Truck sustained damage in Hurricane Irma.
Looks as if a branch or some object hit the
truck and left a dent.
4108011808176 Traffic Operations
TECM
Right side utility box door handle caught the
UPS door, while pulling in next to the door.
Door handle damaged, along with UPS
cabinet door.
4107051909338 Utilities Operations Support Division
UOSD
When employee returned from vacation he
noticed a small dent in the upper part of the
tailgate.
11
16.E.4.a
Packet Pg. 2217 Attachment: All Lines Closed Claim Report 1st QTR FY 20 (11519 : Ratification of Claim FIles Closed by
1,039.16 0.00 0.00 0.00 0.00 0.00 0.00 1,039.16
9/30/2019 9/30/2019 10/24/2019 1,039.16 0.00 0.00 0.00 0.00 0.00 0.00 1,039.16
42 5900
6,678.32 0.00 14,803.50 0.00 0.00 0.00 0.00 21,481.82
6,678.32 0.00 14,803.50 0.00 0.00 0.00 0.00 21,481.82
10,211.00 0.00 0.00 0.00 0.00 0.00 0.00 10,211.00
8/31/2018 3/14/2019 11/30/2019 10,211.00 0.00 0.00 0.00 0.00 0.00 0.00 10,211.00
53 3000
10,211.00 0.00 0.00 0.00 0.00 0.00 0.00 10,211.00
5/20/2019 10/2/2019 10/31/2019 10,211.00 0.00 0.00 0.00 0.00 0.00 0.00 10,211.00
50 3000
11,162.13 0.00 0.00 0.00 0.00 0.00 0.00 11,162.13
9/5/2018 3/14/2019 11/30/2019 11,162.13 0.00 0.00 0.00 0.00 0.00 0.00 11,162.13
53 3000
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
7/12/2019 7/12/2019 10/10/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
50 5900
0.00 0.00 2,210.33 0.00 0.00 0.00 0.00 2,210.33
10/20/2019 10/25/2019 11/21/2019 0.00 0.00 2,210.33 0.00 0.00 0.00 0.00 2,210.33
50 5900
2,604.06 0.00 0.00 0.00 0.00 0.00 0.00 2,604.06
8/13/2019 11/4/2019 11/15/2019 2,604.06 0.00 0.00 0.00 0.00 0.00 0.00 2,604.06
50 3000
4209301909660 Building Plan Review And Inspection Division
BPRI
The driver noticed the cracked windshield
while driving on Immokalee Road by the
Fairgrounds.
Total by Major Coverage 19 Claims
Major Coverage: 50 - Property
5308311808920 CRA
ASAE
A light pole was found knocked down in
Immokalee at First Street near Colorado. No
police report was filed. Pole #6B was
removed by the Immokalee CRA's
Maintenance contractor to a storage facility.
5005201909667 CRA
CRAE
Blue Pole was knocked down. We believe it
was a hit and run because there was no
police report.
5309051808921 CRA
CRAE
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.
5007121909362 Museum
MUSE
A group of students as part of a summer
camp program went behind roped off areas
in the Roberts family house and sat on
furnishings. This resulted in the base of one
of the antique chairs in the living room falling
out onto the floor.
5010201909744 Public Transit & Neighborhood Enhancement
PTNE
Roof leak that ruined a 70" Dell Monitor.
5008131909774 Road Maintenance
RMSE
A guardrail repair on Oil Well Rd E from
damage due to traffic accident. No police
report could be found.
12
16.E.4.a
Packet Pg. 2218 Attachment: All Lines Closed Claim Report 1st QTR FY 20 (11519 : Ratification of Claim FIles Closed by
2,151.74 0.00 0.00 0.00 0.00 0.00 0.00 2,151.74
5/8/2019 11/7/2019 11/21/2019 2,151.74 0.00 0.00 0.00 0.00 0.00 0.00 2,151.74
50 3000
1,026.13 0.00 0.00 0.00 0.00 0.00 0.00 1,026.13
10/27/2019 11/8/2019 11/21/2019 1,026.13 0.00 0.00 0.00 0.00 0.00 0.00 1,026.13
50 3000
0.00 1,461.34 6,481.52 0.00 0.00 0.00 0.00 7,942.86
10/24/2019 11/1/2019 12/31/2019 0.00 1,461.34 6,481.52 0.00 0.00 0.00 0.00 7,942.86
50 5100
734.06 0.00 0.00 0.00 0.00 0.00 0.00 734.06
9/8/2019 9/9/2019 10/11/2019 734.06 0.00 0.00 0.00 0.00 0.00 0.00 734.06
50 5900
504.00 0.00 0.00 0.00 0.00 0.00 0.00 504.00
9/10/2017 9/26/2017 12/18/2019 504.00 0.00 0.00 0.00 0.00 0.00 0.00 504.00
51 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 12/18/2017 10/16/2019 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400
0.00 0.00 1,082.07 0.00 0.00 0.00 0.00 1,082.07
9/26/2019 10/1/2019 10/31/2019 0.00 0.00 1,082.07 0.00 0.00 0.00 0.00 1,082.07
50 5500
658.44 60.00 0.00 396.78 0.00 0.00 0.00 718.44
9/10/2017 12/18/2017 12/18/2019 658.44 60.00 0.00 396.78 0.00 0.00 0.00 718.44
53 5400
2,703.96 60.00 0.00 2,442.30 0.00 0.00 0.00 2,763.96
9/10/2017 12/15/2017 12/18/2019 2,703.96 60.00 0.00 2,442.30 0.00 0.00 0.00 2,763.96
53 5400
436.40 60.00 0.00 174.74 0.00 0.00 0.00 496.40
9/10/2017 12/15/2017 12/18/2019 436.40 60.00 0.00 174.74 0.00 0.00 0.00 496.40
53 5400
5005081909786 Road Maintenance
RMSE
Removal and replacement of damaged
guardrail materials (Accident Remediation)
No police rept found. locates 5/8/19 repairs
started 5/23/19.
5010271909788 Traffic Operations
TECM
Street light down.
5010241909768 Financial Operations & Support Building F
FMGE
The on-call plumber (Jorge Parra) was
dispatched by operations due to a water leak
in room 103 of Building F. It was determined
that the leak was HVAC related. The on-call
HVAC tech and Fireservice were notified of
the situation and are on the way.
5009081909568 EOC
EMSE
Flush valve to the mens toilet malfunction
and it caused water to spray and leak onto
the floor. The water traveled to the 3rd fl
lobby, into the raised flooring, and down to
the 2nd fl CCSO lobby and offices.
5109101704014 Facilities Management (Bldg K & W)
FMGE
Damage to shutters.
5309101707308 Parks & Recreation (Vineryards Community
Park)
MHCP
Hurricane Irma blew away the ceiling tiles at
the Shuffleboard Pavilion 1.
5009261909663 Veterans Community Park
MHCP
Nets and equipment at the batting cages
were stolen.
5309101707307 Parks & Recreation (Vineyards Community
Park)
MHCP
Hurricane Irma winds blew away the ceiling
tiles of Pavilion 8.
5309101707306 Parks & Recreation (Vineyards Park)
MHCP
Hurricane Irma winds blew several pieces of
ceiling from Pavilion 7.
5309101707305 Parks & Recreation (Vineyards Community
Park)
MHCP
Hurricane Irma winds blew and damaged the
ceiling tiles on Pavilion 6.
13
16.E.4.a
Packet Pg. 2219 Attachment: All Lines Closed Claim Report 1st QTR FY 20 (11519 : Ratification of Claim FIles Closed by
536.84 60.00 0.00 275.18 0.00 0.00 0.00 596.84
9/10/2017 12/15/2017 12/18/2019 536.84 60.00 0.00 275.18 0.00 0.00 0.00 596.84
53 5400
2,343.65 0.00 0.00 0.00 0.00 0.00 0.00 2,343.65
8/16/2019 8/22/2019 10/11/2019 2,343.65 0.00 0.00 0.00 0.00 0.00 0.00 2,343.65
50 5900
257.50 60.00 0.00 0.00 0.00 0.00 0.00 317.50
9/10/2017 9/28/2017 12/18/2019 257.50 60.00 0.00 0.00 0.00 0.00 0.00 317.50
51 5400
5,000.00 60.00 0.00 0.00 0.00 0.00 0.00 5,060.00
9/10/2017 10/23/2017 10/4/2019 5,000.00 60.00 0.00 0.00 0.00 0.00 0.00 5,060.00
55 5400
17,810.00 60.00 0.00 8,759.87 0.00 0.00 0.00 17,870.00
9/10/2017 12/14/2017 10/4/2019 17,810.00 60.00 0.00 8,759.87 0.00 0.00 0.00 17,870.00
55 5400
18,733.24 60.00 0.00 26,662.91 0.00 0.00 0.00 18,793.24
9/10/2017 12/15/2017 10/31/2019 18,733.24 60.00 0.00 26,662.91 0.00 0.00 0.00 18,793.24
53 5400
32,635.78 60.00 0.00 23,047.64 0.00 0.00 0.00 32,695.78
9/10/2017 12/15/2017 11/25/2019 32,635.78 60.00 0.00 23,047.64 0.00 0.00 0.00 32,695.78
51 5400
123,832.11 60.00 0.00 107,419.37 0.00 0.00 0.00 123,892.11
9/10/2017 12/15/2017 11/25/2019 123,832.11 60.00 0.00 107,419.37 0.00 0.00 0.00 123,892.11
53 5400
32,951.21 60.00 0.00 17,774.31 0.00 0.00 0.00 33,011.21
9/10/2017 11/16/2017 11/25/2019 32,951.21 60.00 0.00 17,774.31 0.00 0.00 0.00 33,011.21
51 5400
5309101707304 Parks & Recreation (Vineyards Community
Park)
MHCP
Hurricane Irma damaged the ceiling of
Pavilion 5.
5008161909491 Road Maintenance
RMSE
Security Division reported that one of our 4 in
1 cameras by the chemical storage area was
struck and damaged completely by a
lightning strike.
5109101706687 Facilities Management (1973 Bay St. House)
FMGE
Roof tiles damaged by tree that fell on the
roof during Hurricane Irma.
5509101707031 Caracara Prairie Preserve
MHCP
Numerous downed trees and limbs on the
trail.
5509101707290 Parks & Recreation (Tigertail Beach Park)
MHCP
Hurricane Irma uprooted several trees and
scattered tree debris throughout the park
property.
5309101707302 Parks & Recreation (Vineyards Community
Park)
MHCP
Hurricane Irma damaged the roof and ceiling
of Pavilion 1. Soffit missing in some areas.
5109101707299 Parks & Recreation (Sugden Park)
MHCP
Hurricane Irma caused ceiling tile damage in
the Front office at Sugden Regional Park.
5309101707298 Parks & Recration (Sugden Park)
MHCP
Hurricane Irma damaged property in the
open throughout Sugden Regional Park.
5109101707158 Parks & Recreation (Immokalee Community
Park)
MHCP
Hurricane Irma blew away several shingles,
downspout, and fascia. There are several
leaks that damaged ceiling tiles.
14
16.E.4.a
Packet Pg. 2220 Attachment: All Lines Closed Claim Report 1st QTR FY 20 (11519 : Ratification of Claim FIles Closed by
109,314.07 60.00 0.00 85,052.87 0.00 0.00 0.00 109,374.07
9/10/2017 11/16/2017 11/30/2019 109,314.07 60.00 0.00 85,052.87 0.00 0.00 0.00 109,374.07
53 5400
3,167.63 60.00 0.00 0.00 0.00 0.00 0.00 3,227.63
9/10/2017 11/16/2017 11/25/2019 3,167.63 60.00 0.00 0.00 0.00 0.00 0.00 3,227.63
51 5400
93,142.79 60.00 0.00 76,135.36 0.00 0.00 0.00 93,202.79
9/10/2017 11/16/2017 11/25/2019 93,142.79 60.00 0.00 76,135.36 0.00 0.00 0.00 93,202.79
53 5400
144,162.83 60.00 0.00 82,513.96 0.00 0.00 0.00 144,222.83
9/10/2017 10/31/2017 11/25/2019 144,162.83 60.00 0.00 82,513.96 0.00 0.00 0.00 144,222.83
51 5400
89,937.63 60.00 0.00 37,232.11 0.00 0.00 0.00 89,997.63
9/10/2017 10/31/2017 11/25/2019 89,937.63 60.00 0.00 37,232.11 0.00 0.00 0.00 89,997.63
53 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 10/9/2017 10/16/2019 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 10/9/2017 10/16/2019 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 9/22/2017 12/18/2019 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400
5309101707156 Parks & Recreation (Immokalee Community
Park)
MHCP
Damages to rule sign, scoreboards, entry
gates, basketball back board, park medians,
gate covering AC unit, athletic lights, dug out
roof missing , & downed fencing.
5109101707154 Parks & Recreation (GGCP Natural
Resources Bldg)
MHCP
During Hurricane Irma tree branches fell on
one AC unit and the left side of the building
roof. Light covers damaged, dent in soffit and
wet carpet.
5309101707152 Parks & Recreation Div. (GGCP)
MHCP
Hurricane Irma destroyed the park's main
sign and damaged the back sign, the fences
for the soccer field and racquetball court, the
windscreens on the racquetball court, trash
area, and equipment storage, bleachers, light
poles, and scoreboards 1,2,3,4.
5109101707087 Immokalee Sports Complex-IMSC
MHCP
Leaking in the gymnasium and staff offices.
Building gutter damage.
5309101707085 Immokalee Sports Complex-IMSC
MHCP
There is signage damage, multiple bleachers
were destroyed, concrete damage to speed
bump & pool floor, as well as soccer field
fencing ripped apart and metal gate is bent in
parking lot .Damages to light poles.
5309101706848 Museum Division (Main Government
Complex)
MUSE
Torn Screens on orchid house.
5309101706846 Museum Division (Main Government
Complex)
MUSE
Hurricane Irma winds knocked tree down on
structure damaging roof.
5309101706565 Water Division
PELB
Possible lightning impact 2 4160
transformers in the SRO wellfield disabling
both transformers.
15
16.E.4.a
Packet Pg. 2221 Attachment: All Lines Closed Claim Report 1st QTR FY 20 (11519 : Ratification of Claim FIles Closed by
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 10/5/2017 11/30/2019 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
51 5400
2,616.88 0.00 0.00 0.00 0.00 0.00 0.00 2,616.88
10/14/2019 12/12/2019 12/20/2019 2,616.88 0.00 0.00 0.00 0.00 0.00 0.00 2,616.88
50 3000
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 9/26/2017 10/16/2019 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 9/26/2017 10/16/2019 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400
2,040.00 60.00 0.00 0.00 0.00 0.00 0.00 2,100.00
9/10/2017 9/13/2017 10/3/2019 2,040.00 60.00 0.00 0.00 0.00 0.00 0.00 2,100.00
55
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 9/21/2017 10/3/2019 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
55 5400
6,189.00 0.00 0.00 0.00 0.00 0.00 0.00 6,189.00
9/10/2017 2/12/2019 12/18/2019 6,189.00 0.00 0.00 0.00 0.00 0.00 0.00 6,189.00
51 5400
257.50 0.00 0.00 0.00 0.00 0.00 0.00 257.50
9/10/2017 9/28/2017 12/18/2019 257.50 0.00 0.00 0.00 0.00 0.00 0.00 257.50
51 5400
340.00 60.00 0.00 0.00 0.00 0.00 0.00 400.00
9/10/2017 9/12/2017 12/18/2019 340.00 60.00 0.00 0.00 0.00 0.00 0.00 400.00
51 5400
1,260.00 0.00 0.00 0.00 0.00 0.00 0.00 1,260.00
9/10/2017 10/5/2017 11/25/2019 1,260.00 0.00 0.00 0.00 0.00 0.00 0.00 1,260.00
51 5400
5109101706781 Collier County Sheriff Office (Gun Range)
SHEE
During Hurricane Irma the range house and
firing line were damaged.
5010141909880 Traffic Operations
TECM
Flasher down due to car accident.
5309101706624 Facilities Management (Bldg K)
FMGE
Fence segment affected and destroyed by
wind. Damages to sidewalks, light poles,
benches, signs, etc.
5309101706628 Risk Management Div. (Bldg D)
RMGE
Missing piece of handicap ramp rail. Damage
to building location sign.
5509101706439 Museum Division (Government Complex)
MUSE
Flooding caused by Hurricane Irma; retention
pond high, water against hull of dry-docked
Kokomis exhibit, mild flooding of pathways
and other garden areas; causing significant
horticultural debris. Trees down.
5509101706555 Growth Management (Immokalee Bldg
Dept.)
ORMD
Trees sneared off during hurricane Irma.
5109101708787 Immokalee Code Enforcement
FMGE
Damage to flooring due to water intrusion.
5109101706689 Facilities Management (2015 Bay St. House)
FMGE
Some roof tiles broke during hurricane Irma.
5109101706426 Facilities Management (Bldg E- Snack Bar)
FMGE
Hurricane Irma knocked down facsia and
gutters off of Zacks Courthouse Cafe
5109101706782 Collier County Sheriff Office (Gun Range)
SHEE
During Hurricane Irma, trailer, ceiling tiles,
and stairs sustained significant damage.
16
16.E.4.a
Packet Pg. 2222 Attachment: All Lines Closed Claim Report 1st QTR FY 20 (11519 : Ratification of Claim FIles Closed by
149,774.21 0.00 0.00 68,047.38 0.00 0.00 0.00 149,774.21
9/10/2017 11/16/2017 11/25/2019 149,774.21 0.00 0.00 68,047.38 0.00 0.00 0.00 149,774.21
51 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 10/23/2017 10/4/2019 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
55 5400
6,890.00 60.00 0.00 2,655.04 0.00 0.00 0.00 6,950.00
9/10/2017 10/12/2017 10/4/2019 6,890.00 60.00 0.00 2,655.04 0.00 0.00 0.00 6,950.00
55 5400
3,800.00 60.00 0.00 0.00 0.00 0.00 0.00 3,860.00
9/10/2017 10/23/2017 10/3/2019 3,800.00 60.00 0.00 0.00 0.00 0.00 0.00 3,860.00
55 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 10/12/2017 10/16/2019 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400
1,975.00 60.00 0.00 0.00 0.00 0.00 0.00 2,035.00
9/10/2017 10/19/2017 10/4/2019 1,975.00 60.00 0.00 0.00 0.00 0.00 0.00 2,035.00
55 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 12/11/2017 10/16/2019 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400
2,313.00 60.00 0.00 0.00 0.00 0.00 0.00 2,373.00
9/10/2017 10/10/2017 10/3/2019 2,313.00 60.00 0.00 0.00 0.00 0.00 0.00 2,373.00
55 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 10/10/2017 10/16/2019 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
5109101707155 Parks & Recreation (GGCP Aquatic &
Fitness Center)
MHCP
Hurricane Irma caused roof and other
damages to the Aquatic Fitness Center at the
Golden Gate Park
5509101707035 Otter Mound Preserve-CC
MHCP
80% of the trees fell in the 2.67 acre
preserve. A Shell historic wall was damaged
and two signs could not be found in the
debris.
5509101706913 Parks & Recreation (Barefoot Beach
Preserve)
MHCP
Multiple trees down, sand throughout parking
and picnic area, debris scattered.
5509101707034 Nancy Payton Preserve-CC
MHCP
Over 20 large Pine Trees and debris down
over trails and firebreaks.
5309101706909 Ann Olesky Park
MHCP
Boat ramp damaged; two park signs broken,
entrance fence on south side damaged,
bench and shade structure damaged.
5509101707001 Clam Pass Park
MHCP
Damage at Clam Pass Park caused by
Hurricane Irma
5309101707254 Parks & Recreation (Veterans Memorial
Elem. School)
MHCP
Hurricane Irma caused damages to a portion
of fence. light poles, and one soccer goal.
5509101706858 Naples Depot Museum
MUSE
Hurricane Irma winds broke tree limbs and
scattered debris throughout property.
5309101706859 Museum Division (Naples Depot Museum)
MUSE
17
16.E.4.a
Packet Pg. 2223 Attachment: All Lines Closed Claim Report 1st QTR FY 20 (11519 : Ratification of Claim FIles Closed by
10,345.00 60.00 0.00 9,748.44 0.00 0.00 0.00 10,405.00
9/10/2017 10/12/2017 10/3/2019 10,345.00 60.00 0.00 9,748.44 0.00 0.00 0.00 10,405.00
55 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 10/12/2017 10/16/2019 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 10/19/2017 10/16/2019 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400
3,367.50 60.00 0.00 0.00 0.00 0.00 0.00 3,427.50
9/10/2017 10/16/2017 10/4/2019 3,367.50 60.00 0.00 0.00 0.00 0.00 0.00 3,427.50
55 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 12/12/2017 10/16/2019 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400
4,432.50 60.00 0.00 0.00 0.00 0.00 0.00 4,492.50
9/10/2017 10/10/2017 10/4/2019 4,432.50 60.00 0.00 0.00 0.00 0.00 0.00 4,492.50
55 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 10/12/2017 12/18/2019 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400
14,808.77 60.00 0.00 14,037.45 0.00 0.00 0.00 14,868.77
9/10/2017 12/15/2017 10/31/2019 14,808.77 60.00 0.00 14,037.45 0.00 0.00 0.00 14,868.77
53 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 10/19/2017 12/18/2019 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400
5509101706904 Aaron Lutz Park (Grounds)
MHCP
Hurricane Irma winds knocked down trees
and scattered debris.
5309101706903 Aaron Lutz Park Gazebo 2
MHCP
Gazebo 2 missing roof shingles.
5309101707004 Collier Boulevard Boat Ramp
MHCP
Damage occurred at the Collier Blvd. boat
ramp due to Hurricane Irma.
5509101706970 Poinciana Village Park
MHCP
Damage caused by Hurricane Irma at
Poinciana Village Park
5309101707272 Parks & Recreation (Vanderbilt Beach
Access)
MHCP
Due to Hurricane Irma, some boards on
boardwalk destroyed or missing. All trash
cans throughout the access areas of the park
are missing the lids.
5509101706863 Marco Island Museum Grounds
MUSE
Hurricane Irma winds knocked down several
trees and blew debris throughout property.
5309101706902 Aaron Lutz Park Gazebo 1
MHCP
Gazebo 1 missing roof shingles.
5309101707303 Parks & Recreation (Vineyards Community
Park)
MHCP
Hurricane Irma damaged the ceiling tiles of
Pavilion 2. A piece of concrete from one of
the pilars is missing possibly caused by the
impact of an object.
5309101706997 Pelican Bay
PELB
111 street light poles damaged from
Hurricane Irma on Pelican Bay Blvd and Gulf
Park Dr. Map attached.
18
16.E.4.a
Packet Pg. 2224 Attachment: All Lines Closed Claim Report 1st QTR FY 20 (11519 : Ratification of Claim FIles Closed by
141,744.85 60.00 0.00 157,481.25 0.00 0.00 0.00 141,804.85
9/10/2017 2/6/2018 10/31/2019 141,744.85 60.00 0.00 157,481.25 0.00 0.00 0.00 141,804.85
55 5400
42,410.00 60.00 0.00 0.00 0.00 0.00 0.00 42,470.00
9/10/2017 5/31/2018 10/7/2019 42,410.00 60.00 0.00 0.00 0.00 0.00 0.00 42,470.00
55 5400
16,074.24 0.00 0.00 0.00 0.00 0.00 0.00 16,074.24
6/7/2018 6/21/2018 11/30/2019 16,074.24 0.00 0.00 0.00 0.00 0.00 0.00 16,074.24
53 5900
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 10/11/2017 12/18/2019 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 12/4/2017 12/18/2019 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400
57,092.81 60.00 0.00 41,798.88 0.00 0.00 0.00 57,152.81
9/10/2017 9/14/2017 10/31/2019 57,092.81 60.00 0.00 41,798.88 0.00 0.00 0.00 57,152.81
51 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 10/9/2017 10/16/2019 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 10/9/2017 10/16/2019 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 10/9/2017 10/16/2019 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 9/21/2017 12/18/2019 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
51 5400
5509101707505 Pelican Bay Services Division, Location #541
PELB
Substantial amount of trees down needing
removal.
5509101708005 Parks and Recreation (Pelican Bay Park)
MHCP
Hurricane Irma tree clean up
5306071808064 Eagle Lakes Community Park
MHCP
2" irrigation break underneath newly installed
cricket ball playing surface. the break caused
a washout that caused the asphalt above to
collapse along with the artificial carpet.
5309101706895 Pelican Bay Services (Sidewalk Damage)
PELB
IRMA damaged bollard light
5309101707216 Pelican Bay Services (Entrance Fencing and
Flag Pole)
PELB
Entrance monument fencing and flag pole
damaged by hurricane IRMA
5109101706455 Airport Authority Division ( Marco Airport
Hangar B)
OPRS
Garage door blown off of hangar B. Damage
to exterior/interior walls and lighting.
5309101706852 Museum S. Chickee #2
MUSE
Roof and walls sustained damage from
Hurricane Irma winds.
5309101706851 Museum Large Chickee
MUSE
Hurricane Irma winds damaged crosshatch
wood structure and metal flashing.
5309101706850 Museum Small Chickee
MUSE
Hurricane Irma winds damaged the roof
cross braces.
5109101706548 Airport Authority (Immokalee Airport Hangar
A)
OPRS
Exterior electrical panel detached on hangar
Alpha (east side)
19
16.E.4.a
Packet Pg. 2225 Attachment: All Lines Closed Claim Report 1st QTR FY 20 (11519 : Ratification of Claim FIles Closed by
14,492.35 60.00 0.00 0.00 0.00 0.00 0.00 14,552.35
9/10/2017 10/4/2017 12/18/2019 14,492.35 60.00 0.00 0.00 0.00 0.00 0.00 14,552.35
53 5400
1,239,432.35 150,211.84 0.00 1,228,038.93 0.00 0.00 0.00 1,389,644.19
9/10/2017 9/29/2017 11/25/2019 1,239,432.35 150,211.84 0.00 1,228,038.93 0.00 0.00 0.00 1,389,644.19
51 5400
7,717.50 60.00 0.00 0.00 0.00 0.00 0.00 7,777.50
9/10/2017 10/9/2017 10/3/2019 7,717.50 60.00 0.00 0.00 0.00 0.00 0.00 7,777.50
55 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 2/6/2018 11/18/2019 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 2/13/2018 12/19/2019 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 10/3/2017 11/21/2019 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400
167,431.17 60.00 0.00 0.00 0.00 0.00 0.00 167,491.17
9/10/2017 10/5/2017 12/18/2019 167,431.17 60.00 0.00 0.00 0.00 0.00 0.00 167,491.17
53 5400
308,602.37 0.00 0.00 610,811.88 0.00 0.00 0.00 308,602.37
9/10/2017 2/9/2018 12/31/2019 308,602.37 0.00 0.00 610,811.88 0.00 0.00 0.00 308,602.37
51 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 2/15/2018 11/21/2019 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400
5309101706747 Public Utilities Dept. (Naples Landfill)
SOWE
Hurricane Irma winds damaged traffic light
and signages.
5109101706693 IFAS University Extension
UESE
Significant damage to exterior components of
roof and section of roof blown off during
Hurricane Irma. Interior damage to carpet
and ceiling tiles due to wind and water
intrusion.
5509101706838 South Wastewater Plant (General Site)
WATE
Hurricane Irma winds knocked down trees
throughout property.
5309101707517 Public Utilities Department, Wastewater
Collections, PS 103.01
WWTE
Front gate and fence damages.
5309101707627 Public Utilities Department, Wastewater
Collections, PS 321.07
WWTE
Antenna damaged
5309101706737 Public Utilities Dept. (S Water Plant)
WATE
Hurricane Irma winds caused fence damage.
Lime plant odor control H2S Motor Box Pole
dislodged from concrete.
5309101706770 PUD Operations Center East Bldg.
WATE
During Hurricane Irma signs post were blown
down/leaning, main gate off track and fence
damaged in multiple areas.
5109101704018 Public Utilities Department, Wastewater
Collections - Lift Stations Telemetric
Equipment - Blanket Coverage
WWTE
Damage caused to the communication
antennas and telemetric equipment at vaious
lift stations caused by winds, flying debris,
and power surges during Hurricane Irma.
5309101707656 Public Utilities Department, South County
Regional Water Treatment Plant, Lime
Building, Location #677
WATE
20
16.E.4.a
Packet Pg. 2226 Attachment: All Lines Closed Claim Report 1st QTR FY 20 (11519 : Ratification of Claim FIles Closed by
17,981.25 60.00 0.00 0.00 0.00 0.00 0.00 18,041.25
9/10/2017 3/30/2018 12/19/2019 17,981.25 60.00 0.00 0.00 0.00 0.00 0.00 18,041.25
53 5400
720.00 60.00 0.00 0.00 0.00 0.00 0.00 780.00
9/10/2017 2/1/2018 10/3/2019 720.00 60.00 0.00 0.00 0.00 0.00 0.00 780.00
55 5400
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
9/10/2017 2/13/2018 12/18/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
53 5400
4,081.25 0.00 0.00 35,836.00 0.00 0.00 0.00 4,081.25
9/10/2017 3/30/2018 12/18/2019 4,081.25 0.00 0.00 35,836.00 0.00 0.00 0.00 4,081.25
53 5400
2,944,417.70 155,333.18 9,773.92 2,636,342.65 0.00 0.00 0.00 3,109,524.80
2,944,417.70 155,333.18 9,773.92 2,636,342.65 0.00 0.00 0.00 3,109,524.80
2,991,599.16 159,898.01 55,859.68 2,716,529.36 0.00 0.00 0.00 3,207,356.85
2,991,599.16 159,898.01 55,859.68 2,716,529.36 0.00 0.00 0.00 3,207,356.85
5509101707434 Public Utilities Department, Wastewater
Reuse, Foxfire 9
WWTE
Trees damaged.
5309101707607
WWTE
Missing antenna
5309101707822 Public Utilities Department, Water
Distribution, Goodland Storage Tank
5309101707821 Public Utilities Department, Water Division,
SCRWTP
WATE
Damage to Storage Tanks, domes &
screens, and damage to chemical pump
enclosures.
Damage to staff gauge.
WATE
Public Utilities Department, Wastewater
Collections, PS 310.13
Total by Major Coverage 84 Claims
Grand Totals: 163 Claims
21
16.E.4.a
Packet Pg. 2227 Attachment: All Lines Closed Claim Report 1st QTR FY 20 (11519 : Ratification of Claim FIles Closed by
Collier County Government
Subrogation Closed Claim Report
1st QTR FY 2020
Valued as of:1/14/2020
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 14,688.09 0.00 0.00 0.00Facilities Management Division
v. Ocean Harbor Casualty
4103131908907
10/15/20193/13/2019 3/13/2019 0.00 0.00 0.00 14,688.09 0.00 0.00 0.00 0.00FMGE
41 Employee was stopped at a red
light when rearended by a non
Collier County Employee.
3000
0.00 0.00 0.00 0.00 92,500.00 0.00 0.00 0.00Immokalee Jail v. Waste
Connections
5008191909477
12/4/20198/19/2019 8/19/2019 0.00 0.00 0.00 92,500.00 0.00 0.00 0.00 0.00FMGE
50 Waste Connections truck hit
fence around the main gate at
Immokalee Jail.
3000
1,857.33 0.00 0.00 0.00 1,857.33 0.00 0.00 1,857.33Health Department v. Triple AAA
Homeowners Insurance
4109101909574
12/30/20199/10/2019 9/11/2019 1,857.33 0.00 0.00 1,857.33 1,857.33 0.00 0.00 0.00HDPE
41 Employees son was very
frustrated, and took his
frustration out on the county
vehicle that was parked in the
driveway at the employees
home.
5900
0.00 0.00 0.00 0.00 6,470.00 0.00 0.00 0.00Museum v Triple AAA5303241908960
12/31/20193/24/2019 3/26/2019 0.00 0.00 0.00 6,470.00 0.00 0.00 0.00 0.00MUSE
53 When I arrived this morning, I
noticed the Museum sign on
Heathwood was knocked over. I
heard that there was a car
accident last night involving a
driver hitting the sign. I am
trying to get a police report to get
details and exact time of
accident.
3000
-1-
9:55:08AM
1/14/2020
16.E.4.b
Packet Pg. 2228 Attachment: Subrogation Closed Claim Report 1st QTR FY 20 (11519 : Ratification of Claim FIles Closed
Collier County Government
Subrogation Closed Claim Report
1st QTR FY 2020
Valued as of:1/14/2020
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
758.35 0.00 0.00 0.00 0.00 0.00 758.35 0.00Operations And Regulatory
Management Division v. DEC
Contractor
5008171909482
11/30/20198/17/2019 8/19/2019 0.00 0.00 758.35 0.00 758.35 0.00 0.00 0.00ORMD
50 The ceiling collapased at 2800
North Horseshoe Drive (GMD
NORTH). This job was being
completed by (DEC Contractor).
We have water, light fixtures and
office furniture damage .
5900
0.00 0.00 0.00 0.00 4,140.00 0.00 0.00 0.00Pelican Bay Services Division v.
Chubb Insurance
5304011908979
11/5/20194/1/2019 4/1/2019 0.00 0.00 0.00 4,140.00 0.00 0.00 0.00 0.00PELB
53 Vehicle collision with streetlight
pole in median (#A-49) located
at 7117 Pelican Bay Blvd.
3000
0.00 0.00 0.00 0.00 1,955.00 0.00 0.00 0.00Landscape Operations v. State
Farm
5010231609658
10/15/201910/23/2016 9/27/2019 0.00 0.00 0.00 1,955.00 0.00 0.00 0.00 0.00RMSE
50 DRIVER OF VEH#1 WAS
TRAVELING SOUTH ON
LIVINGSTON RD WHEN HE
RAN OFF THE RD INTO THE
MEDIAN AND STRUCK SOME
BUSHES. HE THEN OVER
CORRECTE(l, RAN OFF THE
RIGHT SIDE OF THE RD AND
STRUCK A TREE BEFORE
COMING TO REST IN A FIELD.
DRIVER OF VEH#1 HAD SLUR
3000
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00Traffic Operations v. Travelers
Property Casualty
5308011808384
12/10/20198/1/2018 10/22/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00TECM
53 Low wire over intersection truck
went thru intersection and the
wire connected with truck.
The wire continued with truck
busting the two poles on either
side of Airport puling road . Part
of pole hit our traffic signal and
also the mast arm.
2150
-2-
9:55:08AM
1/14/2020
16.E.4.b
Packet Pg. 2229 Attachment: Subrogation Closed Claim Report 1st QTR FY 20 (11519 : Ratification of Claim FIles Closed
Collier County Government
Subrogation Closed Claim Report
1st QTR FY 2020
Valued as of:1/14/2020
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 20,525.70 0.00 0.00 0.00Wastewater Division v. TECO5010161808378
10/28/201910/16/2018 10/18/2018 0.00 0.00 0.00 20,525.70 0.00 0.00 0.00 0.00WWTE
50 Damage to an 8” gravity sewer
main, and 6” sewer lateral was
observed during a CCTV
pipeline inspection. The cause of
damage has been identified as a
TECO gas main directional
bored through the sewer
pipelines.
5900
0.00 0.00 0.00 0.00 7,734.80 0.00 0.00 0.00Traffic Operations v. State Farm5008041909723
10/28/20198/4/2019 10/15/2019 0.00 0.00 0.00 7,734.80 0.00 0.00 0.00 0.00TECM
50 Street light hit.3000
0.00 0.00 0.00 0.00 1,725.00 0.00 0.00 0.00Landscape Operations v. Amica
Mutual Insurance
5012131609676
10/31/201912/13/2016 10/4/2019 0.00 0.00 0.00 1,725.00 0.00 0.00 0.00 0.00RMSE
50 Vehicle 1 struck vehicle 2
causing her to jump the median
curb and come to rest in the
foliage of the median.
3000
16,450.37 0.00 0.00 0.00 20,000.00 0.00 0.00 16,450.37Immokalee Substation Sheriff
Building v MGA Insurance
5103191909266
10/31/20193/19/2019 6/17/2019 16,450.37 0.00 0.00 20,000.00 16,450.37 0.00 0.00 0.00SHEE
51 A customer drove through the
front doors of Substation 112.
3000
0.00 0.00 0.00 0.00 82,926.68 0.00 0.00 0.00Landscape Operations v.
Progressive Insurance
5005291909635
10/7/20195/29/2019 9/20/2019 0.00 0.00 0.00 82,926.68 0.00 0.00 0.00 0.00RMSE
50 Vehicle 1 was traveling east on
lmmokalee road when he fell
asleep after working a double at
the �ost office. He struck the
center median, crossed into the
west bound
turn lane, woke up and struck
median again.
3000
-3-
9:55:08AM
1/14/2020
16.E.4.b
Packet Pg. 2230 Attachment: Subrogation Closed Claim Report 1st QTR FY 20 (11519 : Ratification of Claim FIles Closed
Collier County Government
Subrogation Closed Claim Report
1st QTR FY 2020
Valued as of:1/14/2020
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 3,795.00 0.00 0.00 0.00Landscape Operations v.
Progressive Insurance
5005241709640
10/28/20195/24/2017 9/23/2019 0.00 0.00 0.00 3,795.00 0.00 0.00 0.00 0.00RMSE
50 Hammock Rd) west of Santa
Barbara Blvd. V01 traveled
northwest across the center and
outside lane and struck the north
curb of CR-864 (Rattlesnake
Hammock Rd). V01 continued
fraveling northwest after the
collision onto the north grassy
shoulder.
3000
316.53 0.00 0.00 0.00 1,878.02 0.00 0.00 316.53Traffic Operations v. First
National Insurance
5008021909649
10/31/20198/2/2019 9/25/2019 316.53 0.00 0.00 1,878.02 316.53 0.00 0.00 0.00TECM
50 Mast arm hit due to a car
accident.
3000
2,227.18 0.00 0.00 0.00 0.00 2,227.18 0.00 0.00Parks & Recreation v.
Progressive Insurance
4105121909136
12/30/20195/12/2019 5/13/2019 0.00 2,227.18 0.00 0.00 2,227.18 0.00 0.00 0.00MHCP
41 While performing official duties
on Marco Island, Park Ranger
County vehicle was struck on left
quarter panel by 3rd party
claimant vehicle.
3000
3,719.32 0.00 0.00 0.00 7,018.14 3,719.32 0.00 0.00Public Transit & Neighborhood
Enhancement Department v.
USAA
4105211909176
10/31/20195/21/2019 5/22/2019 0.00 3,719.32 0.00 7,018.14 3,719.32 0.00 0.00 0.00PTNE
41 Vehicle rear ended county
vehicle CC2-2019.
3000
0.00 0.00 0.00 0.00 841.25 0.00 0.00 0.00Traffic Operations v. Allstate5308301809106
10/31/20198/30/2018 5/2/2019 0.00 0.00 0.00 841.25 0.00 0.00 0.00 0.00TECM
53 Pedestrian pole down due to
accident.
3000
-4-
9:55:08AM
1/14/2020
16.E.4.b
Packet Pg. 2231 Attachment: Subrogation Closed Claim Report 1st QTR FY 20 (11519 : Ratification of Claim FIles Closed
Collier County Government
Subrogation Closed Claim Report
1st QTR FY 2020
Valued as of:1/14/2020
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 4,841.96 0.00 0.00 0.00Landscape operations v.
Southern Owners Insurance
5405091909417
10/10/20195/9/2019 7/29/2019 0.00 0.00 0.00 4,841.96 0.00 0.00 0.00 0.00RMSE
54 He noticed that the rear wheels
of the vehicle were not gripping
to the road and suddenly the
vehicle fishtail and he lost
control. As the vehicle spun out
it traveled to the left and on to
the median striking a palm tree
and shrubs.
3000
0.00 0.00 0.00 0.00 4,364.25 0.00 0.00 0.00Landscape Operations v. State
Farm
5006011709688
10/21/20196/1/2017 10/7/2019 0.00 0.00 0.00 4,364.25 0.00 0.00 0.00 0.00RMSE
50 V1 skidded around up onto
median wih right rear fender
resting against tree.
3000
6,266.46 0.00 0.00 0.00 7,781.43 0.00 0.00 6,266.46Traffic Operations v. Geico5007171909731
11/21/20197/17/2019 10/21/2019 6,266.46 0.00 0.00 7,781.43 6,266.46 0.00 0.00 0.00TECM
50 Street light down due to car
accident.
3000
0.00 0.00 0.00 0.00 880.16 0.00 0.00 0.00Traffic Operations v Allstate5008071909759
12/17/20198/7/2019 10/29/2019 0.00 0.00 0.00 880.16 0.00 0.00 0.00 0.00TECM
50 Mast arm hit due to car accident.3000
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00Landscape Operations v Direct
General
5006011709814
11/21/20196/1/2017 11/19/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00RMSE
50 V2 sideswiped V1 causing them
to veer into the median.
3000
0.00 0.00 0.00 0.00 4,067.00 0.00 0.00 0.00Landscape Operations v.
Progressive Insurance
5403121909363
11/21/20193/12/2019 7/12/2019 0.00 0.00 0.00 4,067.00 0.00 0.00 0.00 0.00RMSE
54 Driver stated that she had to turn
hard to the left to miss the
stopped vehicle and that is when
vehicle #1 struck the curb of the
center median then it struck a
tree with the right front door and
fender area. Then vehicle #1 did
a 360.
3000
-5-
9:55:08AM
1/14/2020
16.E.4.b
Packet Pg. 2232 Attachment: Subrogation Closed Claim Report 1st QTR FY 20 (11519 : Ratification of Claim FIles Closed
Collier County Government
Subrogation Closed Claim Report
1st QTR FY 2020
Valued as of:1/14/2020
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 0.00 706.21 0.00 0.00 0.00Landscape operations v. Corvel5401171908732
10/2/20191/17/2019 1/29/2019 0.00 0.00 0.00 706.21 0.00 0.00 0.00 0.00RMSE
54 There was a car accident that
caused damage to median
landscape materials (See
attached report).
3000
0.00 0.00 0.00 0.00 233.33 0.00 0.00 0.00Traffic Operations v. Progressive
Insurance
5301301908769
10/2/20191/30/2019 2/7/2019 0.00 0.00 0.00 233.33 0.00 0.00 0.00 0.00TECM
53 Sign down due to car accident.3000
5,211.76 0.00 0.00 0.00 5,826.12 0.00 0.00 5,211.76Traffic Operations v. Geico5312101809004
10/31/201912/10/2018 4/8/2019 5,211.76 0.00 0.00 5,826.12 5,211.76 0.00 0.00 0.00TECM
53 Street light down.3000
30,102.45
30,102.45
758.35
758.35
5,946.50
5,946.50
296,755.47
296,755.47 0.00
0.00 0.00
0.00
0.00
0.00
36,807.30
36,807.30Grand Totals: 27 Claims
-6-
9:55:08AM
1/14/2020
16.E.4.b
Packet Pg. 2233 Attachment: Subrogation Closed Claim Report 1st QTR FY 20 (11519 : Ratification of Claim FIles Closed
16.E.4.c
Packet Pg. 2234 Attachment: Resolution 2004-15 PDF0001 (11519 : Ratification of Claim FIles Closed by the Risk Management Director for First Quarter FY20)
16.E.4.c
Packet Pg. 2235 Attachment: Resolution 2004-15 PDF0001 (11519 : Ratification of Claim FIles Closed by the Risk Management Director for First Quarter FY20)
16.E.4.c
Packet Pg. 2236 Attachment: Resolution 2004-15 PDF0001 (11519 : Ratification of Claim FIles Closed by the Risk Management Director for First Quarter FY20)
16.E.4.c
Packet Pg. 2237 Attachment: Resolution 2004-15 PDF0001 (11519 : Ratification of Claim FIles Closed by the Risk Management Director for First Quarter FY20)
16.E.4.c
Packet Pg. 2238 Attachment: Resolution 2004-15 PDF0001 (11519 : Ratification of Claim FIles Closed by the Risk Management Director for First Quarter FY20)
16.E.4.c
Packet Pg. 2239 Attachment: Resolution 2004-15 PDF0001 (11519 : Ratification of Claim FIles Closed by the Risk Management Director for First Quarter FY20)