Agenda 09/26/2017 Item #16E1409/26/2017
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 17.
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 17
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 516-121650-645915 (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 17, 85 files were closed with total expenditures of
$656,363.34. During the same period, 24 subrogation files were closed and the Risk Management
Division recovered $89,602.65 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: To accept the attached Claims Report and ratify the actions taken therein.
Prepared By: Rebecca Collins, Manager, Risk Management
16.E.14
Packet Pg. 2332
09/26/2017
ATTACHMENT(S)
1. Resolution 2004-15 PDF0001 (PDF)
2. Subrogation Closed Claim Report 3rd QTR FY 17 (PDF)
3. All Lines Closed Claim Report 3rd QTR FY 2017 (PDF)
16.E.14
Packet Pg. 2333
09/26/2017
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.E.14
Doc ID: 3503
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 17.
Meeting Date: 09/26/2017
Prepared by:
Title: Manager - Risk Finance – Risk Management
Name: Rebecca Collins
07/18/2017 4:28 PM
Submitted by:
Title: Division Director - Risk Management – Risk Management
Name: Jeff Walker
07/18/2017 4:28 PM
Approved By:
Review:
Administrative Services Department Paula Brethauer Level 1 Division Reviewer Completed 07/18/2017 5:06 PM
Risk Management Jeff Walker Additional Reviewer Completed 07/20/2017 1:43 PM
Administrative Services Department Len Price Level 2 Division Administrator Review Completed 08/24/2017 2:42 PM
County Attorney's Office Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Completed 08/24/2017 3:32 PM
Office of Management and Budget Valerie Fleming Level 3 OMB Gatekeeper Review Completed 08/24/2017 3:42 PM
Office of Management and Budget Laura Wells Additional Reviewer Completed 08/25/2017 8:41 AM
County Manager's Office Nick Casalanguida Level 4 County Manager Review Completed 08/27/2017 9:55 AM
Board of County Commissioners Michael Cox Meeting Completed 09/12/2017 9:00 AM
16.E.14
Packet Pg. 2334
16.E.14.a
Packet Pg. 2335 Attachment: Resolution 2004-15 PDF0001 (3503 : 3rd Quarter Closed Claim Report)
16.E.14.a
Packet Pg. 2336 Attachment: Resolution 2004-15 PDF0001 (3503 : 3rd Quarter Closed Claim Report)
16.E.14.a
Packet Pg. 2337 Attachment: Resolution 2004-15 PDF0001 (3503 : 3rd Quarter Closed Claim Report)
16.E.14.a
Packet Pg. 2338 Attachment: Resolution 2004-15 PDF0001 (3503 : 3rd Quarter Closed Claim Report)
16.E.14.a
Packet Pg. 2339 Attachment: Resolution 2004-15 PDF0001 (3503 : 3rd Quarter Closed Claim Report)
16.E.14.a
Packet Pg. 2340 Attachment: Resolution 2004-15 PDF0001 (3503 : 3rd Quarter Closed Claim Report)
Collier County Government
Subrogation Closed Claim Report
3rd QTR FY 2017
Valued as of:7/13/2017
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
Cost Center
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 1,227.08 0.00 0.00 0.00CC v. Immokalee Fire
Department ($1,227.08)
4110301605569
4/20/201710/30/2016 10/31/2016 0.00 0.00 0.00 1,227.08 0.00 0.00 0.00 0.00144610
41 Medic Truck 4, was on scene of
call for service when Immokalee
Fire Dept. BC30, backed into the
front bumper of Truck 4 causing
a small dent to the passenger
side of the front bumper. No
injuries reported from the
incident.
2450
0.00 0.00 0.00 0.00 1,720.35 0.00 0.00 0.00CC v. CESPEDES, AMADO
($1,720.35)
4102071705822
5/2/20172/7/2017 2/7/2017 0.00 0.00 0.00 1,720.35 0.00 0.00 0.00 0.00144610
41 Ford F-150 struck an ambulance
while they were in route to
hospital; lights and sirens on.
2450
0.00 0.00 0.00 0.00 234.06 0.00 0.00 0.00CC v. Clesen, Kenneth5104031706021
5/15/20174/3/2017 4/4/2017 0.00 0.00 0.00 234.06 0.00 0.00 0.00 0.00156140
51 A library patron, drove a Dodge
sedan over a parking barrier,
across the sidewalk, and into the
side of the Golden Gate Library.
3000
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Electrical Contracting
Service, Inc.
5312131605679
4/4/201712/13/2016 12/14/2016 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00156313
53 Contractor struck/damaging
irrigation pipes and fresh water
pipes at Golden Gate Comunity
Park while installing new light
poles
2000
1,585.00 0.00 0.00 0.00 1,585.00 0.00 0.00 1,585.00CC v. Moleus, Guerline5311271605641
5/22/201711/27/2016 11/28/2016 1,585.00 0.00 0.00 1,585.00 1,585.00 0.00 0.00 0.00156314
53 A Nissan Altima was making a
left turn from Livingston Road
into North Collier Regional Park
when it struck a palm tree and
sign located in the median.
3000
-1-
3:26:29PM
7/13/2017
16.E.14.b
Packet Pg. 2341 Attachment: Subrogation Closed Claim Report 3rd QTR FY 17 (3503 : 3rd Quarter Closed Claim Report)
Collier County Government
Subrogation Closed Claim Report
3rd QTR FY 2017
Valued as of:7/13/2017
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
Cost Center
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
6,038.76 0.00 0.00 0.00 6,173.78 6,038.76 0.00 0.00CC v. Villafuerte, Jose
($6,173.78)
4102271705894
4/13/20172/27/2017 2/27/2017 0.00 6,038.76 0.00 6,173.78 6,038.76 0.00 0.00 0.00156332
41 Employee was driving through
the parking lot at Immokalee
Community Park when a
Dodgew pickup backed into the
passenger side.
3000
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Reyes Balseiro, Luis4101221705780
4/13/20171/22/2017 1/23/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00156363
41 Parked ranger vehicle was
struck by third party pickup truck,
resulting in no damage to third
party vehicle and
scrapes/dents/scratches/rips in
passenger side rear bumper of
ranger vehicle. No injuries.
3000
0.00 0.00 0.00 0.00 1,081.61 0.00 0.00 0.00CC v. Schnell, Todd ($1,081.61)4112201605695
6/8/201712/20/2016 12/20/2016 0.00 0.00 0.00 1,081.61 0.00 0.00 0.00 0.00163628
41 Asset #CC2-1022 was parked
when struck by a private vehicle.
2450
0.00 0.00 0.00 0.00 170.95 0.00 0.00 0.00CC v. Doyle, Teagan ($170.95)5302191705906
4/13/20172/19/2017 3/1/2017 0.00 0.00 0.00 170.95 0.00 0.00 0.00 0.00163630
53 A Mazda CRX was traveling
south on Logan Blvd.; the
vehicle left the roadway and
struck a power pole and a street
sign.
3000
0.00 0.00 0.00 0.00 337.04 0.00 0.00 0.00CC v. Henriquez, Rolando
($708.40)
5310211605567
4/13/201710/21/2016 10/28/2016 0.00 0.00 0.00 337.04 0.00 0.00 0.00 0.00163630
53 A Chevy Town and Country Van
was traveling west on Green
Blvd. when he began to make a
left turn onto Sunshine Blvd.; the
van struck another vehicle,
causing it to strike a pedestrian
crosswalk pole.
3000
-2-
3:26:29PM
7/13/2017
16.E.14.b
Packet Pg. 2342 Attachment: Subrogation Closed Claim Report 3rd QTR FY 17 (3503 : 3rd Quarter Closed Claim Report)
Collier County Government
Subrogation Closed Claim Report
3rd QTR FY 2017
Valued as of:7/13/2017
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
Cost Center
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 11,595.65 0.00 0.00 0.00CC v. Ostergard, Kayla
($11,595.65)
5305181605152
4/26/20175/18/2016 5/24/2016 0.00 0.00 0.00 11,595.65 0.00 0.00 0.00 0.00163630
53 A Volkswagen was traveling
south on Livingston Road when
the driver lost control of her
vehicle on the wet roadway and
struck a street light pole,
knocking it to the ground.
3000
0.00 0.00 0.00 0.00 148.22 0.00 0.00 0.00CC v. Prado, Alfredo5303221706031
5/15/20173/22/2017 4/6/2017 0.00 0.00 0.00 148.22 0.00 0.00 0.00 0.00163630
53 A Nissan Altima was eluding
police while they attempted a
traffic stop. The drver of the
Altima swerved to avoid stop
sticks that had been placed in
the roadway and struck a stop
sign.
3000
0.00 0.00 0.00 0.00 198.04 0.00 0.00 0.00CC v. Hertz5304031706052
6/9/20174/3/2017 4/17/2017 0.00 0.00 0.00 198.04 0.00 0.00 0.00 0.00163630
53 A Buick Sedan was traveling
west on Radio Road when the
vehicle swerved and struck the
curb and a road sign.
3000
0.00 0.00 0.00 0.00 6,785.11 0.00 0.00 0.00CC v. Brown, Joshua5303131705973
6/20/20173/13/2017 3/20/2017 0.00 0.00 0.00 6,785.11 0.00 0.00 0.00 0.00163630
53 A Dodge Ram was traveling east
on Pine Ridge Road when the
vehicle lost control and struck a
palm tree, then a utility pole.
3000
800.00 0.00 0.00 0.00 0.00 0.00 0.00 800.00CC v. Armas, Antonio
($1,400.00)
5405261504540
4/30/20175/26/2015 10/23/2015 800.00 0.00 0.00 0.00 800.00 0.00 0.00 0.00163652
54 A Honda Accord was traveling
north on Livingston Road when
the diver fell asleep, causing the
vehicle to drift off the road and
struck a tree; the vehicle
continued on and struck another
tree.
3000
-3-
3:26:29PM
7/13/2017
16.E.14.b
Packet Pg. 2343 Attachment: Subrogation Closed Claim Report 3rd QTR FY 17 (3503 : 3rd Quarter Closed Claim Report)
Collier County Government
Subrogation Closed Claim Report
3rd QTR FY 2017
Valued as of:7/13/2017
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
Cost Center
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 9,122.86 0.00 0.00 0.00CC v. Accurate Drilling Systems,
Inc. ($9,122.86)
5301131705760
4/5/20171/13/2017 1/17/2017 0.00 0.00 0.00 9,122.86 0.00 0.00 0.00 0.00163801
53 3 " Irrigation Bore hit by Accurate
Drilling Systems boring lines for
Summit Commucations
0.00 0.00 0.00 0.00 1,783.44 0.00 0.00 0.00CC v. Carsone, Anthony5403211706008
5/10/20173/21/2017 3/30/2017 0.00 0.00 0.00 1,783.44 0.00 0.00 0.00 0.00163801
54 3rd party vehicle was traveling
east on Rattlesnake-Hammock
Road when it sideswiped another
vehicle. The collision sent the
other vehicle into the median
damaging bushes, sprinklers, a
traffic sign and a tree.
3000
356.25 0.00 0.00 0.00 0.00 0.00 0.00 356.25CC v. Henry, Judith ($956.25)
(CA)
5401271605453
5/31/20171/27/2016 9/6/2016 356.25 0.00 0.00 0.00 356.25 0.00 0.00 0.00163801
54 A Jeep Cherokee was traveling
north on Airport-Pulling Road N.
when the driver lost control of
the vehicle and drove over the
median, striking a tree.
3000
199.02 0.00 0.00 0.00 0.00 0.00 0.00 199.02CC v. Power Town Line
Construction LLC ($228.87)
5312081505074
4/20/201712/8/2015 4/21/2016 199.02 0.00 0.00 0.00 199.02 0.00 0.00 0.00210125
53 Employees working on behalf of
Power Town Line Construction
LLC struck and shifted a valve
box and concrete pad requiring
repair by County employees.
2000
0.00 0.00 0.00 0.00 22,245.89 0.00 0.00 0.00CC v. Danella Utility
Construction/Accurate Drilling
Service ($22,245.89)
5303151604970
5/2/20173/15/2016 3/18/2016 0.00 0.00 0.00 22,245.89 0.00 0.00 0.00 0.00233351
53 ADS working on behalf of
Danella Utility Construction
struck and damaged a County
owned sewer lateral.
2000
-4-
3:26:29PM
7/13/2017
16.E.14.b
Packet Pg. 2344 Attachment: Subrogation Closed Claim Report 3rd QTR FY 17 (3503 : 3rd Quarter Closed Claim Report)
Collier County Government
Subrogation Closed Claim Report
3rd QTR FY 2017
Valued as of:7/13/2017
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
Cost Center
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
9,594.65 0.00 0.00 0.00 9,000.00 9,425.00 169.65 0.00CC v. Schaber, Brett
($9,356.65)
4109281605512
4/26/20179/28/2016 9/29/2016 0.00 9,425.00 169.65 9,000.00 9,594.65 0.00 0.00 0.00253215
41 While traveling South on
Livingston Road, a Jeep Grand
Cherokee struck a vehicle which
in-turn struck County vehicle
#060009 causing the vehicle to
spin into a light pole. Two other
vehicle were involved as well.
2450
2,732.14 0.00 0.00 0.00 2,753.79 2,732.14 0.00 0.00CC v. Gladdys, Paul4104141706047
6/30/20174/14/2017 4/14/2017 0.00 2,732.14 0.00 2,753.79 2,732.14 0.00 0.00 0.00253215
41 While testing a backflow devive
at 3721 the customer who lives
at 3720 Kent Drive backed into
vehicle CC2-831 which was
parked across the street from
this customer.
3000
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Heritage Utilties5305251706152
6/21/20175/25/2017 5/26/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00ASAE
53 A short circuit and a breaker was
noted to be tripped; a facilities
employee then looked for the
"home run" of the circuit A new
electric j-box was identified near
what appears to be a concrete
job done by a contractor who
ripped the wires causing them .
5900
13,298.79 0.00 0.00 0.00 13,439.78 13,298.79 0.00 0.00CC v. Alas, Carlos ($13,439.78)4109091504445
5/2/20179/9/2015 9/9/2015 0.00 13,298.79 0.00 13,439.78 13,298.79 0.00 0.00 0.00EMSE
41 Motor vehicle accident at
Rattlesnake and US 41. BC 80
was stopped in the intersection
while responding to a call. He
was T-boned by a passenger
car.
2450
2,940.27
2,940.27
169.65
169.65
31,494.69
31,494.69
89,602.65
89,602.65 0.00
0.00 0.00
0.00
0.00
0.00
34,604.61
34,604.61Grand Totals: 24 Claims
-5-
3:26:29PM
7/13/2017
16.E.14.b
Packet Pg. 2345 Attachment: Subrogation Closed Claim Report 3rd QTR FY 17 (3503 : 3rd Quarter Closed Claim Report)
Collier County Government
Closed Claim Report - All
Lines3rd QTR FY 2017
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
Cost Center 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
1002031705817 4,776.06 336.00 0.00 0.00 0.00 0.00 0.00 5,112.06
108010 2/3/2017 2/3/2017 5/31/2017 4,776.06 336.00 0.00 0.00 0.00 0.00 0.00 5,112.06
10 1300 An employee tripped over a parking stop,
while walking into his place of work.
1006011706171 206.10 0.00 0.00 0.00 0.00 0.00 0.00 206.10
108010 6/1/2017 6/2/2017 6/19/2017 206.10 0.00 0.00 0.00 0.00 0.00 0.00 206.10
10 1900 Employee developed an itchy throat and
cough she alleges started after they began
renovations in the building she works in.
1004131706071 136.43 13.75 0.00 0.00 0.00 0.00 0.00 150.18
121156 4/13/2017 4/24/2017 4/30/2017 136.43 13.75 0.00 0.00 0.00 0.00 0.00 150.18
10 1500 Employee was sitting on the floor using a
cell phone for a work related search, when
he stood up he felt pain in the left side of
his neck radiating to the left shoulder.
1002281705896 2,313.28 167.75 0.00 0.00 0.00 0.00 0.00 2,481.03
122410 2/28/2017 2/28/2017 5/31/2017 2,313.28 167.75 0.00 0.00 0.00 0.00 0.00 2,481.03
10 1500 Employee was starting a pressure washer
and it "kicked back, taking his arm with it.
1006121706210 25.88 0.00 0.00 0.00 0.00 0.00 0.00 25.88
122410 6/12/2017 6/15/2017 6/26/2017 25.88 0.00 0.00 0.00 0.00 0.00 0.00 25.88
10 1200 Employee had a sliver of metal enter his
left thumb.
1002151706073 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
138935 2/15/2017 4/24/2017 4/30/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
10 1700 Employee was struck on the elbow by a
door.
1002241705892 1,673.84 154.00 0.00 0.00 0.00 0.00 0.00 1,827.84
144510 2/24/2017 2/24/2017 5/31/2017 1,673.84 154.00 0.00 0.00 0.00 0.00 0.00 1,827.84
10 1500 Employee injured his back lifiting a 25
pound weight bar in order to move it.
1001291705807 1,297.40 126.00 929.24 0.00 0.00 0.00 0.00 2,352.64
144610 1/29/2017 1/31/2017 4/17/2017 1,297.40 126.00 929.24 0.00 0.00 0.00 0.00 2,352.64
10 1600 An employee struck his right hand against
a stretchers' locking mechanism.
1004121706038 1,512.54 41.75 20.00 0.00 0.00 0.00 0.00 1,574.29
144610 4/12/2017 4/12/2017 4/25/2017 1,512.54 41.75 20.00 0.00 0.00 0.00 0.00 1,574.29
10 1300 Employee missed the foot step while
exiting the truck; she heard a pop in her
neck and now has pain.
1003151705962 3,397.57 277.66 0.00 0.00 0.00 0.00 0.00 3,675.23
144610 3/15/2017 3/15/2017 4/30/2017 3,397.57 277.66 0.00 0.00 0.00 0.00 0.00 3,675.23
10 1300 Employee fell back off a lift gate while
unloading pallets.
1005101706107 348.14 25.16 0.00 0.00 0.00 0.00 0.00 373.30
144610 5/10/2017 5/11/2017 5/31/2017 348.14 25.16 0.00 0.00 0.00 0.00 0.00 373.30
10 1900 Employee experienced general weakness,
low blood pressure, and excessive
sweating while attending a training
exercise.
16.E.14.c
Packet Pg. 2346 Attachment: All Lines Closed Claim Report 3rd QTR FY 2017 (3503 : 3rd Quarter Closed Claim Report)
1006021706170 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
144610 6/2/2017 6/2/2017 6/12/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
10 1700 Employee was bit by an insect on her left
arm.
1005151706119 508.76 0.00 0.00 0.00 0.00 0.00 0.00 508.76
144610 5/15/2017 5/15/2017 6/30/2017 508.76 0.00 0.00 0.00 0.00 0.00 0.00 508.76
10 1500 An employee felt a pulling sensation in her
lower back trying to get a mechanical lift
gate to deploy.
1012221605703 29,474.66 493.50 0.00 0.00 0.00 0.00 0.00 29,968.16
155410 12/22/2016 12/22/2016 4/17/2017 29,474.66 493.50 0.00 0.00 0.00 0.00 0.00 29,968.16
10 1300 A volunteer was taking a leashed dog out
of a kennel, when the dog pulled the
volunteer fell forward on her left hip.
1005041706099 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
155410 5/4/2017 5/4/2017 5/5/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
10 1700 Employee had Heparin enter his eye while
depressing a syringe plunger.
1005101706108 136.43 0.00 0.00 0.00 0.00 0.00 0.00 136.43
155410 5/10/2017 5/11/2017 6/1/2017 136.43 0.00 0.00 0.00 0.00 0.00 0.00 136.43
10 1700 Employee was exposed to poison ivy on
the right arm.
1005111706113 220.75 0.00 0.00 0.00 0.00 0.00 0.00 220.75
155410 5/11/2017 5/11/2017 6/13/2017 220.75 0.00 0.00 0.00 0.00 0.00 0.00 220.75
10 1700 Employee was bit under he left breast by
the dog she was handling.
1003021705918 784.57 83.75 0.00 0.00 0.00 0.00 0.00 868.32
156185 3/2/2017 3/6/2017 4/26/2017 784.57 83.75 0.00 0.00 0.00 0.00 0.00 868.32
10 1300 Employee tripped on the leg of a table and
landed on a chair.
1005251706153 227.50 0.00 0.00 0.00 0.00 0.00 0.00 227.50
156310 5/25/2017 5/26/2017 6/6/2017 227.50 0.00 0.00 0.00 0.00 0.00 0.00 227.50
10 1700 Employee accidentally poked herself in the
right eye with the metal support of a
hanging file folder.
1005311706159 393.50 0.00 0.00 0.00 0.00 0.00 0.00 393.50
156314 5/31/2017 5/31/2017 6/9/2017 393.50 0.00 0.00 0.00 0.00 0.00 0.00 393.50
10 1700 Employee was opening a beach ummbrella
when the crank slipped off and struck him
in the face.
1002211705882 1,273.78 84.00 0.00 0.00 0.00 0.00 0.00 1,357.78
156332 2/21/2017 2/22/2017 4/25/2017 1,273.78 84.00 0.00 0.00 0.00 0.00 0.00 1,357.78
10 1300 Employee sprained his left knee stepping
off a mower deck that was slippery.
1001211705777 1,303.22 84.00 0.00 0.00 0.00 0.00 0.00 1,387.22
156332 1/21/2017 1/23/2017 5/31/2017 1,303.22 84.00 0.00 0.00 0.00 0.00 0.00 1,387.22
10 1300 Employee was trimming trees and tripped
and fell onto the branches.
1002091705846 6,018.81 139.75 772.56 0.00 0.00 0.00 0.00 6,931.12
156363 2/9/2017 2/10/2017 5/31/2017 6,018.81 139.75 772.56 0.00 0.00 0.00 0.00 6,931.12
10 1500 Employee was walking past a bench and
stopped abruptly to avoid someone
standing in her path. She turned her left
knee inward and is experiencing pain.
16.E.14.c
Packet Pg. 2347 Attachment: All Lines Closed Claim Report 3rd QTR FY 2017 (3503 : 3rd Quarter Closed Claim Report)
1006201706226 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
156390 6/20/2017 6/21/2017 6/30/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
10 1200 Employee suffered a puncture wound to
his right thumb.
1005171706141 493.13 0.00 0.00 0.00 0.00 0.00 0.00 493.13
163620 5/17/2017 5/23/2017 5/31/2017 493.13 0.00 0.00 0.00 0.00 0.00 0.00 493.13
10 1200 An insect bit/stung the employee on the
face near his left eye; his eye and face
became swollen.
1005231706148 579.99 0.00 0.00 0.00 0.00 0.00 0.00 579.99
163620 5/23/2017 5/24/2017 6/26/2017 579.99 0.00 0.00 0.00 0.00 0.00 0.00 579.99
10 1700 Employee was bit on the right palm and
pinky finger by a dog.
1005301706161 126.00 13.75 0.00 0.00 0.00 0.00 0.00 139.75
163620 5/30/2017 5/31/2017 6/30/2017 126.00 13.75 0.00 0.00 0.00 0.00 0.00 139.75
10 1500 Employee was walking up an embankment
while clearing vegetation; felt a pop in his
left lower calf.
1005231706140 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
173435 5/23/2017 5/23/2017 6/5/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
10 Employee bitten by insect; Has several red
welts.
1004201706078 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
233351 4/20/2017 4/25/2017 4/25/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
10 1200 The back of the employee's left leg was
scraped by a door that closed.
1004251706077 218.14 0.00 0.00 0.00 0.00 0.00 0.00 218.14
233351 4/25/2017 4/25/2017 4/30/2017 218.14 0.00 0.00 0.00 0.00 0.00 0.00 218.14
10 1500 While closing a gate, employee felt pop
and sudden pain in his upper back
between shoulder blades.
1005161706122 538.94 0.00 0.00 0.00 0.00 0.00 0.00 538.94
233351 5/16/2017 5/16/2017 5/31/2017 538.94 0.00 0.00 0.00 0.00 0.00 0.00 538.94
10 1500 Employee felt a sudden pulling sensation in
his right shoulder while pulling a 30-pound
camera out of a manhole.
1004271706087 999.76 28.00 355.00 0.00 0.00 0.00 0.00 1,382.76
233351 4/27/2017 4/28/2017 5/31/2017 999.76 28.00 355.00 0.00 0.00 0.00 0.00 1,382.76
10 1500 An employee was pressure washing, when
he went felt pain in his back.
1001231705779 5,576.23 368.00 1,981.80 0.00 0.00 0.00 0.00 7,926.03
233351 1/23/2017 1/23/2017 5/31/2017 5,576.23 368.00 1,981.80 0.00 0.00 0.00 0.00 7,926.03
10 1500 Employee jumped from the back of a truck
and twisted his right knee.
1005251706158 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
233352 5/25/2017 5/31/2017 6/5/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
10 1200 An employee cut his finger using the
handrail walking downstairs.
1005111706127 283.80 0.00 0.00 0.00 0.00 0.00 0.00 283.80
233353 5/11/2017 5/17/2017 6/1/2017 283.80 0.00 0.00 0.00 0.00 0.00 0.00 283.80
10 1700 An employee was using a wheel barrow to
move a pump, the wheel barrow turned
over on the employee. The handle of the
wheel barrow struck his left wrist.
1002281705897 2,926.23 97.75 497.00 0.00 0.00 0.00 0.00 3,520.98
253212 2/28/2017 2/28/2017 6/30/2017 2,926.23 97.75 497.00 0.00 0.00 0.00 0.00 3,520.98
10 1300 Employee tripped over the tongue of a
trailer and fell.
16.E.14.c
Packet Pg. 2348 Attachment: All Lines Closed Claim Report 3rd QTR FY 2017 (3503 : 3rd Quarter Closed Claim Report)
1006081706189 102.65 0.00 0.00 0.00 0.00 0.00 0.00 102.65
253216 6/8/2017 6/9/2017 6/22/2017 102.65 0.00 0.00 0.00 0.00 0.00 0.00 102.65
10 1700 Employee was stung on the upper back
area by a wasp.
67,874.09 2,534.57 4,555.60 0.00 0.00 0.00 0.00 74,964.26
Total by Major Coverage 37 Claims 67,874.09 2,534.57 4,555.60 0.00 0.00 0.00 0.00 74,964.26
Major Coverage: 20 - General
Liability
2211171504602 REYES, ELLIEMAE 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
156170 11/17/2015 11/17/2015 5/1/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
22 2150 Patron was parked (2012 Toyota Camry
XLE) in the west parking stalls. While she
was leaving a piece of rebar that was
sticking out of a concrete parking barrier
ripped off two underside panels of her
vehicle and detached part of the front
bumper.
2203241706032 HOGAN, JOANNE 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
210155 3/24/2017 4/7/2017 6/7/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
22 2400 Claimant alleges her house, which is
currently up for sale, is not selling because
of the terrible smell that is "sticking to her
walls and furniture". She feels the cause is
a dewatering project being performed in
her back canal.
2202271706145 NOLAN, DELORES 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
233351 2/27/2017 5/24/2017 6/22/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
20 Per the claimant, a sewer blockage
occurred at 1596 Morning Sun Lane on the
evening of 02/27/2017. The claimant hired
a plumber to clear the sewer backup on
02/27/2017. Collier County Wastewater
was notified on 02/28/2017 of the sewer
blockage.
2203041604938 OLMO, CHRISTIAN 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
163620 3/4/2016 3/9/2016 4/27/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
22 3100 Claimant struck a pothole at the edge of
the roadway and states his right front rim is
bent.
2201181705847 Boatman, David 0.00 0.00 937.04 0.00 0.00 0.00 0.00 937.04
156332 1/18/2017 2/10/2017 4/4/2017 0.00 0.00 937.04 0.00 0.00 0.00 0.00 937.04
22 2000 Claimant backed into a parking spot. He
opened his door to check alignment in the
space. His door contacted a broken curb.
This caused damage to his car.
2201301705805 St. Tropez @ Pelican Bay 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
253212 1/30/2017 1/31/2017 4/20/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
22 5100 A water main was being brought back into
service after a repair; a pipe in a condo in
the work zone broke and flooded the lobby
of the building.
2209121605578 Florida Power & Light Company 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
253212 9/12/2016 11/3/2016 6/15/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
22 5300 During the installaton of our water service,
our technician damaged other utilities at
376 Warwick Way.
2201261705804 HUDAK, THOMAS 0.00 0.00 3,696.95 0.00 0.00 0.00 0.00 3,696.95
233351 1/26/2017 1/30/2017 4/12/2017 0.00 0.00 3,696.95 0.00 0.00 0.00 0.00 3,696.95
22 5900 Claimant experienced a sewer back-up at
his residence.
16.E.14.c
Packet Pg. 2349 Attachment: All Lines Closed Claim Report 3rd QTR FY 2017 (3503 : 3rd Quarter Closed Claim Report)
2111141605978 WESTCOTT, WALTER 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
163620 11/14/2016 3/21/2017 5/17/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
21 3000 Claimant was allegedly traveling on Beck
Blvd. and sustained personal injuries and
property damage after striking a tree at the
end of the roadway.
0.00 0.00 4,633.99 0.00 0.00 0.00 0.00 4,633.99
Total by Major Coverage 9 Claims 0.00 0.00 4,633.99 0.00 0.00 0.00 0.00 4,633.99
Major Coverage: 30 - Auto
Liability
3201181705770 SILVIA, THOMAS 0.00 0.00 569.12 0.00 0.00 0.00 0.00 569.12
156344 1/18/2017 1/19/2017 4/4/2017 0.00 0.00 569.12 0.00 0.00 0.00 0.00 569.12
32 2000 County employee hit a 3rd party vehicle
with a front loader at a softball field.
4104111605047 EMS 0.00 0.00 4,710.60 0.00 0.00 0.00 0.00 4,710.60
144610 4/11/2016 4/11/2016 4/10/2017 0.00 0.00 4,710.60 0.00 0.00 0.00 0.00 4,710.60
30 3000 EMS ambulance #35 driven struck 3rd
party; EMS driver cited by Florida Highway
Patrol.
3202241705914 LAMBERT, SCOTT 0.00 0.00 3,400.93 0.00 0.00 0.00 0.00 3,400.93
156363 2/24/2017 3/3/2017 6/30/2017 0.00 0.00 3,400.93 0.00 0.00 0.00 0.00 3,400.93
32 3000 A Collier County Park Ranger Patrol Unit,
while backing, struck another vehicle
slightly causing light damage. No injuries.
3203301706054 PEREZ, VICKIE 0.00 139.10 6,228.59 0.00 0.00 0.00 0.00 6,367.69
163630 3/30/2017 4/18/2017 5/31/2017 0.00 139.10 6,228.59 0.00 0.00 0.00 0.00 6,367.69
32 2450 An employee was traveling east on Davis
Blvd. when he failed to observe stopped
traffic and struck the vehicle in front of his.
That vehicle struck the vehicle in front of it.
3203301706015 Severe, Garry 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
163630 3/30/2017 4/3/2017 6/13/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
32 2450 An employee struck a vehicle in front of
them.
3204211706072 BAUMANN, KEN 0.00 0.00 809.46 0.00 0.00 0.00 0.00 809.46
210154 4/21/2017 4/24/2017 5/23/2017 0.00 0.00 809.46 0.00 0.00 0.00 0.00 809.46
Utilities Ordinance Education and
Compliance Investigator backed into 3rd
party’s car while maneuvering through the
entry gate at Fox Fire Community.
3107111403541 KLENTAK, DARIUSZ 0.00 2,390.46 4,595.23 509.00 0.00 0.00 0.00 6,985.69
122240 7/11/2014 9/3/2014 5/31/2017 0.00 2,390.46 4,595.23 509.00 0.00 0.00 0.00 6,985.69
31 3000 Claimant was rear-ended by a County
vehicle while stopped at a traffic light.
3102231604967 CHUYKO, OLEKSANDR 2,500.00 0.00 1,664.10 0.00 0.00 0.00 0.00 4,164.10
233351 2/23/2016 3/17/2016 4/30/2017 2,500.00 0.00 1,664.10 0.00 0.00 0.00 0.00 4,164.10
31 2450 Claimant's vehicle was struck in the rear
left bumper by a County vehicle that was
changing lanes.
3208191605507 BURKHARDT, LANCE 0.00 0.00 2,564.18 0.00 0.00 0.00 0.00 2,564.18
253212 8/19/2016 9/27/2016 4/13/2017 0.00 0.00 2,564.18 0.00 0.00 0.00 0.00 2,564.18
32 3000 Claimant's vehicle was struck by a County
vehicle that was backing out of a parking
space in a Publix parking lot.
3203091705929 BLOMBERG, NICHOLE 0.00 0.00 1,983.10 0.00 0.00 0.00 0.00 1,983.10
233351 3/9/2017 3/9/2017 6/30/2017 0.00 0.00 1,983.10 0.00 0.00 0.00 0.00 1,983.10
32 2450 County employee rear end a 3rd party
vehicle.
16.E.14.c
Packet Pg. 2350 Attachment: All Lines Closed Claim Report 3rd QTR FY 2017 (3503 : 3rd Quarter Closed Claim Report)
2,500.00 2,529.56 26,525.31 509.00 0.00 0.00 0.00 31,554.87
Total by Major Coverage 10 Claims 2,500.00 2,529.56 26,525.31 509.00 0.00 0.00 0.00 31,554.87
Major Coverage: 40 - Auto
Physical Damage
4101111705748 Wastewater Division 0.00 0.00 2,711.90 0.00 0.00 0.00 0.00 2,711.90
233313 1/11/2017 1/12/2017 5/18/2017 0.00 0.00 2,711.90 0.00 0.00 0.00 0.00 2,711.90
41 3000 IQ personnel was switching lanes after
intersection of Livingston and Pine Ridge,
south bound Livingston Road. Vehicle CC2-
610 side swiped a vehicle when both
vehicles were changing to middle lane.
4104101706036 Wastewater Collections Division 0.00 0.00 2,769.24 0.00 0.00 0.00 0.00 2,769.24
233351 4/10/2017 4/10/2017 5/31/2017 0.00 0.00 2,769.24 0.00 0.00 0.00 0.00 2,769.24
41 3000 While pulling out of a pump station the right
rear of vehicle CC2-745 come into contact
with a fire hydrant.
4103301706007 Traffic Operations Division 0.00 0.00 5,729.60 0.00 0.00 0.00 0.00 5,729.60
163630 3/30/2017 3/30/2017 6/22/2017 0.00 0.00 5,729.60 0.00 0.00 0.00 0.00 5,729.60
41 2450 County Vehicle struck a 3rd party vehicle
from behind.
4211091605676 Pelican Bay Services Division 921.50 0.00 0.00 0.00 0.00 0.00 0.00 921.50
PBSE 11/9/2016 12/13/2016 6/22/2017 921.50 0.00 0.00 0.00 0.00 0.00 0.00 921.50
42 Scrape/scratch to right front fender.
Unknown when, where, or how this
damage occurred. Time of incident above
is estimate. No knowledge of
circumstance.
4205151706120 Library Division 0.00 0.00 302.95 0.00 0.00 0.00 0.00 302.95
156100 5/15/2017 5/16/2017 5/31/2017 0.00 0.00 302.95 0.00 0.00 0.00 0.00 302.95
42 5900 During Fleet maintenance a small crack
was discovered in front windshield.
4101111705750 Department of Health 0.00 0.00 903.57 0.00 0.00 0.00 0.00 903.57
155810 1/11/2017 1/13/2017 6/22/2017 0.00 0.00 903.57 0.00 0.00 0.00 0.00 903.57
41 2000 A vehicle traveling in front of Asset #CC2-
1194 struck an object in the roadway which
then struck the driver's side mirror of the
County vehicle. Staff could not provide a
reason for the damage to the right front of
the vehicle.
4204131706051 Domestic Animal Services Division 1,447.93 0.00 0.00 0.00 0.00 0.00 0.00 1,447.93
155410 4/13/2017 4/17/2017 5/31/2017 1,447.93 0.00 0.00 0.00 0.00 0.00 0.00 1,447.93
42 5900 While in for service, Fleet staff noticed
damage to the driver's side of the van.
According to the officer, he noticed the
damage about a week or two ago while
washing his vehicle. Unknown when or
how it happened.
4109131605484 EMS 0.00 0.00 167.67 0.00 0.00 0.00 0.00 167.67
144610 9/13/2016 9/14/2016 6/22/2017 0.00 0.00 167.67 0.00 0.00 0.00 0.00 167.67
41 2000 Truck 30 was trying to navigate past low
hanging limb by fuel pump of gas station
and struck protective barrier at the end of
fuel island. Truck struck barrier with rubber
rub rail, drivers side, bottom of patient
compartment box.
4103311706014 EMS 0.00 0.00 2,815.00 0.00 0.00 0.00 0.00 2,815.00
144610 3/31/2017 3/31/2017 5/31/2017 0.00 0.00 2,815.00 0.00 0.00 0.00 0.00 2,815.00
41 2000 Medic 25 Truck 33 struck support column
outside ER at NCH-DT
16.E.14.c
Packet Pg. 2351 Attachment: All Lines Closed Claim Report 3rd QTR FY 2017 (3503 : 3rd Quarter Closed Claim Report)
4108171605401 EMS 0.00 0.00 3,882.75 0.00 0.00 0.00 0.00 3,882.75
144610 8/17/2016 8/17/2016 5/23/2017 0.00 0.00 3,882.75 0.00 0.00 0.00 0.00 3,882.75
41 2000 Truck 41 pulling out of bay at Immokalee
Fire Station 31- Bay door released and fell
on top of Truck 41 causing damage to T41
and bay door/frame at IFD.
4102201705877 EMS 0.00 0.00 5,031.92 0.00 0.00 0.00 0.00 5,031.92
144610 2/20/2017 2/20/2017 5/23/2017 0.00 0.00 5,031.92 0.00 0.00 0.00 0.00 5,031.92
41 3000 Truck 28 struck upper overhang canopy
outside the David Lawrence Center when
arriving for a call for service.
4105151706123 EMS 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
144610 5/15/2017 5/16/2017 5/19/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
41 2000 Garage door came down on top of
ambulance
4102021705816 EMS 0.00 0.00 727.08 0.00 0.00 0.00 0.00 727.08
144610 2/2/2017 2/3/2017 5/18/2017 0.00 0.00 727.08 0.00 0.00 0.00 0.00 727.08
41 3000 While returning from Everglades City,
Truck 4 struck a garbage can that was in
the roadway.
4103141705959 EMS 0.00 0.00 283.38 0.00 0.00 0.00 0.00 283.38
144610 3/14/2017 3/14/2017 5/18/2017 0.00 0.00 283.38 0.00 0.00 0.00 0.00 283.38
41 3000 EMS ambulance and Waste Management
were both south bound approaching 4
corners. EMS ambulance was on the left
when the mirror on the passenger's front
cab door contacted the apparatus on the
side of the Waste Management vehicle.
Low speed.
4103311605016 EMS 0.00 0.00 1,649.00 0.00 0.00 0.00 0.00 1,649.00
144610 3/31/2016 4/1/2016 4/27/2017 0.00 0.00 1,649.00 0.00 0.00 0.00 0.00 1,649.00
41 2000 Greater Naples Fire Fighter was operating
ambulance #30 when he struck the rain
gutter at David Lawrence Center; causing
damage to both the rain gutter and truck
#30. No persons were injured during the
incident.
4104261706084 Bureau of Emergency Services Division 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
144210 4/26/2017 4/27/2017 6/6/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
41 3000 County employee backing into position to
turn around to enter Airport-Pulling Rd,
scrapped a concrete wall; damagie to the
right rear tail light.
4102141705865 Building Review and Permitting Division 0.00 0.00 741.70 0.00 0.00 0.00 0.00 741.70
138915 2/14/2017 2/15/2017 4/30/2017 0.00 0.00 741.70 0.00 0.00 0.00 0.00 741.70
41 3000 Inspector backed out of the driveway and
hit the car door.
4104051706028 Building Review & Permitting Division 243.86 0.00 0.00 0.00 0.00 0.00 0.00 243.86
138915 4/5/2017 4/6/2017 4/30/2017 243.86 0.00 0.00 0.00 0.00 0.00 0.00 243.86
41 3000 Inspector was driving N. on Santa Barbara
Blvd. A bus was on the right side of the
truck & merged into the lane, apparently
did not see the inspector's truck. Inspector
swerved left to avoid being side swiped &
made contact with median turn lane curb.
16.E.14.c
Packet Pg. 2352 Attachment: All Lines Closed Claim Report 3rd QTR FY 2017 (3503 : 3rd Quarter Closed Claim Report)
4104041706025 Code Enforcement Division 0.00 0.00 969.60 0.00 0.00 0.00 0.00 969.60
138911 4/4/2017 4/4/2017 6/26/2017 0.00 0.00 969.60 0.00 0.00 0.00 0.00 969.60
41 3000 Investigator was backing out of the
contraction site at 6130 Hidden Oaks
Lane. As he backed up, he hit a tree on
the passenger side rear bumper on the
Corner (a blind spot) causing minimal
damage.
4202281705908 Code Enforcement Division 70.00 0.00 0.00 0.00 0.00 0.00 0.00 70.00
138911 2/28/2017 3/2/2017 4/30/2017 70.00 0.00 0.00 0.00 0.00 0.00 0.00 70.00
42 2000 County employee driving truck CC2-1467
alleges an object hit the windshield and
chipped it.
4210281605990 Facilities Management Division 1,027.03 0.00 0.00 0.00 0.00 0.00 0.00 1,027.03
122240 10/28/2016 3/23/2017 6/22/2017 1,027.03 0.00 0.00 0.00 0.00 0.00 0.00 1,027.03
42 5900 Vehicle has multiple dings and dents on
the exterior of the car.
4102241705927 Parks and Recreation Division 0.00 0.00 731.70 0.00 0.00 0.00 0.00 731.70
156363 2/24/2017 3/8/2017 5/31/2017 0.00 0.00 731.70 0.00 0.00 0.00 0.00 731.70
41 3000 Asset CC2-902 was backing up and a
minor collision occured with a private
citizen's vehicle' minor damage was noted
to both units.
4202071705827 Pelican Bay Services Division 377.61 0.00 0.00 0.00 0.00 0.00 0.00 377.61
PBSE 2/7/2017 2/7/2017 5/31/2017 377.61 0.00 0.00 0.00 0.00 0.00 0.00 377.61
42 2000 While the maintenance staff was trimming
tree limbs, a limb hit the windshield (front
passenger side) of the PBSD vehicle CC2-
629.
4104261706083 Water Division 498.88 0.00 0.00 0.00 0.00 0.00 0.00 498.88
BCC 4/26/2017 4/26/2017 5/23/2017 498.88 0.00 0.00 0.00 0.00 0.00 0.00 498.88
41 2000 Team backed van down incline drive to
SRO well 38 for repairs. Employee opened
the back to grab his tools and the door
swung open hitting a fence post, shattering
the window.
4104131706042 Water Division 0.00 0.00 499.77 0.00 0.00 0.00 0.00 499.77
253215 4/13/2017 4/13/2017 5/19/2017 0.00 0.00 499.77 0.00 0.00 0.00 0.00 499.77
41 2000 While traveling east on Rattlesnake-
Hammock Road, a vehicle pulled out in
front of vehicle CC2-1520. While braking, a
valve (6" OS&Y) rolled forward causing it
to break the rear window.
4103241705992 Water Distribution Division 0.00 0.00 1,798.00 0.00 0.00 0.00 0.00 1,798.00
253215 3/24/2017 3/24/2017 5/31/2017 0.00 0.00 1,798.00 0.00 0.00 0.00 0.00 1,798.00
41 3000 While pulling vehicle #CC2-1520 forward,
the driver struck the vice of vehicle #CC2-
744 causing damage to the right front tool
door.
4,586.81 0.00 31,714.83 0.00 0.00 0.00 0.00 36,301.64
Total by Major Coverage 26 Claims 4,586.81 0.00 31,714.83 0.00 0.00 0.00 0.00 36,301.64
Major Coverage: 50 - Property
5101201705808 Facilities Management Division 0.00 0.00 3,246.47 0.00 0.00 0.00 0.00 3,246.47
122240 1/20/2017 1/31/2017 4/20/2017 0.00 0.00 3,246.47 0.00 0.00 0.00 0.00 3,246.47
51 5500 Vandalism to County toilet - overstuffed
and plugged with paper towels.
5306061706183 Road Maintenance Division 620.09 0.00 0.00 0.00 0.00 0.00 0.00 620.09
163620 6/6/2017 6/7/2017 6/26/2017 620.09 0.00 0.00 0.00 0.00 0.00 0.00 620.09
53 5500 Message Board # CC2-952 was
vandalized, batteries taken and wires cut.
16.E.14.c
Packet Pg. 2353 Attachment: All Lines Closed Claim Report 3rd QTR FY 2017 (3503 : 3rd Quarter Closed Claim Report)
620.09 0.00 3,246.47 0.00 0.00 0.00 0.00 3,866.56
Total by Major Coverage 2 Claims 620.09 0.00 3,246.47 0.00 0.00 0.00 0.00 3,866.56
Major Coverage: 60 - Public
Officials Errors and Ommissions
6704161504017 Brock, Dwight v. Ochs & Markiewicz 0.00 0.00 0.00 0.00 0.00 505,042.02 0.00 505,042.02
311111 4/16/2015 4/20/2015 4/30/2017 0.00 0.00 0.00 0.00 0.00 505,042.02 0.00 505,042.02
67 A summons and complaint has been filed
by Clerk of Courts, Dwight Brock against
County Manager, Leo Ochs and
Purchasing Division Director, Joanne
Markiewicz alleging the unlawful
administration of the Board's Purchasing
policy.
0.00 0.00 0.00 0.00 0.00 505,042.02 0.00 505,042.02
Total by Major Coverage 1 Claim 0.00 0.00 0.00 0.00 0.00 505,042.02 0.00 505,042.02
75,580.99 5,064.13 70,676.20 509.00 0.00 505,042.02 0.00 656,363.34
Grand Totals: 85 Claims 75,580.99 5,064.13 70,676.20 509.00 0.00 505,042.02 0.00 656,363.34
16.E.14.c
Packet Pg. 2354 Attachment: All Lines Closed Claim Report 3rd QTR FY 2017 (3503 : 3rd Quarter Closed Claim Report)