Agenda 06/12/2018 Item #16E 106/12/2018
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 second quarter of FY 18.
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 second quarter of FY
18 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 second quarter of FY 18, 104 files were closed with total expenditures
of $489,163.63. During the same period, 10 subrogation files were closed and the Risk Management
Division recovered $65,250.85 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 acceptance of the report. -JAK
RECOMMENDATION: That the Board of County Commissioners accepts the attached Settlement
Report and ratifies the actions taken therein.
16.E.1
Packet Pg. 1494
06/12/2018
Prepared by: Jeff Walker CPCU, ARM, Division Director, Risk Management Division.
ATTACHMENT(S)
1. Subrogation Closed Claim Report 2nd QTR FY 18 (PDF)
2. All Lines Closed Claim Report 2nd QTR FY 18 (PDF)
3. Resolution 2004-15 PDF0001 (PDF)
16.E.1
Packet Pg. 1495
06/12/2018
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.E.1
Doc ID: 5650
Item Summary: Recommendation to ratify Property, Casualty, Workers’ Compensation and
Subrogation claim files settled and/or closed by the Risk Management Division Director pursuant to
Resolution # 2004-15 for the second quarter of FY 18.
Meeting Date: 06/12/2018
Prepared by:
Title: Division Director - Risk Management – Risk Management
Name: Jeff Walker
05/10/2018 2:28 PM
Submitted by:
Title: Division Director - Risk Management – Risk Management
Name: Jeff Walker
05/10/2018 2:28 PM
Approved By:
Review:
Administrative Services Department Michael Cox Level 1 Division Reviewer Completed 05/14/2018 10:35 AM
Administrative Services Department Len Price Level 2 Division Administrator Review Completed 06/01/2018 1:35 PM
County Attorney's Office Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Completed 06/01/2018 2:16 PM
Office of Management and Budget Valerie Fleming Level 3 OMB Gatekeeper Review Completed 06/01/2018 3:51 PM
Office of Management and Budget Laura Wells Additional Reviewer Completed 06/01/2018 4:31 PM
County Manager's Office Nick Casalanguida Level 4 County Manager Review Completed 06/03/2018 8:52 PM
Board of County Commissioners MaryJo Brock Meeting Pending 06/12/2018 9:00 AM
16.E.1
Packet Pg. 1496
Collier County Government
Subrogation Closed Claim Report
2nd QTR FY 2018
Valued as of:5/10/2018
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
11,154.24 0.00 0.00 0.00 10,000.00 0.00 0.00 11,154.24CC v. Gabriel-Sanchez, Jose
($11,528.24)
5311191605683
1/2/201811/19/2016 12/15/2016 11,154.24 0.00 0.00 10,000.00 11,154.24 0.00 0.00 0.00138324
53 A vehicle owned by Jose Gabriel
Sanchez was traveling east on
West Main Street when it left the
roadway and crashed over a
brick wall, into 2 benches,
landscaping, then a light pole.
3000
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Capeless Jr., James
Joseph
4101311807597
3/9/20181/31/2018 2/12/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00138915
41 I was parked at 6101 Pelican
Bay Blvd. to do an inspection
when I came out the owner of
the vehicle came up to me and
told me he hit the truck. We
exchanged information and took
photos of his vehicle as well.
2000
0.00 0.00 0.00 0.00 1,672.00 0.00 0.00 0.00CC v. Needham, Rita5411111707187
2/26/201811/11/2017 11/28/2017 0.00 0.00 0.00 1,672.00 0.00 0.00 0.00 0.00163801
54 Rita Needham was traveling
north on Livingston Road when
she proceeded through the
intersection at Carlton Lakes.
She failed to make the right turn
& struck a vehicle sitting at the
stop sign, then struck a tree.
3000
0.00 0.00 0.00 0.00 7,480.93 0.00 0.00 0.00CC v. Cardentey, Jose5306191706266
1/22/20186/19/2017 7/10/2017 0.00 0.00 0.00 7,480.93 0.00 0.00 0.00 0.00163630
53 Javier Martinez Cardentey was
traveling north on Collier Blvd.
when traffic came to a stop, but
he was unable to stop in time
due to the rain and struck a light
pole.
3000
-1-
8:17:12AM
5/10/2018
16.E.1.a
Packet Pg. 1497 Attachment: Subrogation Closed Claim Report 2nd QTR FY 18 (5650 : Closed Claim Report to the Board)
Collier County Government
Subrogation Closed Claim Report
2nd QTR FY 2018
Valued as of:5/10/2018
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 8,112.85 0.00 0.00 0.00CC v. Doyle, Richard5306151706263
2/6/20186/15/2017 7/10/2017 0.00 0.00 0.00 8,112.85 0.00 0.00 0.00 0.00163630
53 Noreen Doyle was traveling
south on Livingston Road when
she made a wide right turn on a
red light onto Immokalee Road.
She struck a vehicle traveling
west on Immokalee Road
causing it to strike a guardrail
and a street light.
3000
0.00 0.00 0.00 0.00 1,437.45 0.00 0.00 0.00CC v. Howey, Henriette
($1,653.07)
5305211706180
1/31/20185/21/2017 6/6/2017 0.00 0.00 0.00 1,437.45 0.00 0.00 0.00 0.00163630
53 Stephanie Lopez was traveling
east on Vanderbilt Beach Road
when she attempted to turn left
onto Logan Blvd. She was
driving too fast and unable to
control the vehicle, striking a
light pole.
3000
0.00 0.00 0.00 0.00 2,882.00 0.00 0.00 0.00CC v. Foley, Keith5408221606059
1/31/20188/22/2016 4/21/2017 0.00 0.00 0.00 2,882.00 0.00 0.00 0.00 0.00163801
54 Keith Foley was traveling west
on Radio Road when he
attempted to change lanes and
struck another vehicle who then
drove into the median and struck
palm trees and shrubs.
3000
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Hansen, Russell P.4101161807385
2/12/20181/16/2018 1/16/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163630
41 I picked up my MOT set up in
the west bound inside left turn
lane. I then waited to get the
green light (turn signal indicated
to go left) maintained my lane;
car in the left turn lane to the
right of me merged into the front
right side of my truck
2000
-2-
8:17:12AM
5/10/2018
16.E.1.a
Packet Pg. 1498 Attachment: Subrogation Closed Claim Report 2nd QTR FY 18 (5650 : Closed Claim Report to the Board)
Collier County Government
Subrogation Closed Claim Report
2nd QTR FY 2018
Valued as of:5/10/2018
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 3,821.62 0.00 0.00 0.00CC v. DeJesus, Angel5312151707348
3/2/201812/15/2017 1/4/2018 0.00 0.00 0.00 3,821.62 0.00 0.00 0.00 0.00163630
53 Julissa DeJesus was traveling
east on Immokalee Road and
struck another vehicle waiting to
make a turn onto Wilson Blvd.
then struck a pedestrian
crosswalk pole.
3000
250.00 0.00 0.00 0.00 29,844.00 0.00 0.00 250.00CC v. Hilts, Timothy (CA)5304171201392
1/12/20184/17/2012 4/18/2012 250.00 0.00 0.00 29,844.00 250.00 0.00 0.00 0.00253212
53 Timothy Hilts was turning east
onto Vanderbilt Beach Road
from Mission Hills Plaza when he
accelerated agressively & the
vehicle spun, striking the curb,
then a fire hydrant.
3000
11,404.24
11,404.24
0.00
0.00
0.00
0.00
65,250.85
65,250.85 0.00
0.00 0.00
0.00
0.00
0.00
11,404.24
11,404.24Grand Totals: 10 Claims
-3-
8:17:12AM
5/10/2018
16.E.1.a
Packet Pg. 1499 Attachment: Subrogation Closed Claim Report 2nd QTR FY 18 (5650 : Closed Claim Report to the Board)
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
3,480.00 287.33 0.00 0.00 0.00 0.00 0.00 3,767.33
10/6/2017 10/6/2017 1/31/2018 3,480.00 287.33 0.00 0.00 0.00 0.00 0.00 3,767.33
10 1300
2,223.08 72.86 0.00 0.00 0.00 0.00 0.00 2,295.94
11/29/2017 11/30/2017 1/31/2018 2,223.08 72.86 0.00 0.00 0.00 0.00 0.00 2,295.94
10 1500
539.31 0.00 0.00 0.00 0.00 0.00 0.00 539.31
2/8/2018 2/12/2018 3/19/2018 539.31 0.00 0.00 0.00 0.00 0.00 0.00 539.31
10 1500
7,409.11 76.74 0.00 0.00 0.00 0.00 0.00 7,485.85
12/21/2017 12/21/2017 1/19/2018 7,409.11 76.74 0.00 0.00 0.00 0.00 0.00 7,485.85
10 1400
2,440.94 104.06 80.00 0.00 0.00 0.00 0.00 2,625.00
5/2/2017 5/2/2017 1/23/2018 2,440.94 104.06 80.00 0.00 0.00 0.00 0.00 2,625.00
10 1700
110.70 13.75 0.00 0.00 0.00 0.00 0.00 124.45
2/13/2018 2/13/2018 2/28/2018 110.70 13.75 0.00 0.00 0.00 0.00 0.00 124.45
10 1500
1,532.32 84.00 0.00 0.00 0.00 0.00 0.00 1,616.32
4/11/2017 4/12/2017 1/23/2018 1,532.32 84.00 0.00 0.00 0.00 0.00 0.00 1,616.32
10 1700
3,445.74 100.27 0.00 0.00 0.00 0.00 0.00 3,546.01
11/9/2017 11/9/2017 3/31/2018 3,445.74 100.27 0.00 0.00 0.00 0.00 0.00 3,546.01
10 1100
144612
Employee had a combative patient who
was spitting and she felt it enter her right
eye.
1011091707122
121811
Employee tripped in a hole and popped his
knee
1002131807637
144610
Employee injured forehead when she
opened the outside cabinet door of the
Ambulance.
1004111706041
121811
Employee was injured when he was struck
by a vehicle
1005021706095
144610
Employee had a stretcher collapse onto the
trauma bag she had on her left shoulder.
1002081807580
182901
Employee injured right knee while pruning
saw palmettos.
1012211707328
105010
Employee slipped on wet floor while on
break, and injured her right hip, elbow, and
pinky finger
1011291707210
182901
Employee felt pain in shoulder, elbow and
wrist while digging a hole next to a light pole
Cost Center
Carrier Employer Acc Desc.
Major Coverage: 10 - Workers' Compensation
1010061706800
Collier County Government
Closed Claim Report- All Lines
2nd QTR FY 2018
Valued as of:5/10/2018
Claim Number Employee Name
1
16.E.1.b
Packet Pg. 1500 Attachment: All Lines Closed Claim Report 2nd QTR FY 18 (5650 : Closed Claim Report to the Board)
1,881.58 221.28 80.00 0.00 0.00 0.00 0.00 2,182.86
11/7/2017 11/7/2017 1/23/2018 1,881.58 221.28 80.00 0.00 0.00 0.00 0.00 2,182.86
10 1100
288.00 0.00 0.00 0.00 0.00 0.00 0.00 288.00
2/15/2018 2/16/2018 2/28/2018 288.00 0.00 0.00 0.00 0.00 0.00 0.00 288.00
10 1400
14.16 0.00 0.00 0.00 0.00 0.00 0.00 14.16
3/2/2018 3/2/2018 3/31/2018 14.16 0.00 0.00 0.00 0.00 0.00 0.00 14.16
10 1500
735.59 70.00 152.71 0.00 0.00 0.00 0.00 958.30
9/20/2017 9/29/2017 1/18/2018 735.59 70.00 152.71 0.00 0.00 0.00 0.00 958.30
10 1600
452.44 0.00 0.00 0.00 0.00 0.00 0.00 452.44
2/8/2018 2/9/2018 2/20/2018 452.44 0.00 0.00 0.00 0.00 0.00 0.00 452.44
10 1500
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
3/14/2018 3/15/2018 3/27/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
10 1900
47.50 6.70 0.00 0.00 0.00 0.00 0.00 54.20
1/9/2018 1/10/2018 1/19/2018 47.50 6.70 0.00 0.00 0.00 0.00 0.00 54.20
10 1500
6,381.04 102.01 639.49 0.00 0.00 0.00 0.00 7,122.54
11/14/2017 11/15/2017 3/30/2018 6,381.04 102.01 639.49 0.00 0.00 0.00 0.00 7,122.54
10 1100
195.41 11.47 0.00 0.00 0.00 0.00 0.00 206.88
1/26/2018 1/29/2018 1/31/2018 195.41 11.47 0.00 0.00 0.00 0.00 0.00 206.88
10 1200
3,209.36 90.81 0.00 0.00 0.00 0.00 0.00 3,300.17
11/13/2017 11/14/2017 1/18/2018 3,209.36 90.81 0.00 0.00 0.00 0.00 0.00 3,300.17
10 1300
1011131707135
182901
Employee fell on uneven concrete and
asphalt and injured multiple body parts
233351
Employee twisted left knee while installing
camera in the gravity main
1001261807413
182901
Employee cut finger while he was using a
hedge trimmer
1001091807362
157110
Employee popped back while lifting the
containers of computers after a robotics
program.
1011141707144
233352
Employee injured finger while moving a
barrell with a hand truck
1003141807769
156332
Employee felt foreign particles to left eye
while blowing off the sidewalk at Willoughby
Acres Park.
1009201706718
144610
Employee struck her knee on an O2 bottle.
1002081807553
122240
Employee was involved in a motor vehicle
accident and injured his lower back.
1003021807739
144610
Employee injured elbow when patient of
mother landed on deputy who was
attempting to restrain and move patient
down stairway.
1011071707109
144610
Employee injured back when she caught
the stretcher as it was falling.
1002151807718
2
16.E.1.b
Packet Pg. 1501 Attachment: All Lines Closed Claim Report 2nd QTR FY 18 (5650 : Closed Claim Report to the Board)
292.50 0.00 0.00 0.00 0.00 0.00 0.00 292.50
2/16/2018 2/16/2018 2/28/2018 292.50 0.00 0.00 0.00 0.00 0.00 0.00 292.50
10 1300
274.50 13.75 0.00 0.00 0.00 0.00 0.00 288.25
1/12/2018 1/12/2018 1/26/2018 274.50 13.75 0.00 0.00 0.00 0.00 0.00 288.25
10 1100
376.20 158.35 0.00 0.00 0.00 0.00 0.00 534.55
11/16/2017 11/16/2017 1/18/2018 376.20 158.35 0.00 0.00 0.00 0.00 0.00 534.55
10 1500
0.00 13.75 0.00 0.00 0.00 0.00 0.00 13.75
3/8/2018 3/8/2018 3/27/2018 0.00 13.75 0.00 0.00 0.00 0.00 0.00 13.75
10 1900
103.11 0.00 0.00 0.00 0.00 0.00 0.00 103.11
3/2/2018 3/2/2018 3/21/2018 103.11 0.00 0.00 0.00 0.00 0.00 0.00 103.11
10 1300
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
3/1/2018 3/2/2018 3/20/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
10 1100
2,354.41 211.94 3,752.43 0.00 0.00 0.00 0.00 6,318.78
10/6/2017 10/9/2017 1/31/2018 2,354.41 211.94 3,752.43 0.00 0.00 0.00 0.00 6,318.78
10 1500
349.63 25.86 0.00 0.00 0.00 0.00 0.00 375.49
1/10/2018 1/11/2018 1/22/2018 349.63 25.86 0.00 0.00 0.00 0.00 0.00 375.49
10 1300
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
1/29/2018 1/29/2018 1/31/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
10
1001291807417
157460
Employee cut right leg with metal bracket
on back of chair.
144610
Employee reported he strained his left
upper arm on a call while lifting a patient
onto the stretcher. Advised he was able to
continue working and would advise if he
needs a replacement
1001101807368
156361
Employee slipped and fell while standing in
boat and injured his hand.
1003011807744
TXCE
Employee right hand was injured when the
wind blew the office door open.
1010061706840
156310
Employee had a stick poked his left eye
while spreading mulch around plants in
Butterlfy garden.
1003021807743
233315
Employee fell out of work van when he lost
contact between foot and ground.
1011161707155
156315
Employee thumb was hyperextended
during a swim lesson when a child jumped
into her arms
1003081807755
431310
Employee tripped an fell hitting the front of
her head against a door frame
1001121807380
253212
Employee had a nail went through his boot
while moving items from the back of a
trailer at the Landfill
Employee fell on uneven concrete and
asphalt and injured multiple body parts
1002161807719
3
16.E.1.b
Packet Pg. 1502 Attachment: All Lines Closed Claim Report 2nd QTR FY 18 (5650 : Closed Claim Report to the Board)
522.00 63.71 0.00 0.00 0.00 0.00 0.00 585.71
11/17/2017 11/22/2017 1/19/2018 522.00 63.71 0.00 0.00 0.00 0.00 0.00 585.71
10 1300
603.00 32.91 0.00 0.00 0.00 0.00 0.00 635.91
12/19/2017 12/21/2017 1/31/2018 603.00 32.91 0.00 0.00 0.00 0.00 0.00 635.91
10 1500
39,261.63 1,761.55 4,704.63 0.00 0.00 0.00 0.00 45,727.81
39,261.63 1,761.55 4,704.63 0.00 0.00 0.00 0.00 45,727.81
0.00 0.00 14,255.20 0.00 0.00 0.00 0.00 14,255.20
10/12/2017 10/13/2017 3/15/2018 0.00 0.00 14,255.20 0.00 0.00 0.00 0.00 14,255.20
120 5900
0.00 0.00 14,255.20 0.00 0.00 0.00 0.00 14,255.20
0.00 0.00 14,255.20 0.00 0.00 0.00 0.00 14,255.20
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
12/15/2013 7/17/2014 2/26/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
150
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00Total by Major Coverage 1 Claim
Total by Major Coverage 1 Claim
Major Coverage: 150 - Contingent Law Enforcement Liability
1512151303417 PEREZ, CHRISTOPHER
611011
Claimant was allegedly unnecessarily
beaten and tazed by 2 officers of the Collier
County Sheriff's office.
Total by Major Coverage 29 Claims
Major Coverage: 120 - Pollution Liability
1210121706920 Parks & Recreation Division
156331
Found spill on Richard Green Walkway (oil
or hydraulic).
156363
Employee fell while clearing leftover
hurricane debris and injured his ring finger.
1012201707326
163620
Employee's right elbow swelled up while
using a sledge hammer to break up
concrete.
1011171707171
4
16.E.1.b
Packet Pg. 1503 Attachment: All Lines Closed Claim Report 2nd QTR FY 18 (5650 : Closed Claim Report to the Board)
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
9/2/2017 9/5/2017 2/8/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
22 2000
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
6/7/2017 6/8/2017 3/19/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
22
0.00 0.00 2,372.49 0.00 0.00 0.00 0.00 2,372.49
10/28/2017 10/28/2017 1/31/2018 0.00 0.00 2,372.49 0.00 0.00 0.00 0.00 2,372.49
22 2000
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
6/13/2017 6/14/2017 3/19/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
22
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
9/10/2017 10/30/2017 3/8/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
22 5400
0.00 0.00 160,000.00 0.00 0.00 0.00 0.00 160,000.00
9/17/2017 9/21/2017 3/31/2018 0.00 0.00 160,000.00 0.00 0.00 0.00 0.00 160,000.00
22 5400
751.86 0.00 0.00 0.00 0.00 0.00 0.00 751.86
7/5/2017 7/5/2017 1/18/2018 751.86 0.00 0.00 0.00 0.00 0.00 0.00 751.86
21
210120
Sewer back-up in resident; major damage
to interior of residence. BCC approved
settlement.
2107051706251 BADENLI, BROCK
156398
Claimant jumped off of the rock play
structure within the playground at Eagle
Lakes Comm Park. He informed camp
counselor that he was in discomfort.
2209101707076 MELNICK, STUART
163627
Claimant alleges that the storm sewer on
the north side of his property failed resulting
on the collapse of the west side of the road
and sidewalk, causing damages to his
property.
2209171706535 SMITH, TERRANCE
173441
Team member was on Kirkwood Avenue
off-loading a metal roll off container box.
The container struck a metal fence and the
fence slid into a parked BMW owned by
Auto Performance By J&Y Inc.
2206131706198 15460 Mediterra Circle
233351
A power outage caused the system to LS
103.13 to surcharge and back up into the
maintenance facility at Medittera.
2206071706185 15460 Mediterra Circle
233351
Due to a major storm event L/S 103.13
suffered a power outage and went high
level. The high level caused a backup and
overflow of the drains inside the Mediterra
maintenance facility.
2210281707071 Auto Performance by J&Y, Inc.
Major Coverage: 20 - General Liability
2209021706415 Josephine Violette
163620
Claimant was driving through the
intersection of Georgetown Blvd &
Lanchester Ct. in the Royal Arms
Community off of Palm Street when she
drove over a manhole cover and it flipped
and damage the passenger side door panel
on her vehicle.
5
16.E.1.b
Packet Pg. 1504 Attachment: All Lines Closed Claim Report 2nd QTR FY 18 (5650 : Closed Claim Report to the Board)
112,500.00 2,832.64 0.00 0.00 0.00 0.00 0.00 115,332.64
4/5/2015 4/27/2015 1/31/2018 112,500.00 2,832.64 0.00 0.00 0.00 0.00 0.00 115,332.64
21 2150
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
9/14/2017 2/9/2018 2/26/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
22 5400
0.00 0.00 1,345.84 0.00 0.00 0.00 0.00 1,345.84
8/2/2017 8/2/2017 3/21/2018 0.00 0.00 1,345.84 0.00 0.00 0.00 0.00 1,345.84
22 2000
113,251.86 2,832.64 163,718.33 0.00 0.00 0.00 0.00 279,802.83
113,251.86 2,832.64 163,718.33 0.00 0.00 0.00 0.00 279,802.83
0.00 447.90 4,363.39 0.00 0.00 0.00 0.00 4,811.29
8/3/2017 8/9/2017 3/21/2018 0.00 447.90 4,363.39 0.00 0.00 0.00 0.00 4,811.29
32 2450
0.00 0.00 555.90 0.00 0.00 0.00 0.00 555.90
10/23/2017 10/24/2017 3/15/2018 0.00 0.00 555.90 0.00 0.00 0.00 0.00 555.90
32 3000
0.00 447.90 4,919.29 0.00 0.00 0.00 0.00 5,367.19
0.00 447.90 4,919.29 0.00 0.00 0.00 0.00 5,367.19
3210231707049 Badge, Jason
163611
Claimant had his car backed into by the
driver of Asset #CC2-1028.
Total by Major Coverage 2 Claims
Total by Major Coverage 10 Claims
Major Coverage: 30 - Auto Liability
3208031706351 Reyes Paredes, Roberto
138327
Employee Benjamin Hughes was involved
in vehicular accident involving County
vehicle #CC2-1082 and a Tractor Trailer.
210120
Claimant states they evacuated for
Hurricane Irma; and when returned home
on 9/14/17 there was sewage water on the
bathrooms, bedrooms, and kitchen floors.
2208021706335 Lingar, Kim
121151
Claimant parked in guest parking at GMD.
A large tree branch was laying on the
ground next to her when she returned. The
branch damaged her vehicle as it fell and
left two noticeable dents where the branch
hit on the rear driver’s side of the car.
2104051504049 MONTY, TERESA
156332
Claimant allegedly placed her hand on a
piling to assist getting into a boat when her
right pinky finger was caught on a large nail
causing her finger to be amputated. BCC
approved settlement.
2209141707565 BERMUDEZ, CHRISTINE
6
16.E.1.b
Packet Pg. 1505 Attachment: All Lines Closed Claim Report 2nd QTR FY 18 (5650 : Closed Claim Report to the Board)
0.00 0.00 1,705.57 0.00 0.00 0.00 0.00 1,705.57
9/12/2017 9/26/2017 1/31/2018 0.00 0.00 1,705.57 0.00 0.00 0.00 0.00 1,705.57
41 3000
0.00 0.00 925.63 0.00 0.00 0.00 0.00 925.63
9/26/2017 9/27/2017 1/31/2018 0.00 0.00 925.63 0.00 0.00 0.00 0.00 925.63
41 5900
0.00 0.00 1,303.56 0.00 0.00 0.00 0.00 1,303.56
4/22/2017 8/7/2017 2/28/2018 0.00 0.00 1,303.56 0.00 0.00 0.00 0.00 1,303.56
41 2000
0.00 0.00 2,151.01 0.00 0.00 0.00 0.00 2,151.01
8/3/2017 8/3/2017 2/28/2018 0.00 0.00 2,151.01 0.00 0.00 0.00 0.00 2,151.01
41 2000
0.00 0.00 11,234.05 0.00 0.00 0.00 0.00 11,234.05
12/11/2017 12/11/2017 3/26/2018 0.00 0.00 11,234.05 0.00 0.00 0.00 0.00 11,234.05
41 2450
0.00 0.00 3,507.33 0.00 0.00 0.00 0.00 3,507.33
1/19/2018 1/19/2018 2/28/2018 0.00 0.00 3,507.33 0.00 0.00 0.00 0.00 3,507.33
41 91
0.00 0.00 974.80 0.00 0.00 0.00 0.00 974.80
1/10/2018 1/11/2018 2/28/2018 0.00 0.00 974.80 0.00 0.00 0.00 0.00 974.80
41 3000
1,389.42 0.00 0.00 0.00 0.00 0.00 0.00 1,389.42
9/10/2017 11/7/2017 1/31/2018 1,389.42 0.00 0.00 0.00 0.00 0.00 0.00 1,389.42
42 5400
156332
Door on passenger side of Ford F550 was
damaged by a fallen shingle during
Hurricane Irma.
4101101807375 Health Department
155810
While backing Asset #CC2-1508 out on a
very narrow driveway, the vehicle went
sideways on the left edge and struck the
drain pipe cement cover.
4209101707106 Parks & Recreation Division
144610
Crew was responding to a call on
Immokalee Rd. with lights and siren when a
vehicle in front stopped and the County
vehicle struck the stopped vehicle.
4101191807389 Fleet Management Division
155810
Employee driving county car and planning
to turn right. Her shoe got caught in the
brake and car hit a truck's front passenger
wheel.
4108031706337 EMS Division
144610
Employeewas operating ambulance #27
and struck a mailbox while entering a
patient's driveway causing a scrape the
driver's side front compartment door.
There was no damage to the mailbox. No
persons were injured in the incident.
4112111707269 EMS Division
138915
Inspector went to go pick up loaner truck
and found the back tail lights busted with
the lens on the ground. Looks like
someone backed into it on the lot.
4104221706347 Bureau of Emergency Services Division
144210
Towed light tower set bounced off hitch and
dented tailgate of vehicle.
4109121706610 Tourism Division
101540
While inspecting Collier County Beaches
after Hurricane Irma, employeeI was
attempting to navigate around hurricane
debris and sideswiped a tree.
4109261706638 Building Review & Permitting Division
Major Coverage: 40 - Auto Physical Damage
7
16.E.1.b
Packet Pg. 1506 Attachment: All Lines Closed Claim Report 2nd QTR FY 18 (5650 : Closed Claim Report to the Board)
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
1/3/2018 1/3/2018 3/14/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
41 3000
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
12/19/2017 12/19/2017 1/18/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
42 2000
5,367.38 0.00 0.00 0.00 0.00 0.00 0.00 5,367.38
9/10/2017 11/2/2017 2/28/2018 5,367.38 0.00 0.00 0.00 0.00 0.00 0.00 5,367.38
42 5400
503.50 0.00 0.00 0.00 0.00 0.00 0.00 503.50
10/26/2017 10/27/2017 3/7/2018 503.50 0.00 0.00 0.00 0.00 0.00 0.00 503.50
42 2000
357.36 0.00 0.00 0.00 0.00 0.00 0.00 357.36
9/10/2017 9/18/2017 1/22/2018 357.36 0.00 0.00 0.00 0.00 0.00 0.00 357.36
42 5400
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
8/27/2017 8/29/2017 1/31/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
41 3000
383.29 0.00 0.00 0.00 0.00 0.00 0.00 383.29
9/10/2017 9/20/2017 1/31/2018 383.29 0.00 0.00 0.00 0.00 0.00 0.00 383.29
42 5400
659.30 0.00 0.00 0.00 0.00 0.00 0.00 659.30
10/6/2017 10/6/2017 1/31/2018 659.30 0.00 0.00 0.00 0.00 0.00 0.00 659.30
42 2000
4210061706813 Parks and Recreation Division
156332
While backing out of the shop, the wind
blew the gate closed and struck the truck.
144610
While making a u-turn, M43 hit a mailbox in
the early morning hours when it was still
dark and under heavy rain when departing
from a patient's house .
4209101706529 Domestic Animal Services Division
155410
Trailer #060186 was damaged by debris
during Hurricane Irma.
4209101706492 EMS Division
144610
Damage noted to the passenger side air
horn and side step after Hurricane Irma.
4108271706393 EMS
122240
Due to hurricane there are several
damages to County vehicle #CC2-1315.
Damage to roof ladder rack, driver door
blinds, and marks on front left corner.
4210261707066 Building Review & Permitting
138915
Inspector was parked on the side of the
road doing his inspection and a mower
kicked up a rock.
4212191707316 CC v. Valvoline
138915
At Valvoline for C service and wiper slipped
out of the technician's hand hitting the
windshield. There was a loud cracking
noise and the technician told me that there
was now a small crack in the lower part of
the windshield.
4209101707090 Facilities Management Division
4101031807347 Emergency Medical Services
144610
Greater Naples Firefighter was backing an
ambulance down a driveway while on a 911
call and hit a metal pole. Minor damage /
nothing structural. Rear bumper damage.
8
16.E.1.b
Packet Pg. 1507 Attachment: All Lines Closed Claim Report 2nd QTR FY 18 (5650 : Closed Claim Report to the Board)
1,902.07 0.00 0.00 0.00 0.00 0.00 0.00 1,902.07
9/15/2017 9/18/2017 2/12/2018 1,902.07 0.00 0.00 0.00 0.00 0.00 0.00 1,902.07
42 2000
0.00 0.00 1,578.00 0.00 0.00 0.00 0.00 1,578.00
9/12/2017 9/21/2017 1/31/2018 0.00 0.00 1,578.00 0.00 0.00 0.00 0.00 1,578.00
41 2000
13,549.81 0.00 0.00 0.00 0.00 0.00 0.00 13,549.81
6/13/2017 6/15/2017 1/31/2018 13,549.81 0.00 0.00 0.00 0.00 0.00 0.00 13,549.81
42 5000
0.00 0.00 15,138.63 0.00 0.00 0.00 0.00 15,138.63
9/28/2017 9/28/2017 1/31/2018 0.00 0.00 15,138.63 0.00 0.00 0.00 0.00 15,138.63
41 2000
3,159.28 0.00 0.00 0.00 0.00 0.00 0.00 3,159.28
9/10/2017 9/27/2017 3/14/2018 3,159.28 0.00 0.00 0.00 0.00 0.00 0.00 3,159.28
42 5400
0.00 0.00 3,111.85 0.00 0.00 0.00 0.00 3,111.85
10/6/2017 10/10/2017 2/28/2018 0.00 0.00 3,111.85 0.00 0.00 0.00 0.00 3,111.85
41 2450
0.00 0.00 1,946.54 0.00 0.00 0.00 0.00 1,946.54
9/22/2017 9/25/2017 3/9/2018 0.00 0.00 1,946.54 0.00 0.00 0.00 0.00 1,946.54
41 3100
163651
Employee was parking in the County
garage at Horseshoe Dr. coming from the
S. Horseshoe Drive entrance. When
entering the garage, the vehicle scraped
the wall and the result was damage to the
passenger side, especially the rear door.
4110061706862 Transportation Engineering & Construction
Management Division
163651
County driver collided with a vehcile at the
intersection of Golden Gate Parkway and
CR951.
4109221706587 Transportation Engineering Division
163641
Employee was on an active construction
site. While turning right, failed to negotiate
around 6" PVC pipe used as marker for
buried water valve sticking 2' to 3' ft. out of
the ground causing damage to the
passenger side of truck.
4209101706662 Landscape Operations Division
163647
Vehicle parked outside of essential
personnel home damaged due to Hurricane
Irma force winds; there was flying debris
that hit County vehicle.
4206131706207 Road Maintenance Division
163620
Truck # 050248 caught fire while parked at
facility
4109281706682 Natural Resources Division
156332
Truck was parked at Sugden Park and a
branch from a tree fell on the back driver's
side of truck bed.
4109121706543 Parks and Recreation Division
156363
While operating Patrol Unit CC2-286
enroute to Clam Pass, an unknown passing
vehicle carrying storm debris lost some of
it's load which fell to the road and struck
unit CC2-286.
4209151706481 Parks & Recreation Division
9
16.E.1.b
Packet Pg. 1508 Attachment: All Lines Closed Claim Report 2nd QTR FY 18 (5650 : Closed Claim Report to the Board)
1,280.93 0.00 0.00 0.00 0.00 0.00 0.00 1,280.93
9/20/2017 9/22/2017 1/3/2018 1,280.93 0.00 0.00 0.00 0.00 0.00 0.00 1,280.93
42 5900
0.00 0.00 3,978.97 0.00 0.00 0.00 0.00 3,978.97
7/5/2017 7/5/2017 3/7/2018 0.00 0.00 3,978.97 0.00 0.00 0.00 0.00 3,978.97
41 3000
135.30 0.00 0.00 0.00 0.00 0.00 0.00 135.30
9/22/2017 9/22/2017 3/26/2018 135.30 0.00 0.00 0.00 0.00 0.00 0.00 135.30
42
753.38 0.00 0.00 0.00 0.00 0.00 0.00 753.38
8/30/2017 8/30/2017 1/31/2018 753.38 0.00 0.00 0.00 0.00 0.00 0.00 753.38
42 5900
261.28 0.00 0.00 0.00 0.00 0.00 0.00 261.28
9/10/2017 9/14/2017 1/16/2018 261.28 0.00 0.00 0.00 0.00 0.00 0.00 261.28
42 5400
0.00 0.00 955.15 0.00 0.00 0.00 0.00 955.15
11/3/2017 11/8/2017 2/12/2018 0.00 0.00 955.15 0.00 0.00 0.00 0.00 955.15
41 2450
0.00 0.00 3,250.37 0.00 0.00 0.00 0.00 3,250.37
9/22/2017 9/26/2017 3/7/2018 0.00 0.00 3,250.37 0.00 0.00 0.00 0.00 3,250.37
41 3000
385.23 0.00 0.00 0.00 0.00 0.00 0.00 385.23
9/10/2017 9/13/2017 3/26/2018 385.23 0.00 0.00 0.00 0.00 0.00 0.00 385.23
42 5400
856.79 0.00 0.00 0.00 0.00 0.00 0.00 856.79
9/10/2017 9/16/2017 1/3/2018 856.79 0.00 0.00 0.00 0.00 0.00 0.00 856.79
42 5400
253212
Hurricane Irma damage.
4209101706436 Wastewater Division
233315
Windshield cracked by roof tile during
Hurricane Irma
4209101706471 Water Distribution Division
210130
Light changed to green, proceeded to go,
car in front did not.
4109221706619 Wastewater Division
233315
While navigating in tight quarters (in
complete darkness) at the Hurricane Irma
generator staging area, vehicle CC2-1306
came into contact with the tongue of a
portable generator.
4209101706446 Airport Authority Division
192370
Flying debris shattered rear passenger
window during Hurricane Irma. Possible
interior water damage as well.
4111031707110 Solid & Hazardous Waste Management
Division
182901
Hurricane IRMA - Vehicle was damaged
while hauling tree limbs.
4208301706399 Airport Authority Division
192310
Vehicle was taken to Fleet Management
and found to have damage to the driver's
side rear bumper from unknown incident.
4107051706252 Conservation Collier Division
178987
Backed into a railroad crossing post that
was leaning on an angle.
4209221706570 Pelican Bay Services Division
4209201706569 Solid & Hazardous Waste Management
Division
173410
Upon inspection of all vehicles post storm,
operator noticed a dent in the passenger
side rear door. Appears to be vegetation
from storm debris damage.
10
16.E.1.b
Packet Pg. 1509 Attachment: All Lines Closed Claim Report 2nd QTR FY 18 (5650 : Closed Claim Report to the Board)
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
9/10/2017 9/17/2017 1/9/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
42 5400
8,307.48 0.00 0.00 0.00 0.00 0.00 0.00 8,307.48
9/10/2017 9/16/2017 1/31/2018 8,307.48 0.00 0.00 0.00 0.00 0.00 0.00 8,307.48
42 5400
657.65 0.00 0.00 0.00 0.00 0.00 0.00 657.65
9/10/2017 9/15/2017 1/31/2018 657.65 0.00 0.00 0.00 0.00 0.00 0.00 657.65
42 5400
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
7/8/2017 7/8/2017 1/2/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
41 2000
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
9/10/2017 9/18/2017 1/9/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
42 5400
616.93 0.00 0.00 0.00 0.00 0.00 0.00 616.93
9/10/2017 10/31/2017 1/3/2018 616.93 0.00 0.00 0.00 0.00 0.00 0.00 616.93
42 5400
601.96 0.00 0.00 0.00 0.00 0.00 0.00 601.96
9/15/2017 11/14/2017 1/31/2018 601.96 0.00 0.00 0.00 0.00 0.00 0.00 601.96
42 5900
0.00 0.00 3,411.50 0.00 0.00 0.00 0.00 3,411.50
12/4/2017 2/26/2018 3/21/2018 0.00 0.00 3,411.50 0.00 0.00 0.00 0.00 3,411.50
41 2450
877.25 0.00 0.00 0.00 0.00 0.00 0.00 877.25
9/10/2017 9/19/2017 1/16/2018 877.25 0.00 0.00 0.00 0.00 0.00 0.00 877.25
42 5400
138327
Flying debris from Hurricane Irma struck
and penetrated the aluminum frame of the
truck door and roof while parked in
employees driveway. Truck was assigned
to take home for emergency duty
associated with Irma.
4112041707728 Building Review & Permitting Division
138915
County employee while crossing US 41 had
a low impact collision with another truck.
No injuries, CCSO called and arrived on-
scene.
4209101706494 Growth Management Division
156332
The passenger side mirror of Asset #CC2-
1170 sustained damage caused by
Hurricane Irma while at Eagle Lakes
Community Park.
4209151707141 Traffic Operations Division
163630
Unknown cause of damage, discovered
after Hurricane Irma.
4209101706493 EMS Division
144610
Fog light on passenger side found broken
after Hurricane Irma.
4209101707088 Eagle Lakes Community Park
253212
During Hurricane Irma, there was damage
to the vehicle.
4107081706261 EMS
EMSE
While leaving the Chevron on Marco Island,
employee struck the left-lower box section
of Tk#14 on a concrete/metal barrier. Minor
damage to truck. Unable to determine
damage to barrier. No injuries. Cheveron
staff informed. Photos attached.
4209101706470 Water Distribution Division
253212
Hurricane Irma damage.
4209101706461 Water Distribution Division
4209101706477 Water Distribution Division
253212
Hurricane Irma damage.
11
16.E.1.b
Packet Pg. 1510 Attachment: All Lines Closed Claim Report 2nd QTR FY 18 (5650 : Closed Claim Report to the Board)
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
9/10/2017 9/20/2017 1/10/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
42 5400
0.00 0.00 978.95 0.00 0.00 0.00 0.00 978.95
8/21/2017 8/22/2017 2/28/2018 0.00 0.00 978.95 0.00 0.00 0.00 0.00 978.95
41 3000
2,860.27 0.00 0.00 0.00 0.00 0.00 0.00 2,860.27
9/10/2017 9/26/2017 2/28/2018 2,860.27 0.00 0.00 0.00 0.00 0.00 0.00 2,860.27
42 5400
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
9/10/2017 9/18/2017 3/13/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
42 5400
9,399.80 0.00 0.00 0.00 0.00 0.00 0.00 9,399.80
9/19/2017 10/11/2017 3/21/2018 9,399.80 0.00 0.00 0.00 0.00 0.00 0.00 9,399.80
42
0.00 0.00 66.81 0.00 0.00 0.00 0.00 66.81
12/17/2017 12/20/2017 1/31/2018 0.00 0.00 66.81 0.00 0.00 0.00 0.00 66.81
41 2150
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
1/24/2018 1/25/2018 2/12/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
41 3000
0.00 152.80 18,689.71 0.00 0.00 0.00 0.00 18,842.51
8/3/2017 8/3/2017 1/31/2018 0.00 152.80 18,689.71 0.00 0.00 0.00 0.00 18,842.51
41 3000
1,718.41 0.00 0.00 0.00 0.00 0.00 0.00 1,718.41
9/10/2017 12/4/2017 1/31/2018 1,718.41 0.00 0.00 0.00 0.00 0.00 0.00 1,718.41
42 5400
233312
Damage to F150 from Huricane Irma. Roof
tiles hit the front driver side by the
headlight. Vehicle was parked and damage
occured during the storm.
4108031706338 Natural Resources Division
178984
A two vehicle accident between #CC2-1082
and a semi truck.
4209101707212 Wastewater Division
192310
Employee was entering the gate at X01 and
the right side mirror clipped the edge of the
gate, causing it to fold back and crack.
4101241807405 Traffic Operations
163630
To avoid hitting cement piller, employee
turned wheel and caught the edge of the
piller causing dent in bumper.
4209191706889 Pelican Bay Services Division
182901
The bed of the vehicle was damaged from
hauling hurricane debris (large limbs).
4112171707323 Airport Authority Division
233351
CC2-1353 hood was damaged by
hurricane Irma.
4209101706491 EMS Division
144610
Street sign broken from Hurricane Irma
scratched the side of the Medic Unit.
4108211706378 Transportation Engineering & Construction
Management
163630
While parking at gas station on South
Horseshoe Drive, employee backed up and
impacted the 3 ft. yellow concrete post.
4209101706599 Wastewater Division
4209101706513 EMS Division
144610
Water intrusion inside the door or roof
during the hurricane. Unsure where it's
located, but it's audible when braking or
excelerating the vehicle. Vehicle now has a
bad smell inside from the water.
12
16.E.1.b
Packet Pg. 1511 Attachment: All Lines Closed Claim Report 2nd QTR FY 18 (5650 : Closed Claim Report to the Board)
0.00 0.00 952.20 0.00 0.00 0.00 0.00 952.20
12/14/2017 12/14/2017 3/21/2018 0.00 0.00 952.20 0.00 0.00 0.00 0.00 952.20
41 3000
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
9/10/2017 9/16/2017 1/4/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
42 5400
971.48 0.00 0.00 0.00 0.00 0.00 0.00 971.48
9/10/2017 9/16/2017 1/31/2018 971.48 0.00 0.00 0.00 0.00 0.00 0.00 971.48
42 5400
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
9/10/2017 9/16/2017 2/2/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
42 5400
0.00 0.00 457.26 0.00 0.00 0.00 0.00 457.26
10/23/2017 10/24/2017 1/31/2018 0.00 0.00 457.26 0.00 0.00 0.00 0.00 457.26
41 3000
56,955.55 152.80 76,317.89 0.00 0.00 0.00 0.00 133,426.24
56,955.55 152.80 76,317.89 0.00 0.00 0.00 0.00 133,426.24
500.97 0.00 0.00 0.00 0.00 0.00 0.00 500.97
10/16/2017 10/16/2017 1/16/2018 500.97 0.00 0.00 0.00 0.00 0.00 0.00 500.97
53 5500
4,650.00 0.00 0.00 0.00 0.00 0.00 0.00 4,650.00
9/10/2017 9/13/2017 2/28/2018 4,650.00 0.00 0.00 0.00 0.00 0.00 0.00 4,650.00
53 5400
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
9/10/2017 10/20/2017 2/15/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
56 5400
192370
Significant damage to fencing and gates,
and parking lights bent/inoperable.
5609101707015 Traffic Operations Division (VMB CC2-364
& CC2-859)
163630
Two Variable Message Boards were placed
on Immokalee Rd by Gulf Coast HS 9/8/17
to let the public know that the Hurricane
Shelters were open. Message board CC2-
364 has minor damage; CC2-859 requires
extensive repairs.
5310161706974 Parks & Recreation Division
156332
Race Car inside the playground at Coconut
Circle Park was burned.
5309101706440 Marco Island Airport
4110231707037 Transportation Engineering Division
163651
When backing vehicle into a spot in the
parking garage, employee scraped the
driver's side rear fender on another
vehicle's headlight.
Total by Major Coverage 55 Claims
Major Coverage: 50 - Property
253212
Hurricane Irma damage.
4209101706466 Water Distribution Division
253212
Hurricane Irma damage.
4209101706472 Water Distribution Division
253212
Hurricane Irma damage.
4209101706473 Water Distribution Division
4112141707293 EMS Division
EMSE
Motor vehicle accident. Non-Moving. While
exiting his ambulance, employee Canas'
door struck Mr. Black's vehicle as it passed
at a slow rate of speed.
13
16.E.1.b
Packet Pg. 1512 Attachment: All Lines Closed Claim Report 2nd QTR FY 18 (5650 : Closed Claim Report to the Board)
0.00 0.00 1,974.74 0.00 0.00 0.00 0.00 1,974.74
11/9/2017 11/9/2017 1/16/2018 0.00 0.00 1,974.74 0.00 0.00 0.00 0.00 1,974.74
52 5500
0.00 0.00 510.00 0.00 0.00 0.00 0.00 510.00
1/8/2018 1/9/2018 2/26/2018 0.00 0.00 510.00 0.00 0.00 0.00 0.00 510.00
52 5500
2,948.65 0.00 0.00 0.00 0.00 0.00 0.00 2,948.65
9/10/2017 9/13/2017 2/28/2018 2,948.65 0.00 0.00 0.00 0.00 0.00 0.00 2,948.65
51 5400
8,099.62 0.00 2,484.74 0.00 0.00 0.00 0.00 10,584.36
8,099.62 0.00 2,484.74 0.00 0.00 0.00 0.00 10,584.36
217,568.66 5,194.89 266,400.08 0.00 0.00 0.00 0.00 489,163.63
217,568.66 5,194.89 266,400.08 0.00 0.00 0.00 0.00 489,163.63
Total by Major Coverage 6 Claims
Grand Totals: 104 Claims
5/10/2018
8:18:02 AM
253215
While taking lunch at Wendy's located at
28140 South Tamiaimi Trail Bonita Springs,
a backflow test kit valued at $800 was
stolen from the back of a County vehicle #
CC2-645.
5109101706437 Airport Authority Division (Marco Airport
Terminal)
192370
Damage to canopy overhang resulting in
wind/water penetration into facility; attic
insultation blown away in some places;
several leaks identified, potential mold
growing. Minor damage to ceiling
tiles/insultation/carpets inside.
5211091707119 Public Utilities Department
210155
Backpack was stolen with laptop, ipad, and
misc tools/cables from Vehicle while parked
after break in.
5201081807358 PUD Meter Operations
14
16.E.1.b
Packet Pg. 1513 Attachment: All Lines Closed Claim Report 2nd QTR FY 18 (5650 : Closed Claim Report to the Board)
16.E.1.c
Packet Pg. 1514 Attachment: Resolution 2004-15 PDF0001 (5650 : Closed Claim Report to the Board)
16.E.1.c
Packet Pg. 1515 Attachment: Resolution 2004-15 PDF0001 (5650 : Closed Claim Report to the Board)
16.E.1.c
Packet Pg. 1516 Attachment: Resolution 2004-15 PDF0001 (5650 : Closed Claim Report to the Board)
16.E.1.c
Packet Pg. 1517 Attachment: Resolution 2004-15 PDF0001 (5650 : Closed Claim Report to the Board)
16.E.1.c
Packet Pg. 1518 Attachment: Resolution 2004-15 PDF0001 (5650 : Closed Claim Report to the Board)
16.E.1.c
Packet Pg. 1519 Attachment: Resolution 2004-15 PDF0001 (5650 : Closed Claim Report to the Board)