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Agenda 09/25/2018 Item #16E 209/25/2018 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 third quarter of FY18. 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 FY18 is attached. The report may include claims and/or settlements previously approved by the Board of Commissioners as well as litigated files with a final court determination. FISCAL IMPACT: Funds are budgeted and available in Fund 516-121650-645920 (Property and Casualty Self Insurance Fund) and 518-121630-645928 (Workers’ Compensation Fund) for the payment of claims and settlements. For the third quarter of FY18, 88 files were closed with total expenditures of $213,541.38. During the same period, 134 subrogation files were closed, and the Risk Management Division recovered $27,935.36 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 Settlement Report and ratify the actions taken therein. 16.E.2 Packet Pg. 2016 09/25/2018 Prepared by: Jeff Walker CPCU, ARM, Division Director, Risk Management Division ATTACHMENT(S) 1. All Lines Closed Claim Report 3rd QTR 2018 (PDF) 2. Subrogation Closed Claim Report 3rd QTR 2018 (PDF) 3. Resolution 2004-15 PDF0001 (PDF) 16.E.2 Packet Pg. 2017 09/25/2018 COLLIER COUNTY Board of County Commissioners Item Number: 16.E.2 Doc ID: 6525 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 18. Meeting Date: 09/25/2018 Prepared by: Title: Division Director - Risk Management – Risk Management Name: Jeff Walker 08/24/2018 11:24 AM Submitted by: Title: Division Director - Risk Management – Risk Management Name: Jeff Walker 08/24/2018 11:24 AM Approved By: Review: Administrative Services Department Paula Brethauer Level 1 Division Reviewer Completed 08/24/2018 1:33 PM Administrative Services Department Len Price Level 2 Division Administrator Review Completed 09/11/2018 4:42 PM Office of Management and Budget Valerie Fleming Level 3 OMB Gatekeeper Review Completed 09/11/2018 4:51 PM Office of Management and Budget Laura Wells Additional Reviewer Completed 09/11/2018 5:06 PM County Attorney's Office Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Completed 09/12/2018 7:35 AM County Manager's Office Leo E. Ochs Level 4 County Manager Review Completed 09/17/2018 2:00 PM Board of County Commissioners MaryJo Brock Meeting Pending 09/25/2018 9:00 AM 16.E.2 Packet Pg. 2018 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 RiskStatus Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total Coverage Cause 396.38 79.77 0.00 0.00 0.00 0.00 0.00 476.15 3/26/2018 3/27/2018 4/19/2018 396.38 79.77 0.00 0.00 0.00 0.00 0.00 476.15 10 1500 19,443.02 297.75 2,266.32 0.00 0.00 0.00 0.00 22,007.09 8/10/2017 8/10/2017 4/19/2018 19,443.02 297.75 2,266.32 0.00 0.00 0.00 0.00 22,007.09 10 1500 5,289.48 404.13 431.99 0.00 0.00 0.00 0.00 6,125.60 1/31/2018 1/31/2018 4/27/2018 5,289.48 404.13 431.99 0.00 0.00 0.00 0.00 6,125.60 10 303.10 34.12 0.00 0.00 0.00 0.00 0.00 337.22 4/4/2018 4/4/2018 4/11/2018 303.10 34.12 0.00 0.00 0.00 0.00 0.00 337.22 10 1700 12,467.82 3,111.97 0.00 0.00 0.00 0.00 0.00 15,579.79 9/26/2017 9/26/2017 5/21/2018 12,467.82 3,111.97 0.00 0.00 0.00 0.00 0.00 15,579.79 10 1400 1,625.82 13.75 0.00 0.00 0.00 0.00 0.00 1,639.57 5/26/2018 5/29/2018 6/12/2018 1,625.82 13.75 0.00 0.00 0.00 0.00 0.00 1,639.57 10 259.58 29.84 0.00 0.00 0.00 0.00 0.00 289.42 3/1/2018 3/1/2018 6/12/2018 259.58 29.84 0.00 0.00 0.00 0.00 0.00 289.42 10 1100 2,724.28 329.41 2,382.34 0.00 0.00 0.00 0.00 5,436.03 3/2/2018 3/2/2018 6/8/2018 2,724.28 329.41 2,382.34 0.00 0.00 0.00 0.00 5,436.03 10 1300 590.02 81.61 938.09 0.00 0.00 0.00 0.00 1,609.72 4/9/2018 4/9/2018 5/24/2018 590.02 81.61 938.09 0.00 0.00 0.00 0.00 1,609.72 10 1500 144610 Employee felt right shoulder pain while helping lift the stretcher back into the Ambulance Employee hand was caught between the rear of the stretcher and the wall of an elevator 1003021807740 144610 Employee was knocked down the stairs while Collier County Sheriff's Officer was restraining a patient 1004091807865 1005261807998 144610 1003011807738 144610 Allergic Reaction 122410 Employee had debris blew in right eye while woking on County boat trailer 1009261706623 138912 Employee was involved in a motor vehicle accident where he was struck from behind. 1001311807419 122410 EE injured left pinky and thigh area while inflating a tire. 1004041807854 122240 Employee felt a pinch in his lower back while working and laying down troubleshooting a condensor unit. 1008101706357 122240 Employee felt a pull in his left shoulder while hanging a fan. Cost Center Carrier Employer Acc Desc. Major Coverage: 10 - Workers' Compensation 1003261807805 Collier County Government Closed Claim Report- All Lines 3rd QTR FY 2018 Valued as of:8/3/2018 Claim Number Employee Name 1 16.E.2.a Packet Pg. 2019 Attachment: All Lines Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the 7,150.02 276.66 7,764.60 0.00 0.00 0.00 0.00 15,191.28 3/28/2017 3/29/2017 5/24/2018 7,150.02 276.66 7,764.60 0.00 0.00 0.00 0.00 15,191.28 10 1500 21,019.71 255.59 5,595.20 0.00 0.00 0.00 0.00 26,870.50 2/13/2018 2/13/2018 5/11/2018 21,019.71 255.59 5,595.20 0.00 0.00 0.00 0.00 26,870.50 10 1500 533.48 86.13 0.00 0.00 0.00 0.00 0.00 619.61 2/7/2018 2/7/2018 5/11/2018 533.48 86.13 0.00 0.00 0.00 0.00 0.00 619.61 10 1500 136.43 5.95 0.00 0.00 0.00 0.00 0.00 142.38 4/5/2018 4/5/2018 4/11/2018 136.43 5.95 0.00 0.00 0.00 0.00 0.00 142.38 10 1900 136.43 5.95 0.00 0.00 0.00 0.00 0.00 142.38 4/5/2018 4/5/2018 4/11/2018 136.43 5.95 0.00 0.00 0.00 0.00 0.00 142.38 10 1900 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 5/23/2018 5/31/2018 6/8/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 10 593.06 0.00 0.00 0.00 0.00 0.00 0.00 593.06 5/8/2018 5/8/2018 5/23/2018 593.06 0.00 0.00 0.00 0.00 0.00 0.00 593.06 10 1200 645.03 45.80 0.00 0.00 0.00 0.00 0.00 690.83 5/5/2018 5/5/2018 5/18/2018 645.03 45.80 0.00 0.00 0.00 0.00 0.00 690.83 10 1200 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 6/25/2018 6/25/2018 6/30/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 10 1300 320.83 34.99 0.00 0.00 0.00 0.00 0.00 355.82 4/2/2018 4/2/2018 4/20/2018 320.83 34.99 0.00 0.00 0.00 0.00 0.00 355.82 10 1500 9,559.05 140.24 2,648.65 0.00 0.00 0.00 0.00 12,347.94 4/11/2018 4/12/2018 6/7/2018 9,559.05 140.24 2,648.65 0.00 0.00 0.00 0.00 12,347.94 10 1500 163620 Employee felt pain in right groin area while pulling on root stump in drainage pipe. 1004021807843 156332 Employee pulled a muscle on right side of rib cage while pulling heavy trash bags. 1004111807874 156313 Employee gash right hand when he jumped off the guard stand at Golden Gate Community Park 1006251808077 156315 Employee slipped on wet floor and injured his left wrist. 155410 1005081807950 156310 Employee had laceration to left thigh trimming hedges. 1005051807947 Employee had cat bite on right side of forearm while picking up cat 1004051807860 144612 Employee transported a patient and may have come in contact with Menigitis 1005231808006 144610 Employee injured elbow while attending to an unconsious unresponsive patient 1004051807859 144610 Employee may have been exposed to meningitis from patient 1002131807636 144610 Employee stepped out of the ambulance truck on uneven ground and felt a "pop" to his foot. 1002071807542 1003281706006 144610 Employees left knee buckled as he was entering an ambulance cab. 2 16.E.2.a Packet Pg. 2020 Attachment: All Lines Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the 565.40 72.26 0.00 0.00 0.00 0.00 0.00 637.66 4/10/2018 4/10/2018 4/27/2018 565.40 72.26 0.00 0.00 0.00 0.00 0.00 637.66 10 1500 133.98 0.00 0.00 0.00 0.00 0.00 0.00 133.98 5/30/2018 5/30/2018 6/14/2018 133.98 0.00 0.00 0.00 0.00 0.00 0.00 133.98 10 367.20 50.80 0.00 0.00 0.00 0.00 0.00 418.00 5/3/2018 5/4/2018 5/24/2018 367.20 50.80 0.00 0.00 0.00 0.00 0.00 418.00 10 1500 5,196.80 146.12 0.00 0.00 0.00 0.00 0.00 5,342.92 12/14/2017 12/20/2017 6/12/2018 5,196.80 146.12 0.00 0.00 0.00 0.00 0.00 5,342.92 10 1500 618.31 84.92 0.00 0.00 0.00 0.00 0.00 703.23 3/16/2018 3/16/2018 4/19/2018 618.31 84.92 0.00 0.00 0.00 0.00 0.00 703.23 10 1400 154.94 0.00 0.00 0.00 0.00 0.00 0.00 154.94 5/25/2018 5/29/2018 6/14/2018 154.94 0.00 0.00 0.00 0.00 0.00 0.00 154.94 10 11,282.24 174.33 4,020.35 0.00 0.00 0.00 0.00 15,476.92 1/2/2018 1/2/2018 4/30/2018 11,282.24 174.33 4,020.35 0.00 0.00 0.00 0.00 15,476.92 10 1700 182.14 0.00 0.00 0.00 0.00 0.00 0.00 182.14 5/4/2018 5/4/2018 6/8/2018 182.14 0.00 0.00 0.00 0.00 0.00 0.00 182.14 10 1700 126.09 0.00 0.00 0.00 0.00 0.00 0.00 126.09 6/5/2018 6/6/2018 6/27/2018 126.09 0.00 0.00 0.00 0.00 0.00 0.00 126.09 10 1500 1,992.84 85.65 0.00 0.00 0.00 0.00 0.00 2,078.49 4/3/2018 4/3/2018 4/30/2018 1,992.84 85.65 0.00 0.00 0.00 0.00 0.00 2,078.49 10 1300 0.00 13.75 0.00 0.00 0.00 0.00 0.00 13.75 6/25/2018 6/25/2018 6/30/2018 0.00 13.75 0.00 0.00 0.00 0.00 0.00 13.75 10 1900 253214 Employee became overheated while working outside in the sun. 1004031807849 253212 Employee tripped in a small hole and has mild pain in left knee. 1006251808079 253211 Employee was struck by another Toro utility cart while sitting in vehicle 1006051808021 253212 Employee injured left foot when the tongue of the trailer vactor fell. 1001021807342 233351 EE struck groin area while lifting the pipleline camera out of manhole 1005041807944 182901 Employee felt pain to back, shoulder and left wrist when Kubota truck CC2-984 back into CC2-1364 truck 1005251807997 233351 Employee injured his left groin when picking containers up. Employee felt sharp pain in lower back while closing the tailgate of County vehicle 1012141707319 182901 EE twisted his right shoulder while using an auger for digging holes 1003161807779 1005301808000 163630 1005031807943 163651 Employee felt pain on left ankle when he stepped out of the county vehicle 1004101807869 163620 Employee injured neck while opening a stuck storm drain lid 3 16.E.2.a Packet Pg. 2021 Attachment: All Lines Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the 1,040.47 19.70 0.00 0.00 0.00 0.00 0.00 1,060.17 5/1/2018 5/1/2018 6/8/2018 1,040.47 19.70 0.00 0.00 0.00 0.00 0.00 1,060.17 10 1300 396.48 0.00 0.00 0.00 0.00 0.00 0.00 396.48 5/25/2018 5/25/2018 6/6/2018 396.48 0.00 0.00 0.00 0.00 0.00 0.00 396.48 10 1500 105,250.43 5,881.19 26,047.54 0.00 0.00 0.00 0.00 137,179.16 105,250.43 5,881.19 26,047.54 0.00 0.00 0.00 0.00 137,179.16 5,433.56 0.00 0.00 0.00 0.00 0.00 0.00 5,433.56 11/13/2017 12/13/2017 6/12/2018 5,433.56 0.00 0.00 0.00 0.00 0.00 0.00 5,433.56 21 2050 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 3/29/2018 3/29/2018 6/22/2018 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 5/3/2017 5/5/2017 6/14/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 22 5300 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 2/24/2018 3/28/2018 6/14/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 20 2102241807815 SIMON, IRENE RMGE Received letter from Morgan and Morgan stating- This firm has been retained to represent the above client in a claim for damages against you resulting from an accident that occurred on the above-captioned date.--2-24-18. No other information provided. 163613 Claimant notice two holes on his PVC fence; went out to speak to a county employee operating a dump truck picking up tree debris. The employee contacted his supervisor who instructed the claimant to contact our office. Claimant is alleging that the 2205031706102 McGaughey, Susan 163615 Property Owner is claiming that Collier County's construction of the new road in front of their home is a direct cause for needed septic drainfield repairs and is requesting $1800 to pay for a new lift station he is having to install. 2111131707285 SHANGOLD, MAXINE 163620 Claimant was riding her bike on the bike path that runs paralleled to Immokalee Rd on the north side when she hit an area of sidewalk that was torned up and has no signage. The asphalt brought claimant to a stop and throw her off her bike. 2203291807820 KARAKOSTA, STEPHEN 1005251807992 SOWE Employee ran into bollard and hit middle of chest while dusting off generator. Total by Major Coverage 33 Claims Major Coverage: 20 - General Liability 1005011807929 253214 Emplooyee was pulling on a bar trying to remove a motor/pump and it came loose causing him to fall backwards. 4 16.E.2.a Packet Pg. 2022 Attachment: All Lines Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the 0.00 0.00 1,808.50 0.00 0.00 0.00 0.00 1,808.50 12/28/2016 3/31/2017 4/23/2018 0.00 0.00 1,808.50 0.00 0.00 0.00 0.00 1,808.50 22 5900 0.00 0.00 1,100.00 0.00 0.00 0.00 0.00 1,100.00 11/27/2017 11/29/2017 5/21/2018 0.00 0.00 1,100.00 0.00 0.00 0.00 0.00 1,100.00 22 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4/25/2017 4/26/2017 6/12/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 22 5900 0.00 1,285.00 0.00 0.00 0.00 0.00 0.00 1,285.00 2/1/2016 11/16/2016 4/3/2018 0.00 1,285.00 0.00 0.00 0.00 0.00 0.00 1,285.00 21 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 3/4/2018 3/7/2018 5/31/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 22 5900 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 3/5/2018 3/5/2018 5/1/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 21 2900 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 5/12/2017 5/22/2017 4/20/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 22 5300 210155 Homeowner Mario Ventresca contacted the Project Manager Diana Dueri to report water/ sewage damage inside his residence located at 128 Heron Avenue. 2103051807749 PINTO, JAMES 155410 Mr. Pinto was sticking his fingers through the kennel door to 'pet the dog', when she supposedly nipped his left forefinger and middle finger. Mr. Pinto's statement on bite card: "petting dog from outside of cage". 2205121706137 Ventresa, Mario 253212 Claimant alleges he lost control of his bicycle while riding on the sidewalk in Saturnia Lakes and struck his head on a concrete/metal structure. 2203041807754 QUARRY GULF CLUB, CLUB HOUSE 233351 According to the club house facilities manager the sewer main of the club house backup on 3/4/18. Hecalled Rotter Rooter who brought a drain jetting machine and unclogged the system. Rotter Rooter told the claimant that the lift station was not working. 2204251706081 STAPLETON, LORI 253215 Meter Operations team members completed a large meter change-out at Grand Bay in Pelican Bay on 4-25-17. Work was scheduled and written notice provided on 4-21-17. Customer claims that her hot water tank stopped working due to the work completed. 2102011605613 DEL SORDO, JAMES 233351 Wastewater Collections received a call of ongoing sewer related issues and a sinkhole at 518 -108th Ave N (Naples Park). A CCTV inspection was completed of the sewer service lateral and a shifted pipe joint was found within the County owned section. 2211271707731 The Community Association for Mill Run Inc 233351 While pulling into the entrance to Mill Run, the driver pulled too close to the key pad building and hit the corner of the roof damaging the tiles. Vehicle #CC2-1567 2212281606010 DeLong, Michael 5 16.E.2.a Packet Pg. 2023 Attachment: All Lines Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the 0.00 0.00 862.99 0.00 0.00 0.00 0.00 862.99 9/20/2017 9/21/2017 6/12/2018 0.00 0.00 862.99 0.00 0.00 0.00 0.00 862.99 22 5400 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 9/10/2017 11/9/2017 5/11/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 22 5400 0.00 0.00 463.75 0.00 0.00 0.00 0.00 463.75 4/11/2018 4/20/2018 6/12/2018 0.00 0.00 463.75 0.00 0.00 0.00 0.00 463.75 22 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 9/4/2017 10/10/2017 6/18/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 22 5300 0.00 0.00 899.34 0.00 0.00 0.00 0.00 899.34 10/20/2016 11/22/2016 6/25/2018 0.00 0.00 899.34 0.00 0.00 0.00 0.00 899.34 22 2000 5,433.56 1,285.00 5,134.58 0.00 0.00 0.00 0.00 11,853.14 5,433.56 1,285.00 5,134.58 0.00 0.00 0.00 0.00 11,853.14 0.00 144.00 9,627.76 0.00 0.00 0.00 0.00 9,771.76 12/11/2017 12/11/2017 6/18/2018 0.00 144.00 9,627.76 0.00 0.00 0.00 0.00 9,771.76 32 2450 0.00 0.00 1,516.30 0.00 0.00 0.00 0.00 1,516.30 12/14/2017 12/14/2017 6/30/2018 0.00 0.00 1,516.30 0.00 0.00 0.00 0.00 1,516.30 32 2000 144610 An Ambulance was parked at the Tuscany Villa entrance, claimant saw the driver get out to pull the stretcher from the back. As the claimant drove by to park a person inside the ambulance open the passenger door ripping the driver side mirror and 3212111707268 TOSLLUKU, JULIAN 144610 Motor vehicle accident; Property damage without injury. Driver's vehicle was struck Driver side rear quarter panel. 3212141707287 BLACK, SHAWN 2210201605634 CENTURY LINK 163620 Century Link alleges a 50 pair buried cable was damaged by County employees during a street excavation. Total by Major Coverage 16 Claims Major Coverage: 30 - Auto Liability 210116 After inputting the code for entry into Bucks Run truck #CC2-733 made contact with the security keypad. 2209041706869 FRAUMENI, LYNETTE 210116 Resident is complaining about pool pavers shifting after vibration for the road reconstruction. Also, new homeowner said the seawall has cracks because of the construction. 2209101707120 CHAPMAN, SYLVIA 156332 During Hurricane Irma claimant stayed at the North Collier Regional Park shelter from 9/8/17 until 9/13/17. After the hurricane passed and the people were allow to go outside the claimant saw that a tree had fallen on her car. 2204111807976 Bucks Run Reserve 2209201706534 John Catalano 210120 Resident alleges sewer back up in dishwasher due to county error in reversing flow. 6 16.E.2.a Packet Pg. 2024 Attachment: All Lines Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the 0.00 120.40 2,064.30 0.00 0.00 0.00 0.00 2,184.70 2/14/2017 2/14/2017 6/20/2018 0.00 120.40 2,064.30 0.00 0.00 0.00 0.00 2,184.70 32 3000 0.00 0.00 1,214.74 0.00 0.00 0.00 0.00 1,214.74 12/4/2017 12/4/2017 6/30/2018 0.00 0.00 1,214.74 0.00 0.00 0.00 0.00 1,214.74 32 2450 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 3/25/2018 4/2/2018 4/27/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 32 L105 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 5/10/2018 5/10/2018 6/19/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 32 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 5/10/2018 5/10/2018 6/20/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 32 0.00 125.36 4,513.75 0.00 0.00 0.00 0.00 4,639.11 2/6/2018 2/7/2018 4/30/2018 0.00 125.36 4,513.75 0.00 0.00 0.00 0.00 4,639.11 32 3000 0.00 389.76 18,936.85 0.00 0.00 0.00 0.00 19,326.61 0.00 389.76 18,936.85 0.00 0.00 0.00 0.00 19,326.61 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4/3/2018 4/3/2018 5/7/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 41 3000 172960 Employee took CC2-147 to our contracted carwash Neapolitan Carwash, where the vehicle was damaged during the wash. 253212 While driving down Bonita Beach Road going east near Imperial Blvd. Claimant was rear ended by a county vehicle. Total by Major Coverage 8 Claims Major Coverage: 40 - Auto Physical Damage 4104031807851 CC V. Neapolitan Carwash 320510180795702 Salazar Popo, Christian CENE While driving northbound on Livingston Rd, employee had a rear end collision with a Nissan that was slowing down due to a broken down vehicle (Chevrolet). The collision caused the Nissan to rear end the Chevrolet. 3202061807541 O'CONNOR, HARRY RMSE Ronald Russo-(Non government employee) was driving the proper speed in the right hand lane on Livingston, when his car hit a man-made pot hole hazard in front of the existing construction at the Luxury Storage Buildings by Kensington development. 320510180795701 Friend, John CENE While driving northbound on Livingston Rd, employee had a rear end collision with a Nissan that was slowing down due to a broken down vehicle (Chevrolet). The collision caused the Nissan to rear end the Chevrolet. 3212041707215 Elite Electrical Contractors, LLC 138915 County employee while crossing US 41 had a low impact collision with another truck. No injuries, CCSO called and arrived on-scene. 3203251807846 RUSSO, RONALD 3202141705858 SWANK, STEPHANIE 138915 Inspector backed up in driveway and hit citizen's driver's side passenger door. 7 16.E.2.a Packet Pg. 2025 Attachment: All Lines Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the 1,035.84 0.00 0.00 0.00 0.00 0.00 0.00 1,035.84 4/23/2018 4/23/2018 6/11/2018 1,035.84 0.00 0.00 0.00 0.00 0.00 0.00 1,035.84 41 2900 0.00 0.00 1,665.41 0.00 0.00 0.00 0.00 1,665.41 3/16/2018 3/16/2018 6/30/2018 0.00 0.00 1,665.41 0.00 0.00 0.00 0.00 1,665.41 41 0.00 0.00 159.22 0.00 0.00 0.00 0.00 159.22 5/24/2018 5/24/2018 6/22/2018 0.00 0.00 159.22 0.00 0.00 0.00 0.00 159.22 41 3000 0.00 0.00 820.57 0.00 0.00 0.00 0.00 820.57 3/16/2018 3/16/2018 5/17/2018 0.00 0.00 820.57 0.00 0.00 0.00 0.00 820.57 41 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 5/30/2018 5/30/2018 6/12/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 41 3000 0.00 0.00 1,610.00 0.00 0.00 0.00 0.00 1,610.00 11/13/2017 11/13/2017 6/12/2018 0.00 0.00 1,610.00 0.00 0.00 0.00 0.00 1,610.00 41 2,828.27 0.00 0.00 0.00 0.00 0.00 0.00 2,828.27 9/10/2017 9/15/2017 6/21/2018 2,828.27 0.00 0.00 0.00 0.00 0.00 0.00 2,828.27 42 5400 700.50 0.00 0.00 0.00 0.00 0.00 0.00 700.50 9/10/2017 9/22/2017 4/30/2018 700.50 0.00 0.00 0.00 0.00 0.00 0.00 700.50 42 5400 4209101706572 Solid & Hazardous Waste Management Division 173441 Hurricane IRMA Damage to CC2-1332 torn tarp and damage to the right rear fender. 253215 While pulling vehicle #CC2-1537 forward, Jacob Rivera struck the right front bumper of vehicle CC2-1201. This caused a dent in the left side of vehicle CC2-1537. 4209101706457 Building Review & Permitting Division 138915 Tree branch came down during the hurricane and hit on the passenger side on the cab behind the door. 410530180800301 Solid Waste SOWE Mackenzie Pierre was turning right (north bound) on U.S.41 from Collier BLVD (south bound). The driver in front of Mackenzie stopped to yield to on coming traffic and Mackenzie hit the left rear bumper of driver. 4111131707131 Water Distribution Division FMGE Loading Materials into truck bumped the edge of the window with material and the window shattered. 4103161807780 Pelican Bay Services PBSE Utility vehicle/Kubota CC2-1364 hit the back of Utility vehicle/Kubota CC2-984. Jeovany Caraballo was driving CC2-1364. Abraham Hernandez was driving CC2-984. Jeovany states that he hit the accelerator instead of the break & hit CC2-984. 4103161804003 Pelican Bay Services PBSE Utility vehicle/Kubota CC2-1364 hit the back of Utility vehicle/Kubota CC2-984. Jeovany Caraballo was driving CC2-1364. Abraham Hernandez was driving CC2-984. Jeovany states that he hit the accelerator instead of the break & hit CC2-984. 4105241807987 Facilities Management 4104231807910 Traffic Operations 163630 Right quarter panel has a dent. I noticed the damage while washing my vehicle at the Collier County Car Wash around 2:00 PM on 4/23/2018 8 16.E.2.a Packet Pg. 2026 Attachment: All Lines Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the 0.00 0.00 6,187.57 0.00 0.00 0.00 0.00 6,187.57 12/11/2017 12/12/2017 4/30/2018 0.00 0.00 6,187.57 0.00 0.00 0.00 0.00 6,187.57 41 3000 627.06 0.00 0.00 0.00 0.00 0.00 0.00 627.06 8/9/2017 8/11/2017 6/12/2018 627.06 0.00 0.00 0.00 0.00 0.00 0.00 627.06 41 2150 2,110.96 0.00 0.00 0.00 0.00 0.00 0.00 2,110.96 1/26/2018 2/1/2018 4/30/2018 2,110.96 0.00 0.00 0.00 0.00 0.00 0.00 2,110.96 42 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 4/17/2018 4/19/2018 4/30/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 42 2900 1,746.20 0.00 0.00 0.00 0.00 0.00 0.00 1,746.20 9/10/2017 11/27/2017 6/30/2018 1,746.20 0.00 0.00 0.00 0.00 0.00 0.00 1,746.20 42 5400 0.00 0.00 7,219.18 0.00 0.00 0.00 0.00 7,219.18 12/7/2017 12/7/2017 6/12/2018 0.00 0.00 7,219.18 0.00 0.00 0.00 0.00 7,219.18 41 3000 0.00 0.00 1,634.22 0.00 0.00 0.00 0.00 1,634.22 2/20/2018 2/24/2018 6/11/2018 0.00 0.00 1,634.22 0.00 0.00 0.00 0.00 1,634.22 41 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 3/15/2018 3/16/2018 4/27/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 41 3000 144610 EMS Tk16 struck a Red Kia in the front driver side while responding to a call from the shopping plaza at Vinyards and Paine Ridge. no injuries reported. 4103151807778 Building Review & Permitting 138915 Inspector heard a noise while driving. He got out of his truck and noticed a chunk out of the passenger side mirror. 4112071707234 Wastewater Division 233313 While pulling out of the parking garage, the driver contacted one of the balasts, causing damage to the left side of the utility bed. 4102201807726 Emergency Medical Services 156363 County vehicle CC2-902 was struck by a baseball, breaking the glass on the passenger side mirror. 4209101707182 Parks & Recreation Division 156310 Damage to the left rear door. The staff believes this happened during the hurricane. 4201261807450 Mary Topoleski 156381 On January 26th staff member Ronishia Moxam found damage to the passenger side door of the van. Ronisha left her supervisor a note to inform her of the damage she found. 4204171807903 Beach and Water 182901 Pickup truck (CC2-553) was backing up - the trailer (15F040) that was attached to it - "jackknifed" resulting in it hitting the truck & denting the rear left side of it. 4108091706358 Water Division 210113 A long valve key was transported from the weld shop to the plant. The key was transported with the handle tied off in the bed and the shaft held between the door and the mirror. The shaft rubbed on the paint and scraped the paint. 4112111707282 Pelican Bay Services Division 9 16.E.2.a Packet Pg. 2027 Attachment: All Lines Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the 574.45 0.00 0.00 0.00 0.00 0.00 0.00 574.45 12/18/2017 12/19/2017 4/30/2018 574.45 0.00 0.00 0.00 0.00 0.00 0.00 574.45 42 5900 0.00 0.00 1,186.71 0.00 0.00 0.00 0.00 1,186.71 8/30/2017 8/30/2017 6/30/2018 0.00 0.00 1,186.71 0.00 0.00 0.00 0.00 1,186.71 41 2150 0.00 0.00 2,474.94 0.00 0.00 0.00 0.00 2,474.94 2/6/2018 2/6/2018 5/21/2018 0.00 0.00 2,474.94 0.00 0.00 0.00 0.00 2,474.94 41 3000 0.00 0.00 1,431.80 0.00 0.00 0.00 0.00 1,431.80 1/5/2018 1/9/2018 5/21/2018 0.00 0.00 1,431.80 0.00 0.00 0.00 0.00 1,431.80 41 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 5/8/2018 5/8/2018 5/10/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 41 0.00 0.00 664.33 0.00 0.00 0.00 0.00 664.33 3/23/2018 3/23/2018 6/30/2018 0.00 0.00 664.33 0.00 0.00 0.00 0.00 664.33 41 3000 9,623.28 0.00 25,053.95 0.00 0.00 0.00 0.00 34,677.23 9,623.28 0.00 25,053.95 0.00 0.00 0.00 0.00 34,677.23Total by Major Coverage 23 Claims 253212 Michael Haight Utility Tech for the meter team was driving into the Bay Front subdivision when the gate at the entrance came down and struck his vehicle. 4103231807792 JAIMES, ROGELIO PBSE A silver Cadillac SUV gently tapped/hit the rear bumper of our PBSD Pick-up truck CC2-1167. The driver of the SUV got out of his vehicle, looked at the rear of our truck, stated "there's no damage" and then got back in his SUV and drove off. 4101051807357 Water Division 253212 While backing trailer to dump load, vice mounted on bumper of utility truck hit the box mounted onto the tounge of the trailer. 4105081807952 Water 253212 While at the landfill attempting to get to the location designated by the staff on site, truck and trailer got stuck and pulled out by the bull dozer, damaging the trailer. 4102061807511 Water Division 253212 While driving down Bonita Beach Road going east struck back of vehicle near Imperial Blvd. 4212181707317 Building Review & Permitting Division 138915 Inspector came back to his truck after completing an inspection and noticed a hole in the side of his truck. He did not see anyone near the truck and did not witness how this hole got to be there. 4108301706398 Water Distribution Division 10 16.E.2.a Packet Pg. 2028 Attachment: All Lines Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the 381.02 0.00 0.00 0.00 0.00 0.00 0.00 381.02 12/19/2017 4/26/2018 5/17/2018 381.02 0.00 0.00 0.00 0.00 0.00 0.00 381.02 53 2,505.00 0.00 0.00 0.00 0.00 0.00 0.00 2,505.00 2/1/2018 2/7/2018 6/11/2018 2,505.00 0.00 0.00 0.00 0.00 0.00 0.00 2,505.00 53 2000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 9/12/2017 11/8/2017 5/16/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 56 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 9/10/2017 9/25/2017 4/24/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 52 5400 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 8/9/2017 4/11/2018 5/29/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 50 0.00 0.00 2,572.72 0.00 0.00 0.00 0.00 2,572.72 4/28/2018 4/28/2018 6/11/2018 0.00 0.00 2,572.72 0.00 0.00 0.00 0.00 2,572.72 56 5,046.50 0.00 0.00 0.00 0.00 0.00 0.00 5,046.50 11/8/2017 5/18/2018 6/11/2018 5,046.50 0.00 0.00 0.00 0.00 0.00 0.00 5,046.50 53 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 5/17/2018 6/12/2018 6/26/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 54 5405171808044 CC V. Allstate 163646 Vehicle 1 was traveling eastbound on Vanderbilt Beach Rd. in the middle lane.Driver 1 stated while driving he hydroplane and lost control of V1. V1 started turning in a counter clockwise direction and the right front door hit a tree in the median. 173441 Team member Bob Best was operating Bobcat skid steer loader when the windshield shattered. 5311081707975 Traffic Operations Division 163630 Street light pole G116 down on the ground. I was unsuccessfull on finding a crash report. 5308091707872 CC v. City of Naples 163630 City of Naples called and said they were working out on Davis blvd and hit a roadway lighting conduit. 5604281807926 Collier County 163630 Variable Message Board (VMB) CC2-458 was placed on Immokalee Rd at Oil Well approximatly 9/8/17 advising that the Shelter was open before Hurricane Irma. It was last seen on 9/12/2017. We are unable to locate VMB. Board was located on 11/14/17. 5209101706592 Library Division (Naples Regional Branch) 156100 Hurricane Irma winds caused roof damage thereby creating leaks in the ceiling. The ceiling leaks damaged multiple contents: bookcase, desk, phone, check depositor, microwave, printer, refrigerator, four chairs, calculator, storage cabinet, computer. 5302011807540 Collier Area Transit 138336 Shelter side anchors broken; it appears to have been hit. 5609121707111 Traffic Operations (VMB CC2-458) Major Coverage: 50 - Property 5312191707921 Traffic Operations Division 163630 Staff was working in area and noticed the pedestrian signal down at the intersection Tamiami Trail and Manatee Rd. I was unsuccessful in finding an accident report for this damage. We do not know when it happened. 11 16.E.2.a Packet Pg. 2029 Attachment: All Lines Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the 7,932.52 0.00 2,572.72 0.00 0.00 0.00 0.00 10,505.24 7,932.52 0.00 2,572.72 0.00 0.00 0.00 0.00 10,505.24 128,239.79 7,555.95 77,745.64 0.00 0.00 0.00 0.00 213,541.38 128,239.79 7,555.95 77,745.64 0.00 0.00 0.00 0.00 213,541.38 10:19:23 AM Total by Major Coverage 8 Claims Grand Totals: 88 Claims 8/3/2018 12 16.E.2.a Packet Pg. 2030 Attachment: All Lines Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the Collier County Government Subrogation Closed Claim Report 3rd QTR FY 2018 Valued as of:8/3/2018 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 833.10 0.00 0.00 0.00 500.00 833.10 0.00 0.00CC v. Gonzalez Pena, Marielle ($833.10) (CA) (PC) 4110241403668 5/22/201810/24/2014 10/30/2014 0.00 833.10 0.00 500.00 833.10 0.00 0.00 0.00105010 41 Marielle Gonzalez Pena attempted to make it through a yellow light before it turned red while traveling south on Airport Road and didn't notice traffic had come to a stop. She struck a vehicle assigned to the Property Appraiser's office from behind. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Seminole Petroleum4108231706387 5/29/20188/23/2017 8/24/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00122240 41 Fuel truck (Seminole Petroleum) backed into my vehicle (CC2-1067) while I was refueling. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Scott Powerline & Utility4109221706558 6/15/20189/22/2017 9/22/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00253212 41 While parked at 347 Benson Street, a tree trimming company vehicle backed into Asset #CC2-1551. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Planes, Anthony Gene5408081706353 6/15/20188/8/2017 8/9/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00156140 54 An elderly man in a sedan hit a parked suv and pushed it up into the shrubs at the Golden Gate Library. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Toledo, Jacqueline5406031706330 6/14/20186/3/2017 8/1/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163801 54 Rene Fernandez Rodriguez was traveling east on Rine Ridge Road when the vehicle started to hydroplane. The vehicle drove into the median and struck landscaping and irrigation. 3000 -1- 10:16:25AM 8/3/2018 16.E.2.b Packet Pg. 2031 Attachment: Subrogation Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the Collier County Government Subrogation Closed Claim Report 3rd QTR FY 2018 Valued as of:8/3/2018 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 0.00 0.00 0.00 0.00CC v. Sylla, Rosita5407011706371 6/14/20187/1/2017 8/15/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00162507 54 Rosita Sylla was traveling south on Hunter Blvd. She veered to the left and struck the curb, then a tree. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Kee, Gregory5308061706352 6/22/20188/6/2017 8/9/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163630 53 Gregory Kee was traveling north on Tamiami Trail North when he made a late, wide turn to head west on Wiggins Pass Road. He drove onto the north shoulder, then off the road and into a pedestrian crosswalk pole. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Robinson, Kellie5306011706374 6/14/20186/1/2017 8/17/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163801 53 Claimant was traveling south on Collier Blvd. when another vehicle allegedly pulled up next to her and sideswiped her vehicle. She then lost control of the vehicle and drove over the median. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00Emergency Medical Services4101201705772 6/13/20181/20/2017 1/21/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00144610 41 Medic 46/Truck 22 was enroute to a call in Bridgewater Bay community. Security gates were opened using County supplied EVAC remote. While driving trhough the gates, the right side gate arm came down and struck the truck in the passenger side mirror 2000 -2- 10:16:25AM 8/3/2018 16.E.2.b Packet Pg. 2032 Attachment: Subrogation Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the Collier County Government Subrogation Closed Claim Report 3rd QTR FY 2018 Valued as of:8/3/2018 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 0.00 0.00 0.00 0.00CC V. Bobby Williams4103201807791 5/29/20183/20/2018 3/23/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00155810 41 While stopped in traffic, I was rear-ended by a Toyota Corolla, which had been rear-ended by a construction truck from Southern Gulf Construction. 3000 1,785.87 0.00 0.00 0.00 9.68 1,785.87 0.00 0.00CC v. Veliz, Jesse ($1,785.87)5205181504109 5/22/20185/18/2015 5/18/2015 0.00 1,785.87 0.00 9.68 1,785.87 0.00 0.00 0.00156100 52 During some unknown time between Friday, May 15, 2015 7 pm and Monday, May 18, 2015 10 am, our library was burglarized and vandalized. 5500 0.00 0.00 0.00 0.00 583.68 0.00 0.00 0.00CC v. Baptiste, Garry Jean (PC)5401100902654 5/4/20181/10/2009 2/4/2009 0.00 0.00 0.00 583.68 0.00 0.00 0.00 0.00163647 54 JE Garry Baptiste was traveling eastbound on US41 @ 93 MPH and struck the edge of the median curb, lost control of the vehicle & struck a palm tree. 1400 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Bald Eagle Towing4107061605279 5/22/20187/6/2016 7/6/2016 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00122240 41 Vehicle was mounted on the tow truck. Tow truck driver (Benjamin Young) was inside the vehicle driving it on the bed of the tow truck but, drove it too far and hit the stopper on the loading mechanism. 3100 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Bowman, Shae (PC)5105100801925 5/3/20185/10/2008 6/10/2008 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00122240 51 JE While Shae Bowman was being escorted out of the sub-station, he lunged forward and "headbutted" the glass panel in the front door, breaking the glass. -3- 10:16:25AM 8/3/2018 16.E.2.b Packet Pg. 2033 Attachment: Subrogation Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the Collier County Government Subrogation Closed Claim Report 3rd QTR FY 2018 Valued as of:8/3/2018 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 0.00 0.00 0.00 0.00CC v. Wilkerson, Rayburn Lee (PC) 5310120802464 5/3/201810/12/2008 10/14/2008 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163630 53 JE Rayburn Wilkerson was traveling along 8th Street heading south when another vehicle ran a stop sign causing Rayburn to swerve, striking a stop sign. 1400 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00Bayshore CRA vs. Southern Motor Sports (PC) 6712221003884 5/4/201812/22/2010 1/4/2011 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00138318 67 JE Claim against Southern Motor Sports for non payment of rent for the months of October, November & December 2009. 2900 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00Sanchez & Martinez (SAO)5303241003600 5/4/20183/24/2010 5/7/2010 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00156381 53 JE An informational sign was spray painted with graffiti. 2350 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Hamilton, Brian5301091003611 5/4/20181/9/2010 6/1/2010 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163620 53 JE Jo Dee Hamilton was traveling north on SR29 when she dropped her cigarette & bent over to pick it up & lost control of the vehicle, striking 3 sections of guardrail. 1400 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Dorce, Roberson (PC)5304251103993 5/4/20184/25/2011 4/26/2011 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163620 53 Roberson Dorce's vehicle caught fire when he turned on his air conditioner, causing damage to curbing and the roadway. 5000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Roder, Christopher (PC)5412181101284 5/11/201812/18/2011 3/9/2012 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00138325 54 Christopher Roder was traveling west on US41 & had a collision with a person driving a moped & damaged a palm tree. 3000 -4- 10:16:25AM 8/3/2018 16.E.2.b Packet Pg. 2034 Attachment: Subrogation Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the Collier County Government Subrogation Closed Claim Report 3rd QTR FY 2018 Valued as of:8/3/2018 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 0.00 0.00 0.00 0.00CC v. Simon, Philippe (PC)5312171101102 5/11/201812/17/2011 1/17/2012 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00156363 53 Philippe Simon was on the north side of Vanderbilt Beach Road attempting to travel south through a grass field & exit onto VBR when he struck a coin meter, beding it to the ground. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Chaidee, Arkom5305011201601 5/11/20185/1/2012 6/25/2012 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163620 53 Noophan Saneydee was traveling east on Immokalee Road & for unknown reasons, traveled into the path of an ocoming vehicle causing a collision. A fuel spill caused the road to deteriorate. 2450 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Jeanry, Mark (PC)5305131201581 5/11/20185/13/2012 6/11/2012 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163620 53 Mark Jeanry was traveling west on Tamiami Trail E when he became confused as to which lane another vehicle was in & struck the rear of that vehicle & caused it to collide with a guardrail. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Walker, Antoine ($1,157.40) 5311071605602 6/13/201811/7/2016 11/10/2016 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00138336 53 Waste container and bus shelter struck by a vehicle. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Gregory, Allen (PC)5308211104001 5/10/20188/21/2011 9/23/2011 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163620 53 Kenneth Thompson took part in digging up the sidewalk at 2854 Becca Ave. along with another individual (Allen Gregory) 2350 -5- 10:16:25AM 8/3/2018 16.E.2.b Packet Pg. 2035 Attachment: Subrogation Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the Collier County Government Subrogation Closed Claim Report 3rd QTR FY 2018 Valued as of:8/3/2018 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 0.00 0.00 0.00 0.00CC v. Hyppolite, Brunette (PC)5305301100732 5/10/20185/30/2011 8/5/2011 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163620 53 Fadson Thermidor was nearing the exit of a gas station & pressed the gas pedal instead of the brake & drove onto the road, losing control of the vehicle & struck a pedestrian sign. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Fox, Frank (PC)4204131003531 5/4/20184/13/2010 4/15/2010 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00138911 42 JE The driveway the County vehicle was stopped on gave way, damaging the undercarriage. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Arnold, Joshua (SAO)5310180903411 5/4/201810/18/2009 12/17/2009 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00156361 53 JE Joshua Arnold was detained after being caught spraypainting graffiti on the park amphitheater. 2350 2,201.06 0.00 0.00 0.00 0.00 2,201.06 0.00 0.00CC V. US Water4103131807764 6/11/20183/13/2018 3/13/2018 0.00 2,201.06 0.00 0.00 2,201.06 0.00 0.00 0.00233350 41 Van # CC2- 1624 was side swiped by a golf cart while parked at the Golden Gate WWTP. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. NASA Holdings ($14,257.77) (CA) 5204011504031 5/14/20184/1/2015 4/23/2015 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00156314 52 Outsourced vendor (NASA Holdings) received items for their use during the term of the contract. Multiple pieces of equipment returned in a lesser manner. Also, 3 months of compensation not received. 3 concession complexes needed to be cleaned. -6- 10:16:25AM 8/3/2018 16.E.2.b Packet Pg. 2036 Attachment: Subrogation Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the Collier County Government Subrogation Closed Claim Report 3rd QTR FY 2018 Valued as of:8/3/2018 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 0.00 0.00 0.00 0.00CC v. Nantz, Nakia ($1,618.71) (CA) 5307161504321 5/14/20187/16/2015 7/24/2015 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163620 53 Jo Ann Perkins was traveling east on Randall Blvd. when a deer allegedly ran in front of the vehicle. She swerved, trying to miss the deer and struck a section of guardrail. 3000 7,780.00 0.00 0.00 0.00 6,298.64 0.00 0.00 7,780.00CC v. Joseph Boney/Michael Reyna (SAO) 7004041203640 5/23/20184/4/2012 10/15/2014 7,780.00 0.00 0.00 6,298.64 7,780.00 0.00 0.00 0.00156349 70 2 Employees were caught submitting false time sheets containing unworked hours for another employee, then forging that employee's signature on the checks created, and cashing them. L204 1,000.00 0.00 0.00 0.00 0.00 0.00 0.00 1,000.00CC v. Barbaro, Dylan5303021705912 6/14/20183/2/2017 3/2/2017 1,000.00 0.00 0.00 0.00 1,000.00 0.00 0.00 0.00157410 53 Vandalism of 1920's baggage car, 1909 caboose & little train fence equiptment. 1920's baggage double glass doors broken (both door frame & glass panels) by huge rock, 1909 caboose door panel (bottom section) kicked in & little train fence broken. 5500 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Munguia, Mary (CA)5306181201728 5/11/20186/18/2012 8/16/2012 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00162524 53 Joshua Crump was traveling west on CR846 in the area of Colorado Ave., entered the turn lane & continued west through the intersection where he impacted the median curbing, then a light pole. 3000 -7- 10:16:25AM 8/3/2018 16.E.2.b Packet Pg. 2037 Attachment: Subrogation Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the Collier County Government Subrogation Closed Claim Report 3rd QTR FY 2018 Valued as of:8/3/2018 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 0.00 0.00 0.00 0.00CC v. Walsh Trucking, Inc. (306.99) (PC) 5912301302955 5/14/201812/30/2013 1/6/2014 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163620 59 Kenneth Miller, a driver for Walsh Trucking spilled hydraulic fluid on the roadway, requiring clean-up by County personnel. 3100 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Brown, Joyce (PC)5308201201793 5/11/20188/20/2012 9/6/2012 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163620 53 Tyrone Brown was traveling east on Tamiami Trail when he changed lanes & discovered there was a vehicle stopped in front of him for unknown reasons. He quickly changed lanes again & sideswiped another vehicle causing it to strike a street sign. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Telfort, Enise (PC)5406061201820 5/11/20186/6/2012 9/18/2012 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163652 54 Enise Telfort was traveling west on Rattlesnake-Hammock when she attempted to change lanes & struck another vehicle. This caused her vehicle to spin out of control, then up onto a median, damaging landscaping. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Thompson, Karen5912191101073 5/11/201812/19/2011 12/19/2011 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163620 59 Christopher Thompson was traveling east on US 41 & purposely swerved into the path of an oncoming Semi Tractor Trailer causing a collision and diesel fuel to spill. 2450 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00Immokalee CRA5311051707169 6/15/201811/5/2017 11/20/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00162524 53 A car/truck ran into the decorative light pole on the median in front of the casino. 3000 -8- 10:16:25AM 8/3/2018 16.E.2.b Packet Pg. 2038 Attachment: Subrogation Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the Collier County Government Subrogation Closed Claim Report 3rd QTR FY 2018 Valued as of:8/3/2018 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 0.00 0.00 0.00 0.00CC v. ESP Waste Disposal Service 5311281707192 6/15/201811/28/2017 11/28/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00173435 53 ESP Roll off truck 3000 approached the scale #3 at CCLF. Driver did not realize the door was still open and the dumpster door hit the stop light and pole near scale. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Thompson, Kenneth (PC)5308211100856 5/11/20188/21/2011 9/23/2011 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163620 53 Ken Thompson requested the sidewalk at 2854 Becca Ave. be removed & when the County refused, he took part in digging it up, along with another individual (Allen Gregory). 2350 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Curcio, Nickolas (PC)5910010903372 5/4/201810/1/2009 10/30/2009 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163620 59 JE Nickolas Curcio was traveling south on 13th Street SW when he fell asleep at the wheel & ran a stop sign. The vehicle vaulted off of an earth berm, became airborne and landed on its side. 3100 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Breedlove, Kathleen (PC)5304270903269 5/4/20184/27/2009 9/15/2009 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163620 53 JE An unknown driver was traveling about 80 MPH westbound on Tamiami Trail when a tire blew out causing the vehicle to swerve off the road and strike a guardrail. 1400 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Lahmann,Raymond (PC)4102170902714 5/4/20182/17/2009 2/18/2009 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163620 41 JE A County vehicle was traveling southbound on Airport Road when Raymond Lahmann Jr. pulled out of Trade Center Way and struck the County vehicle. OTH -9- 10:16:25AM 8/3/2018 16.E.2.b Packet Pg. 2039 Attachment: Subrogation Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the Collier County Government Subrogation Closed Claim Report 3rd QTR FY 2018 Valued as of:8/3/2018 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 0.00 0.00 0.00 0.00CC v. Bonard, Rodney (CA)5312270802658 5/4/201812/27/2008 1/29/2009 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163620 53 JE Rodney Bonard was traveling west on US41 and became fatigued, as he had been up for 21 hours, and failed to negotiate a curve to the left and struck a guardrail. 1400 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Saint-Macary, Idalia (PC)5305170802100 5/3/20185/17/2008 6/11/2008 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163620 53 JE Orlando Scott, who was driving a vehicle owned by Idalia Saint-MaCary, fell asleep while traveling south on State Road 29 and struck a guardrail. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Auer, Michael (PC)5305130802390 5/3/20185/13/2008 10/8/2008 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163620 53 JE Michael Auer was fleeing from deputies after a traffic infraction & attempted to make a right turn onto Goodlette Road to head northbound, but the vehicle continued westbound, striking an aluminum hand rail. 1400 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Benavidez, Rolando (PC)5306210802407 5/3/20186/21/2008 10/21/2008 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163620 53 JE Rolando Benavidez was traveling southbound on 846 East towards East Main Street and failed to maintain control of his vehicle on the bend, striking 2 signs & 2 posts. 1400 -10- 10:16:25AM 8/3/2018 16.E.2.b Packet Pg. 2040 Attachment: Subrogation Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the Collier County Government Subrogation Closed Claim Report 3rd QTR FY 2018 Valued as of:8/3/2018 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 0.00 0.00 0.00 0.00CC v. Calow, Michael (PC)5912080802643 5/3/201812/8/2008 1/29/2009 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163620 59 JE James Calow was traveling westbound on US 41approaching a traffic signal & looked away momentarily & upon looking back realized it was too late to avoid a collision with the vehicle in front of him; this caused a 6 car chain reaction. 2450 0.00 0.00 0.00 0.00 250.00 0.00 0.00 0.00CC v. Isme, Simelant (PC)5312080802642 5/3/201812/8/2008 1/29/2009 0.00 0.00 0.00 250.00 0.00 0.00 0.00 0.00163620 53 JE Simelant Isme was traveling west on US41 while another vehicle was traveling east on US41. He alleges that the glare from the high beams of the oncoming vehicle obstructed his view & caused him to cross the center line & enter the other vehicles path. 1400 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Artola, Yansiel (PC)5305070701106 5/1/20185/7/2007 6/4/2007 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163620 53 JE Yansiel Artola's vehicle experienced transmission failure & leaked oil on the roadway, requiring clean-up by County personnel. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Lyons Lawn and Tree Service (PC) 5904230700938 5/1/20184/23/2007 5/17/2007 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163620 59 JE Clean-up and set up of MOT for equipment malfunction which caused a landscape trailer to overturn. -11- 10:16:25AM 8/3/2018 16.E.2.b Packet Pg. 2041 Attachment: Subrogation Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the Collier County Government Subrogation Closed Claim Report 3rd QTR FY 2018 Valued as of:8/3/2018 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 0.00 0.00 0.00 0.00CC v. Cisneros, Jose5307071706264 6/15/20187/7/2017 7/10/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163630 53 Cristian Cisneros was traveling south on Collier Blvd. when the vehicle's rear slid out (due to bald tires), traveled over the median and struck a "do not enter" sign. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Webster, Jason ($6,786.06) 5302111705893 6/13/20182/11/2017 2/24/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163630 53 Jason Webster was traveling south on Bayshore Drive when he alleges one of his tires blew out causing him to lose control of the vehicle striking a light pole, a fence, and landscaping. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Chiriguayo, Christopher5301151705885 6/13/20181/15/2017 2/23/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163652 53 Christopher Chiriguayo was traveling west on Vanderbilt Beach Road when he ran a stop sign, drove through a fence and struck a tree. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC V. Blackburn, John5305051807973 5/30/20185/5/2018 5/18/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163630 53 Street light pole 256 damaged from a car accident 68.00 0.00 0.00 0.00 4,767.10 0.00 0.00 68.00CC v. Johnson, James ($7,209.64) (CA) 5303281504007 5/23/20183/28/2015 4/17/2015 68.00 0.00 0.00 4,767.10 68.00 0.00 0.00 0.00163630 53 James Johnson was crossing between Bayshore Drive, westbound, from the Gulfgate Plaza when he failed to yield to traffic and struck a vehicle traveling south on Bayshore. The impact caused the other vehicle to go into a spin and strike a light pole. 3000 -12- 10:16:25AM 8/3/2018 16.E.2.b Packet Pg. 2042 Attachment: Subrogation Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the Collier County Government Subrogation Closed Claim Report 3rd QTR FY 2018 Valued as of:8/3/2018 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 0.00 0.00 0.00 0.00CC v. Marciano, Michael ($2,330.31) (CA) 5306211605264 5/22/20186/21/2016 6/28/2016 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163630 53 Michael Marciano was traveling east on Estey Avenue when he failed to stop at the flashing red light and struck another vehicle. He then drove over a curb and into a pedestrian pole. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Smashey, Nicholas5305241605232 5/17/20185/24/2016 6/20/2016 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163630 53 Amy Lowell was driving north on Goodlette Road N. when she felt something wrong with the vehicle. She heard a bang and the vehicle made an abrupt change in direction. She alleges she had no control of the vehicle and struck a light pole and a tree. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Hilts, Amy5403121605238 5/14/20183/12/2016 6/22/2016 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163652 54 Amy Hilts was traveling east on Golden Gate Blvd. when she failed to maintain control of her vehicle and struck a concrete median and landscaping. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Dreamscapes Speciality, Inc. ($1,043.76) (PC) 5311041302867 5/14/201811/4/2013 11/27/2013 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163630 53 Bruce Squarebrigs was traveling south on Collier Blvd. when he veered to the right, drove over the curbed island & struck a traffic signal pole. 3000 -13- 10:16:25AM 8/3/2018 16.E.2.b Packet Pg. 2043 Attachment: Subrogation Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the Collier County Government Subrogation Closed Claim Report 3rd QTR FY 2018 Valued as of:8/3/2018 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 0.00 100.00 0.00 0.00 0.00CC v. Merring, Mark ($4,498.92) (CA) 5308271302678 5/14/20188/27/2013 9/3/2013 0.00 0.00 0.00 100.00 0.00 0.00 0.00 0.00163630 53 Mark Merring was traveling west on Davis Blvd. when his tire allegedly blew out, causing him to lose control of the vehicle & collide with a street light. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Gonzalez, Pablo (PC)5306261202018 5/11/20186/26/2012 11/26/2012 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163630 53 Yasiel Rodriguez was traveling east on CR886 when the vehicle began skidding & struck a sign post. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Deroy, Albert (SAO)5304181103980 5/4/20184/18/2011 4/21/2011 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163630 53 Richard Deroy was traveling west on Recreation Lane. When he turned south onto Santa Barbara Blvd., he lost control of the vehicle, crossed over the median & northbound lanes, then struck a light pole. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CCv. Tait, Heather (SAO) (CA)5310071003822 5/4/201810/7/2010 11/24/2010 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163630 53 Heather Tait was traveling north on Collier Blvd. & as she approached slower traffic, she made an abrupt move into the right lane, then overcorrected to the left & lost control of the vehicle. She struck another vehicle & it collided with a light pole. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Morales, Antonio Vazquez (SAO) 5305100801865 5/2/20185/10/2008 5/15/2008 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163630 53 JE Antonio Morales was traveling southbound on Carson Road when his vehicle left the roadway and struck a bus shelter. -14- 10:16:25AM 8/3/2018 16.E.2.b Packet Pg. 2044 Attachment: Subrogation Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the Collier County Government Subrogation Closed Claim Report 3rd QTR FY 2018 Valued as of:8/3/2018 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 0.00 0.00 0.00 0.00CC v. Jeanty, Frantzy (PC)5305150700983 5/1/20185/15/2007 6/12/2007 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163630 53 JE Frantzy Jeanty suffered a possible seisure/blackout and ran his vehicle off the road, sideswiping several vehicles and striking a utility pole, street sign, and curbing. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Southwest Disposal5312121707327 6/18/201812/12/2017 12/21/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163630 53 Jesse Hough was driving a dump truck and while coming through the emergency exit for the Greater Naples Fire Dept., the arm struck the emergency traffic signal. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. JW Craft, Inc.5305101707139 6/14/20185/10/2017 11/14/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163630 53 Kenneth Paul was traveling north on US41 approaching Pelican Bay Blvd. N. He tried to stop the vehicle for a yellow light, but his brakes failed and he struck another vehicle then drove up onto the median. 2450 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Beltran, Alicia5304291707136 6/14/20184/29/2017 11/14/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163630 53 Vanessa Beltran was traveling west on Tamiami Trail when she lost control of the vehicle and the vehicle began to spin and struck a median. 3100 -15- 10:16:25AM 8/3/2018 16.E.2.b Packet Pg. 2045 Attachment: Subrogation Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the Collier County Government Subrogation Closed Claim Report 3rd QTR FY 2018 Valued as of:8/3/2018 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 0.00 0.00 0.00 0.00CC v. Tovar Campos, Eloy5405021707138 6/14/20185/2/2017 11/14/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163801 54 Eloy Tovar Campos was stopped at a traffic light eastbound on Tamiami Trail East. When the light changed, he accelerated and lost control of the vehicle on the wet roadway, driving over the median and striking 2 trees. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Drew Transport5311081707117 6/15/201811/8/2017 11/9/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00173435 53 At about 7:26 AM, a transport truck #T1229 working for Drew Transport struck and knocked down sections of the front fence and gate at ITS. Site is now not securable. Security has been notified. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Alfaro, Guadalupe5305311706194 6/14/20185/31/2017 6/12/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163630 53 Karina Estrada was stopped at a stop sign facing North on Jackson Street. She moved north on Jackson Street into the path of another vehicle causing a collision and her vehicle overturned. The other vehicle continued to travel and struck a stop sign. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Lang, Joseph5405181706213 6/14/20185/18/2017 6/15/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163801 54 Joseph Lang was traveling west on Vanderbilt Beach Road. Traffic ahead was stopped and he failed to stop his vehicle in time, striking the vehicle in front of his. After the impact, the other vehicle was pushed into the median, striking a palm tree. 3000 -16- 10:16:25AM 8/3/2018 16.E.2.b Packet Pg. 2046 Attachment: Subrogation Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the Collier County Government Subrogation Closed Claim Report 3rd QTR FY 2018 Valued as of:8/3/2018 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 0.00 0.00 0.00 0.00CC v. Lanphear, Jacob5306121706199 6/14/20186/12/2017 6/14/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00182901 53 Jordan Lanphear was turning onto Laurel Oak Drive heading west from Tamiami Trail when the vehicle lost traction on the wet roadway. He drove over the median and struck a "one way" sign. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Balzarini III, William5411271606068 6/13/201811/27/2016 4/21/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163801 54 William Balzarini III was traveling north on Collier Blvd. when the vehicle drifted to the left, entered the median and collided with a palm tree. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Loredo-Armendariz, Sandra 5409071606063 5/24/20189/7/2016 4/21/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163801 54 Ezequiel Loredo was traveling east on US41 when he pulled the wheel hard to the right then steered back to the left causing the vehicle to spin out of control striking the curb, then a tree. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Belen Resto, Yolanda5409051606062 5/24/20189/5/2016 4/21/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163801 50 Yolanda Belen Resto was traveling south on US41 when she looked down at her cell phone, veered left and traveled over the raised median colliding with a traffic sign, a palm tree and landscaping. 3000 -17- 10:16:25AM 8/3/2018 16.E.2.b Packet Pg. 2047 Attachment: Subrogation Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the Collier County Government Subrogation Closed Claim Report 3rd QTR FY 2018 Valued as of:8/3/2018 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 0.00 0.00 0.00 0.00CC v. Santiago, Brandon5408261606060 5/22/20188/26/2016 4/21/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163801 54 Brandon Santiago was traveling south on Airport Road and made a -turn at Orange Blossom Drive. He went to accelerate, lost traction in his tires and slid all over the road. He then drove into the median and struck 2 palm trees & several shrubs. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Flood, Mark5408161605407 5/22/20188/16/2016 8/18/2016 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163647 54 Jacob Flood was traveling east on Immokalee Road when he attempted to stop, but the vehicle continued forward on the wet roadway and struck landscaping & irrigation. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Salter, Thomas E.4101101807367 6/14/20181/10/2018 1/11/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00RMGE 41 CC2-1100 rear ended at traffic light on the intersection of Airpot Road and Estey Avenue (CC2-1100 at complete stop) 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Palomino Vargas, Martha ($1,093.80) (PC) 5406031504559 5/14/20186/3/2015 10/29/2015 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163652 54 Ernesto Salvador Huerta Chairez was traveling north on US 41 when he changed lanes to avoid a collision with a phantom vehicle & began to fishtail. His vehicle collided with another vehicle & that vehicle struck landscaping. 3000 -18- 10:16:25AM 8/3/2018 16.E.2.b Packet Pg. 2048 Attachment: Subrogation Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the Collier County Government Subrogation Closed Claim Report 3rd QTR FY 2018 Valued as of:8/3/2018 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 0.00 500.00 0.00 0.00 0.00CC v. Nunez, Chad ($784.26) (PC) 5409131302842 5/14/20189/13/2013 11/14/2013 0.00 0.00 0.00 500.00 0.00 0.00 0.00 0.00163652 54 Jeff Ramos was on a high speed chase with deputies when they performed a P.I.T. maneuver & Jeff went over a median and struck a tree, landscaping, and irrigation. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Prentice, Renee (PC)5411081101218 5/11/201811/8/2011 3/6/2012 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163652 54 Richard Marabel was traveling west on Pine Ridge Road when he swerved to the right to avoid a collision with the vehicle in front of him. The right side tires collided with the north curbed shoulder, damaging landscaping. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Vazquez, Moises (SAO)5404261100634 5/10/20184/26/2011 6/13/2011 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163652 54 Moises Vazquez was traveling south in the northbound lane of S. 1st Street when he jumped the the curb and struck a palm tree. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Schroeder, Lauren5409071605532 5/25/20189/7/2016 10/13/2016 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163801 54 Ryan Hafenbrack was making a left turn from Naples Blvd. to Airport Road when he lost control of the vehicle on wet pavement, entered the median and struck landscaping. 3000 -19- 10:16:25AM 8/3/2018 16.E.2.b Packet Pg. 2049 Attachment: Subrogation Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the Collier County Government Subrogation Closed Claim Report 3rd QTR FY 2018 Valued as of:8/3/2018 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 0.00 0.00 0.00 0.00CC v. Sandoval Salinas, Jose5409061605520 5/22/20189/6/2016 10/6/2016 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163801 54 Jose Sandoval Salinas was traveling east on Golden Gate Blvd. when he swerved suddenly to avoid striking the CAT bus that was stopped ahead. When he did so, he side swiped another vehicle, sending it into the median and damaging landscaping. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Brown, Ashley ($2,350.00) 5407241605463 5/22/20187/24/2016 9/8/2016 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163801 54 Ashley Brown was traveling east on Golden Gate Parkway then drifted or swerved to the right striking the curb, then a bicycle path sign and a tree. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Mansolilli, Deborah5406111605465 5/22/20186/11/2016 9/9/2016 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163801 54 Deborah Mansolilli was traveling north on Airport Road when a phantom vehicle allegedly pulled out from the Audi Dealership causing her to swerve to avoid a collision. She drove up onto the median and struck a City water meter box and a tree. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Obidiegwu, George5412291506057 5/14/201812/29/2015 4/21/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163801 54 George Obidiegwu fell asleep at the wheel and drifted off the roadway. He struck the curb and drove onto the grassy median, damaging landscaping. 3000 -20- 10:16:25AM 8/3/2018 16.E.2.b Packet Pg. 2050 Attachment: Subrogation Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the Collier County Government Subrogation Closed Claim Report 3rd QTR FY 2018 Valued as of:8/3/2018 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 0.00 0.00 0.00 0.00CC v. Augenstein, Sherry5408091606058 5/22/20188/9/2016 4/21/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163801 54 Keith Baasch was traveling at a high rate of speed on Collier Blvd. when he struck the median curb, left the roadway and struck several palm trees. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Signature Tree Care5308301706404 6/15/20188/30/2017 8/31/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00172960 53 Contractor - Signature Tree Care - Ven #104528 - was doing a job at the Otter Mound Preserve and accidentally backed equipment into and damamged a bench. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC vs. Ashbritt5310181706988 6/15/201810/18/2017 10/18/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00233351 53 Customer Beth Mcnichols called in a broken manhole lid cover at 2182 Jackson Ave. She said that the tree/ debris contractor was using the claw on the truck and damaged the manhole while doing so. 5900 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Gilreath, Richard (PC)5402141302266 5/14/20182/14/2013 3/21/2013 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163652 54 Richard Gilreath was traveling south on Weber Blvd. & lost control of the vehicle while making a left turn onto Golden Gate Blvd, striking a tree. 3000 -21- 10:16:25AM 8/3/2018 16.E.2.b Packet Pg. 2051 Attachment: Subrogation Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the Collier County Government Subrogation Closed Claim Report 3rd QTR FY 2018 Valued as of:8/3/2018 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 0.00 0.00 0.00 0.00CC v. Moss, Lauren (PC)5307280701201 5/1/20187/28/2007 8/1/2007 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163620 53 JE Zachery Jones (who was driving a car owned by Lauren Moss) was traveling north on Corkscrew Road at a high rate of speed. He was unable to stop for the stop sign at the intersection due to the rate of speed & he struck a yellow warning sign, then a tree 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Abarca, Juan5303310801800 5/1/20183/31/2008 4/18/2008 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163620 53 JE Juan Abarca was traveling south on Camp Keais Road & as he approached the stop sign at the intersection, an unknown driver failed to stop. Juan crossed over County Line Road & struck the guardrail. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Goebel, Kenneth (SAO)5304030801866 5/1/20184/3/2008 5/15/2008 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163630 53 JE Kenneth Goebel was traveling west on US41 in the westbound lane approaching the intersection of Rattlesnake Road. He failed to brake for stopped traffic at the inter-section due to intoxication striking 2 vehicles, a light pole, then another vehicle. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Castro, Alejandro (PC)5310200701709 5/1/201810/20/2007 2/21/2008 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163630 53 JE Alejandro Castro was traveling southbound on 42nd Terrace SW at a high rate of speed. He was unable to navigate a right turn onto 18th Avenue SW and struck a stop sign located at that intersection. Driver & all passengers fled the scene. -22- 10:16:25AM 8/3/2018 16.E.2.b Packet Pg. 2052 Attachment: Subrogation Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the Collier County Government Subrogation Closed Claim Report 3rd QTR FY 2018 Valued as of:8/3/2018 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 0.00 0.00 0.00 0.00CC v. Reyes, Ramiro (PC)5306080701903 5/1/20186/8/2007 5/30/2008 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163630 53 JE Ramiro Reyes fell asleep at the wheel, his vehicle left the roadway and struck a street sign. 0.00 0.00 0.00 0.00 200.00 0.00 0.00 0.00CC v. Fane, Elionardo/Almeida (PC) 5408010703058 5/1/20188/1/2007 7/1/2009 0.00 0.00 0.00 200.00 0.00 0.00 0.00 0.00163647 54 JE Julio Almeida was traveling north on Livingston Road when the vehicle blew a tire. The driver lost control of the vehicle & drove into the path of another vehicle which drove over the median to avoid a collision, damaging landscaping & irrigation. 1400 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Rolando, Giovani (SAO)5303020701108 5/1/20183/2/2007 7/23/2007 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163647 53 JE Giovani Rolando was traveling west on Main Street when he veered left, entering the median, and struck a light pole. 0.00 0.00 0.00 0.00 2,466.58 0.00 0.00 0.00CC v. Cervantez, Jessie (CA)5303030700931 5/1/20183/3/2007 5/25/2007 0.00 0.00 0.00 2,466.58 0.00 0.00 0.00 0.00163620 53 JE Hizarith Torres was traveling east on Immokalee Road & kept looking back to speak to the rear passengers when his vehicle traveled into the eastbound lane. He swerved to the right avoid oncoming traffic and struck a section of guardrail. -23- 10:16:25AM 8/3/2018 16.E.2.b Packet Pg. 2053 Attachment: Subrogation Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the Collier County Government Subrogation Closed Claim Report 3rd QTR FY 2018 Valued as of:8/3/2018 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 0.00 0.00 0.00 0.00CC v. Nadvit, Robert J. (PC)5303150700960 5/1/20183/15/2007 6/5/2007 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163630 53 JE (Driver Unknown) was traveling eastbound on 103rd Ave., N. approaching 6th Street. The vehicle traveled through the intersection and struck a stop sign, then went into a ditch, striking the concrete culvert. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Johnson, Christina (PC)5412090501589 4/30/201812/9/2005 1/28/2008 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163647 54 JE Christina Johnson was traveling westbound on US41 when she suffered a medical emergency causing her to lose control of her vehicle, she traveled into the median and struck a tree. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Duntz, Christopher M. (PC) 5307110600829 4/24/20187/11/2006 4/13/2007 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163630 53 JE Christopher Duntz was making a left-hand turn from Collier Blvd. onto Green Blvd., he failed to yield the right-of-way to oncoming traffic, collided with another vehicle, which spun into a lightpole. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Rodriguez, Eric (PC)5111230600359 4/24/201811/23/2006 11/23/2006 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163620 51 JE Eric Rodriguez was traveling SB on SR29, lost control of his vehicle, and struck a guardrail. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Garcia, Diosteres E. (PC)5304150600828 4/24/20184/15/2006 4/13/2007 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163630 53 JE Mr. Garcia alleges a small animal ran out in front of his vehicle and he swerved to avoid hitting it and struck a street sign. -24- 10:16:25AM 8/3/2018 16.E.2.b Packet Pg. 2054 Attachment: Subrogation Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the Collier County Government Subrogation Closed Claim Report 3rd QTR FY 2018 Valued as of:8/3/2018 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 0.00 0.00 0.00 0.00CC v. Huerta, Jose (PC)5308290600864 4/24/20188/29/2006 4/13/2007 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163630 53 JE Jose Huerta's vehicle skidded to right shoulder off the roadway and struck a street sign. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Frazier, Mark (PC)5105290600152 4/24/20185/29/2006 8/16/2006 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163620 51 JE Mark Frazier, who was driving too fast for wet conditions, swerved to avoid hitting traffic in front of him that was slowing and he struck the guardrail. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Vargas, Sofia M. (PC)5104130600351 4/23/20184/13/2006 6/7/2006 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163620 51 JE Because she was driving too fast, Sofia M. Vargas lost control of her vehicle while making a right turn off US41 onto Turner River Road, and struck a guardrail. 0.00 0.00 0.00 0.00 1,859.68 0.00 0.00 0.00CC v. Martinez Hernandez, Gervasio 5311191707265 4/27/201811/19/2017 12/11/2017 0.00 0.00 0.00 1,859.68 0.00 0.00 0.00 0.00163630 53 Gervasio Martinez Hernandez was traveling west on Golden Gate Parkway when he crashed into a vehicle that was stopped for a red light then struck a traffic light pole. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Walsh Trucking, Inc. ($19,657.50) (CA) 5912271202083 4/23/201812/27/2012 12/31/2012 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163620 59 A truck owned by Walsh Trucking was traveling south on Collier Blvd. when the driver failed to see 2 stopped vehicles stopped in front of his & attempted to drive in between them. His vehicle overturned, spilling it's load of sand onto the roadway. 2450 -25- 10:16:25AM 8/3/2018 16.E.2.b Packet Pg. 2055 Attachment: Subrogation Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the Collier County Government Subrogation Closed Claim Report 3rd QTR FY 2018 Valued as of:8/3/2018 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 0.00 0.00 0.00 0.00CC v. Santiago, Rogelio5303201706016 6/14/20183/20/2017 4/3/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163624 53 Hector Lopez Bautista was traveling west on Immokalee Road when he allegedly swerved in order to avoid a collision, entered a grassy area overturned and struck a panther fence. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Hoy, Paul ($1,929.94)5307121706293 6/15/20187/12/2017 7/19/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163630 53 Paul Hoy was traveling south on Pine Ridge Road and ran a red light at the intersection of Napa Blvd., striking another vehicle. The 2nd vehicle lost a tire which struck a pedestrian crosswalk signal and the vehcle damaged some landscaping. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Sanchez, Ambrosia ($1,830.11) 5312221605715 6/13/201812/22/2016 12/30/2016 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163630 53 Gabriel Hernandez was traveling west on Pine Ridge Road when he ran off the road and struck a light pole. 3000 343.70 0.00 0.00 0.00 0.00 343.70 0.00 0.00CC v. Balance Professionals ($343.70) 4112301605716 6/28/201812/30/2016 12/30/2016 0.00 343.70 0.00 0.00 343.70 0.00 0.00 0.00253212 41 While a Balance Professional employee was putting tools in Asset #CC2-511, accidently struck side window, shattering it. 2000 -26- 10:16:25AM 8/3/2018 16.E.2.b Packet Pg. 2056 Attachment: Subrogation Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the Collier County Government Subrogation Closed Claim Report 3rd QTR FY 2018 Valued as of:8/3/2018 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 1,305.00 0.00 0.00 0.00 0.00 0.00 0.00 1,305.00CC v. Eglaus, Dieunie ($1,405.00) (PC) 5303111504004 5/22/20183/11/2015 4/16/2015 1,305.00 0.00 0.00 0.00 1,305.00 0.00 0.00 0.00163652 53 Dieunie Eglaus was stopped on Bear Creek Drive & made a right turn onto Airport Road, crossing all 3 southbound lanes of traffic & striking another vehicle, causing it to travel onto the median and strike a Palm tree & other landscaping. 3000 170.00 0.00 0.00 0.00 10,400.00 0.00 0.00 170.00CC v. Pericles, Perius (CA)5305101302411 5/14/20185/10/2013 5/23/2013 170.00 0.00 0.00 10,400.00 170.00 0.00 0.00 0.00163630 53 Marie Guerda Pericles Cadet was traveling north on Santa Barbara in the right lane & attempted to change lanes, but did not see the vehicle in that lane. She moved quickly back into the right lane, but kept going & drove onto the sidewalk & struck a tra 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Devose, Reginald (CA)5305241100575 5/10/20185/24/2011 5/27/2011 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163630 53 Reginald Devose was traveling north on Goodlette Road & for an unknown reason, drifted to the right and struck a light pole. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Amador, Mary Jane (PC)5405071100574 5/10/20185/7/2011 6/9/2011 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163652 50 Mary Jane Amador failed to slow safely to make a u-turn to go southbound on CR31 and drove up on the median, striking landscaping. 3000 -27- 10:16:25AM 8/3/2018 16.E.2.b Packet Pg. 2057 Attachment: Subrogation Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the Collier County Government Subrogation Closed Claim Report 3rd QTR FY 2018 Valued as of:8/3/2018 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 0.00 0.00 0.00 0.00CC v. Dehnz, Richard (PC)5104060600307 4/24/20184/6/2006 11/6/2006 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163630 51 JE A tire blew out on Richard Dehnz's vehicle causing him to leave the roadway and strike a street sign. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Beach, Austin5402151707134 6/14/20182/15/2017 11/13/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163801 54 Austin Beach was traveling east on Pine Ridge Road when his vehicle hit standing water causing him to lose control of the vehicle. He swerved into the median and struck a palm tree. 3100 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Geter, William5304181706105 6/14/20184/18/2017 5/8/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163630 53 Damian Rivera was traveling NW on New Market Road when he entered a curve too fast for conditions. The vehicle traveled off the toadway and struck a tree, it then rotated and collided with a light pole. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Byrne, Jerome5412131606069 6/13/201812/13/2016 4/21/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163801 54 Janice Byrne was leaving a shopping plaza when she struck an oncoming vehicle while trying to enter Rattlesnake-Hammock Road causing that vehicle to enter the median and damage landscaping. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Morton, Robert5410101606067 6/13/201810/10/2016 4/21/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163801 54 Aurica Tulbure was traveling south on Goodlette-Frank Road when she allegedly blacked out, entered the median and struck a palm tree. 3000 -28- 10:16:25AM 8/3/2018 16.E.2.b Packet Pg. 2058 Attachment: Subrogation Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the Collier County Government Subrogation Closed Claim Report 3rd QTR FY 2018 Valued as of:8/3/2018 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 0.00 0.00 0.00 0.00CC v. Townsend, Michael5409241606066 6/13/20189/24/2016 4/21/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163801 54 Michael Townsend was traveling south on Livingston Road when he failed to maintain his lane, exited to the left into a curbed median and collided into a tree. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Bartis, Gregory5409261606065 6/13/20189/26/2016 4/21/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163801 54 Gregory Bartis was traveling north on Livingston Road and drifted to the right where he struck a curbed edge of the roadway and damaged landscaping. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Sealy, Cynthia5410191606070 6/13/201810/19/2016 4/21/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163801 54 Anthony Sealy was traveling east on Orange Blossom Drive turning onto Airport Road when he lost control of the vehicle and stuck the curb then collided with a tree. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Gonzalez, Rayza/Claudelle Philistin 5301181705793 6/13/20181/18/2017 1/26/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163630 53 Claudelle Philistin was fleeing from police and eventually lost control of the vehicle and struck a pedestrian signal. 3000 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Brockwell, Russell5512291605859 6/13/201812/29/2016 2/15/2017 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163647 55 Russell Brockwell was turning right onto Tamiami Trail from Lely Resort Blvd. and lost control of the vehicle. He ran off the roadway and struck a palm tree. 3000 -29- 10:16:25AM 8/3/2018 16.E.2.b Packet Pg. 2059 Attachment: Subrogation Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the Collier County Government Subrogation Closed Claim Report 3rd QTR FY 2018 Valued as of:8/3/2018 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 1,000.00 0.00 0.00 0.00 0.00 1,000.00 0.00 0.00CC v. Genesis Aviation Enterprises, Inc. ($1,593.86) 1002141705860 6/14/20182/14/2017 2/15/2017 0.00 1,000.00 0.00 0.00 1,000.00 0.00 0.00 0.00AAUD 102 At approximately 6:55pm, a Beechcraft Baron (twin-engine, 5 passenger aircraft) landed “gear-up” on the runway at the Marco Airport with 5 persons onboard. 9-1-1 was called and Greater Naples Fire, EMS and CCSO responded. No injuries were sustained 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Addorisio, Lisa (PC)5411220602867 4/30/201811/22/2006 5/5/2009 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163647 54 JE Vehicle was traveling southbound on CR951 & swerved, thinking another vehicle was entering her lane, lost control of the vehicle & began to spin, striking landscaping in the median. 3100 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. American Lighting & Signalization Inc. 5301111807386 6/18/20181/11/2018 1/17/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00163647 53 On above date, county employee discovered that an electrical line that provides power to a county owned irrigation controller was cut by contractor work on US 41 North. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CC v. Accurate Drilling Systems, Inc. 5301281807418 6/19/20181/28/2018 1/30/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00233351 53 6" clay service lateral at 665 101 ave north naples Park was damaged by ADS contractor while installing a service line. 2000 10,323.00 10,323.00 0.00 0.00 6,163.73 6,163.73 27,935.36 27,935.36 0.00 0.00 0.00 0.00 0.00 0.00 16,486.73 16,486.73Grand Totals: 134 Claims -30- 10:16:25AM 8/3/2018 16.E.2.b Packet Pg. 2060 Attachment: Subrogation Closed Claim Report 3rd QTR 2018 (6525 : Ratification of Closed Claims by the 16.E.2.c Packet Pg. 2061 Attachment: Resolution 2004-15 PDF0001 (6525 : Ratification of Closed Claims by the Risk Maangement Director) 16.E.2.c Packet Pg. 2062 Attachment: Resolution 2004-15 PDF0001 (6525 : Ratification of Closed Claims by the Risk Maangement Director) 16.E.2.c Packet Pg. 2063 Attachment: Resolution 2004-15 PDF0001 (6525 : Ratification of Closed Claims by the Risk Maangement Director) 16.E.2.c Packet Pg. 2064 Attachment: Resolution 2004-15 PDF0001 (6525 : Ratification of Closed Claims by the Risk Maangement Director) 16.E.2.c Packet Pg. 2065 Attachment: Resolution 2004-15 PDF0001 (6525 : Ratification of Closed Claims by the Risk Maangement Director) 16.E.2.c Packet Pg. 2066 Attachment: Resolution 2004-15 PDF0001 (6525 : Ratification of Closed Claims by the Risk Maangement Director)