Agenda 05/12/2020 Item #16E 3 (Workers Comp and Subrogation claims)05/12/2020
EXECUTIVE SUMMARY
Recommendation to ratify Property, Casualty, Workers’ Compensation and Subrogation claim
files settled and/or closed by the Risk Management Division Director pursuant to Resolution #
2004-15 for the second quarter of FY20.
OBJECTIVE: To settle routine, administrative and minor claims matters, which promotes the efficient
use of resources and the efficient administration of the program and allows for a timely response to
claimants and/or their representatives.
CONSIDERATIONS: Resolution 04-15 grants limited authority to the Risk Management Division
Director to settle certain damage claims against Collier County and to authorize the payment of
investigation and adjustment expenses as presented to the County’s Risk Management Program.
Authority is delegated as follows:
• Bodily Injury Liability- Premises, Auto, Operations: Non-litigated claims less than $50,000
• Property Damage Liability Claims- Premises, Auto, Operations: Non-litigated claims less than
$75,000
• Errors, Omissions, Professional Liability, Employment Practices Liability: Non-litigated claims
less than $50,000
• Property Losses to County Owned Property: Full authority
• Workers’ Compensation: Full authority subject to the provisions of F.S. 440 and subject to
approval by the Judge of Compensation as needed
• Employer’s Liability: Non-litigated claims less than $50,000
• Subrogation- Bodily Injury and Property Damage: Full authority to pursue non-litigated
subrogation recoveries
• Subrogation- Workers’ Compensation: Full authority to pursue non-litigated subrogation
recoveries.
Pursuant to the Resolution, claims are settled and paid according to the loss verification procedures
contained in the Resolution which include the completion of claim forms, documentation of evidence,
valuation, and the determination of a finding of liability where applicable. Closed claim files are also
subject to review by the external auditor. A listing of claim files closed during the second quarter of FY
20 is attached. The report may include claims and/or settlements previously approved by the Board of
Commissioners as well as litigated files with a final court determination.
FISCAL IMPACT: Funds are budgeted and available in Fund 516-121650-645920 (Property and
Casualty Self Insurance Fund) and 518-121630-645928 (Workers’ Compensation Fund) for the payment
of claims and settlements. For the second quarter of FY 20, 191 files were closed with total expenditures
of $3,249,975.13. Reinsurance recoveries for the second quarter of FY 20 were $1,357,740.29. During the
same period, 33 subrogation files were closed, and the Risk Management Division recovered $102,132.96
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.3
Packet Pg. 790
05/12/2020
Prepared by: Jeff Walker CPCU, ARM, Division Director, Risk Management Division.
ATTACHMENT(S)
1. All Lines Closed Claim Report 2nd QTR FY 20 (PDF)
2. Subrogation Closed Claim Report 2nd QTR FY 20 (PDF)
3. Resolution 2004-15 PDF0001 (PDF)
16.E.3
Packet Pg. 791
05/12/2020
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.E.3
Doc ID: 12233
Item Summary: Recommendation to ratify Property, Casualty, Workers’ Compensation and
Subrogation claim files settled and/or closed by the Risk Management Division Director pursuant to
Resolution # 2004-15 for the second quarter of FY20.
Meeting Date: 05/12/2020
Prepared by:
Title: – Risk Management
Name: Heidi Dareus
04/17/2020 10:24 AM
Submitted by:
Title: Division Director - Risk Management – Risk Management
Name: Jeff Walker
04/17/2020 10:24 AM
Approved By:
Review:
Risk Management Jeff Walker Additional Reviewer Completed 04/17/2020 12:49 PM
Administrative Services Department Paula Brethauer Level 1 Division Reviewer Completed 04/21/2020 8:48 AM
Administrative Services Department Len Price Level 2 Division Administrator Review Completed 04/29/2020 11:09 AM
Office of Management and Budget Debra Windsor Level 3 OMB Gatekeeper Review Completed 04/29/2020 11:58 AM
County Attorney's Office Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Completed 04/29/2020 2:03 PM
Office of Management and Budget Laura Wells Additional Reviewer Completed 04/29/2020 2:55 PM
County Manager's Office Nick Casalanguida Level 4 County Manager Review Completed 05/04/2020 11:21 AM
Board of County Commissioners MaryJo Brock Meeting Pending 05/12/2020 9:00 AM
16.E.3
Packet Pg. 792
Med/BI/Comp Expense Ind/PD/Coll Recovery Deductible Legal Other Total Inc
Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total
Date of Loss Date Report to Risk Status Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total
Coverage Cause
480.00 17.85 0.00 0.00 0.00 0.00 0.00 497.85
12/31/2019 12/31/2019 1/9/2020 480.00 17.85 0.00 0.00 0.00 0.00 0.00 497.85
10 1300
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
3/19/2020 3/19/2020 3/26/2020 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
10 1300
162.51 7.40 0.00 0.00 0.00 0.00 0.00 169.91
1/3/2020 1/3/2020 1/9/2020 162.51 7.40 0.00 0.00 0.00 0.00 0.00 169.91
10 1200
449.53 87.32 0.00 0.00 0.00 0.00 0.00 536.85
1/8/2020 1/8/2020 1/14/2020 449.53 87.32 0.00 0.00 0.00 0.00 0.00 536.85
10 1000
3,525.44 140.66 0.00 0.00 0.00 0.00 0.00 3,666.10
12/13/2019 12/13/2019 2/29/2020 3,525.44 140.66 0.00 0.00 0.00 0.00 0.00 3,666.10
10 1300
263.50 26.90 0.00 0.00 0.00 0.00 0.00 290.40
12/31/2019 12/31/2019 1/23/2020 263.50 26.90 0.00 0.00 0.00 0.00 0.00 290.40
10 1200
539.92 11.90 0.00 0.00 0.00 0.00 0.00 551.82
1/10/2020 1/10/2020 1/15/2020 539.92 11.90 0.00 0.00 0.00 0.00 0.00 551.82
10 1900
441.17 23.80 0.00 0.00 0.00 0.00 0.00 464.97
1/13/2020 1/13/2020 1/21/2020 441.17 23.80 0.00 0.00 0.00 0.00 0.00 464.97
10 1400
1001132009967
CENE
Employee was involved in a motor vehicle
accident and is complaining of sore neck pain.
DASE
Employee had dog bite to right thumb while
trying to scan for a microchip.
1001102009959
ASAE
Employee was treating a patient for possible
exposure of heroin and is complaining of
dizziness and weakness.
1012131909884
MHCP
Employee fell while running on turf during work.
1012311909920
BPRI
Employee was peforming a building inspection
and dog bit lower right leg.
1001082009945
DASE
Employee was adding bleach to the washing
machine when the chemical backsplashed into
his eye.
Employee was tending to a patient and missed
a step in bathroom, and fell to the ground.
1003192010192
TECM
Employee fell on buttocks and left wrist when he
exited the parking garage at work. There was a
drop off on the sidewalk as he turned right.
1001032009930
Carrier Accident Desc.
Major Coverage: 10 - Workers' Compensation
1012311909921
ASAE
Collier County Government
Closed Claim Report- All Lines
2nd QTR FY 2020
Claim Number Claimant Name
Division
16.E.3.a
Packet Pg. 793 Attachment: All Lines Closed Claim Report 2nd QTR FY 20 (12233 : Ratification of Claim FIles Closed by
522.18 54.59 0.00 0.00 0.00 0.00 0.00 576.77
1/19/2020 1/24/2020 1/31/2020 522.18 54.59 0.00 0.00 0.00 0.00 0.00 576.77
10 1300
383.44 5.95 0.00 0.00 0.00 0.00 0.00 389.39
1/31/2020 1/31/2020 2/6/2020 383.44 5.95 0.00 0.00 0.00 0.00 0.00 389.39
10 1700
485.48 19.70 0.00 0.00 0.00 0.00 0.00 505.18
1/19/2020 1/21/2020 2/11/2020 485.48 19.70 0.00 0.00 0.00 0.00 0.00 505.18
10 1700
1,713.78 102.90 0.00 0.00 0.00 0.00 0.00 1,816.68
9/5/2019 9/5/2019 2/29/2020 1,713.78 102.90 0.00 0.00 0.00 0.00 0.00 1,816.68
10 1900
1,899.43 5.95 417.10 0.00 0.00 0.00 0.00 2,322.48
1/28/2020 1/29/2020 2/19/2020 1,899.43 5.95 417.10 0.00 0.00 0.00 0.00 2,322.48
10 1500
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
3/6/2020 3/6/2020 3/31/2020 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
10 1700
721.65 37.49 0.00 0.00 0.00 0.00 0.00 759.14
7/29/2019 7/29/2019 2/4/2020 721.65 37.49 0.00 0.00 0.00 0.00 0.00 759.14
10 1200
10,430.90 3,126.82 0.00 0.00 0.00 0.00 0.00 13,557.72
3/11/2019 3/11/2019 2/19/2020 10,430.90 3,126.82 0.00 0.00 0.00 0.00 0.00 13,557.72
10 1900
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
1/2/2017 1/3/2017 1/6/2020 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
10 1200
356.14 0.00 0.00 0.00 0.00 0.00 0.00 356.14
2/6/2020 2/7/2020 2/14/2020 356.14 0.00 0.00 0.00 0.00 0.00 0.00 356.14
10 1200
ORMD
Employee was attending a meeting and when
she got up from her chair, the whiteboard and
tray penetrated her pants causing a puncture
wound to buttocks.
1001021705720
DASE
Employee was bitten on right thumb by an
injured cat she was trying to pick up.
1002062010069
ASAE
Employee cut left middle finger when he
reached into the rear equipment pouch attached
to department's heart monitor with left hand and
an uncapped single blade razor lacerated tip of
finger.
1003111908898
CENE
Employee hit head on window of vehicle when
the tires locked up.
1003062010160
FMGE
Employee was working on the jail muffin
monster, when a gust of wind blew the metal lid
down and the lid hit jorge in the back of the
head.
1007291909419
EMSE
Employee was trying to suction a patient who
overdose on heroin and vomit went up her
nose.
1001282010028
EMSE
Employee was attempting to get vials of blood
from patient when suddenly the patient got
violent and twist right arm.
1001192009996
MHCP
Employee was struck in right leg by a trailer
driven by a patron.
1009051909528
EMSE
Employee was stepping out of the Ambulance,
when her right foot slipped off of the bumper
causing her to fall on the ground and is
complaining of pain in upper back and right hip.
1001312010042
EMSE
Employee struck another vehicle while
responding to a 911 call and is having neck
pain.
1001192010012 16.E.3.a
Packet Pg. 794 Attachment: All Lines Closed Claim Report 2nd QTR FY 20 (12233 : Ratification of Claim FIles Closed by
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
1/28/2020 1/28/2020 1/29/2020 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
10 1200
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
3/6/2020 3/9/2020 3/31/2020 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
10 1100
0.00 13.75 0.00 0.00 0.00 0.00 0.00 13.75
2/10/2020 2/12/2020 2/29/2020 0.00 13.75 0.00 0.00 0.00 0.00 0.00 13.75
10 1300
0.00 13.75 0.00 0.00 0.00 0.00 0.00 13.75
3/12/2020 3/12/2020 3/31/2020 0.00 13.75 0.00 0.00 0.00 0.00 0.00 13.75
10 1500
201.00 0.00 0.00 0.00 0.00 0.00 0.00 201.00
2/6/2020 2/6/2020 2/26/2020 201.00 0.00 0.00 0.00 0.00 0.00 0.00 201.00
10 1900
354.86 0.00 0.00 0.00 0.00 0.00 0.00 354.86
2/26/2020 2/26/2020 2/29/2020 354.86 0.00 0.00 0.00 0.00 0.00 0.00 354.86
10 1300
440.96 25.65 0.00 0.00 0.00 0.00 0.00 466.61
1/24/2020 1/24/2020 1/31/2020 440.96 25.65 0.00 0.00 0.00 0.00 0.00 466.61
10 1900
0.00 13.75 0.00 0.00 0.00 0.00 0.00 13.75
3/19/2020 3/19/2020 3/26/2020 0.00 13.75 0.00 0.00 0.00 0.00 0.00 13.75
10 1900
2,678.60 184.18 6,821.36 0.00 0.00 0.00 0.00 9,684.14
1/1/2020 1/2/2020 2/29/2020 2,678.60 184.18 6,821.36 0.00 0.00 0.00 0.00 9,684.14
10 1500
26,050.49 3,920.31 7,238.46 0.00 0.00 0.00 0.00 37,209.26
26,050.49 3,920.31 7,238.46 0.00 0.00 0.00 0.00 37,209.26
ASAE
Employee injured left knee when she stepped
out of Ambulance.
Total by Major Coverage 27 Claims
1003192010193
RMSE
Employee was working on Guardrail project and
became dizzy and passed out.
1001012009923
ORMD
Employee was taking photos on construction
site, when right foot hit an upright piece of wood
causing him to trip and fall forward scraping his
shin.
1001242010017
SOWE
Employee was bit by insect on neck and has
swelling and redness near airway.
1002062010063
WWTE
Employee was stung by a bee in the abdomen.
1002262010136
WATE
Employee tripped and fell in SE Garage at the
Operation Center
1003122010175
WATE
Employee fell while working on a water main
and injured left leg
1003062010166
TXCE
Employee was preparing the office carpet and
floor cleaning, when a plastic carpet cover
slipped out of her hands, and landed on left foot
second toe.
1002102010081
1001282010027
TXCE
Employee was cutting paper with scissors and
cut tip of left thumb.
16.E.3.a
Packet Pg. 795 Attachment: All Lines Closed Claim Report 2nd QTR FY 20 (12233 : Ratification of Claim FIles Closed by
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
2/27/2020 2/27/2020 2/29/2020 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
22 2150
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
1/16/2018 7/17/2018 2/26/2020 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
21 2050
1,280.00 0.00 0.00 0.00 0.00 0.00 0.00 1,280.00
11/24/2018 7/9/2019 1/16/2020 1,280.00 0.00 0.00 0.00 0.00 0.00 0.00 1,280.00
21 2050
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
10/10/2017 10/10/2017 2/24/2020 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
21
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
6/6/2019 11/25/2019 2/19/2020 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
22 2000
0.00 0.00 611.52 0.00 0.00 0.00 0.00 611.52
2/5/2020 2/6/2020 2/21/2020 0.00 0.00 611.52 0.00 0.00 0.00 0.00 611.52
22 5900
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
2/21/2020 2/24/2020 2/29/2020 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
22 3000
RMSE
Citizen turned on Shadowlawn and hit pot hole.
2202052010062 VIZCAYA, RIGOBERTO
PUAO
3rd party vehicle was driving in the left lane,
CC2-1332 in the right lane, going up the bridge
leaving Marco Island, and a piece of metal flew
out of CC2-1332, citizen tried to avoid it, but the
piece of metal still hit 3rd party vehicle.
2202212010131 ADAMO, THOMAS
MHCP
Greg (15y/o male) was running during a
Xcountry Meet for Baron Collier HS. After his
race, he complained of being dizzy and felt like
he was going to faint, he then collapsed. A
cardiologist on site began CPR and a parent
called 911. An AED was
2206061909827 KLEINTOP, JOHN REED
PUAO
A cleanout pipe on homeowners property was
crushed/smashed by Mitchell & Stark
Construction during the "Vanderbilt Road
Project" resulting in backup sewage into the
home.
2111241809346 BEATTY, KAREN
CRAE
Citizen walked with a friend to and from
Celebration Park, at night, for the 4th time, but
the first time on this path. On the section of
sidewalk between Bayview and Shoreview, on
the west side of Bayshore, the toe of my
sneaker caught onto a a paver
2110101706874 Stovring, Greg
ASAE
SRU80 - CCE-S1 / 050386 driven by (non-
county employee-Chris VanBuski of North
Collier Fire). While backing into a driveway on a
~30degree grade, the rear tow hitch dragged
against the ground, causing a noticeable gouge
in the concrete.
2101161808126 De Los Angeles Pelaez, Maria
RMSE
Received letter from Atty-Morgan & Morgan.
Client was walking and she tripped due to a
broken curb.
Major Coverage: 20 - General Liability
2202272010141 THOMAS, RAY DAVID
16.E.3.a
Packet Pg. 796 Attachment: All Lines Closed Claim Report 2nd QTR FY 20 (12233 : Ratification of Claim FIles Closed by
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
4/20/2019 6/27/2019 2/14/2020 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
21 2050
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
7/8/2019 7/8/2019 2/26/2020 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
22 2150
957.00 0.00 0.00 0.00 0.00 0.00 0.00 957.00
1/24/2020 1/24/2020 3/31/2020 957.00 0.00 0.00 0.00 0.00 0.00 0.00 957.00
21 2050
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
7/2/2019 2/13/2020 2/29/2020 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
22 5100
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
12/5/2019 12/5/2019 2/24/2020 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
22 5100
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
5/2/2018 12/20/2019 1/21/2020 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
11/15/2019 11/18/2019 1/22/2020 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
11/9/2019 1/22/2020 1/30/2020 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
22 5900
2211091910009 Grey Oaks
WWTE
A 12" forcemain break was called in outside of
normal hours of operation. The break was found
to be under a wall with the street names on it.
The wall was removed to repair the pipe.
RMSE
Century Link is claiming their 12-strand fiber
optic cable was damaged during swale
maintenance by Collier County.
2211151909806 Weyers, Robert
WWTE
Received a phone call from homeowner about
county connection at home. They called in a
plumber to repair their 4" lateral line and the
plumber tied them in wrong at the county 6"
lateral. County had to replace county 6"
cleanout.
2212051909861 SCULTHORPE, SARHA
WWTE
While cleaning a wastewater gravity main in
Isles of Collier a resident appoached the Vac
Truck operator to report water splashing out of
their toilet.
2205021809903 Century Link
RMSE
Citizen was walking down the sidewalk and she
tripped over an elevated sewer cap, injuring her
shoulder.
2207021910095 O'CONNELL, BARBARA
WATE
Main break occurred and customer is claiming
this caused damaged in her home several
hundred feet and behind a master meter from
incident. She is requesting payment of
$49,020.82.
2207081909345 Comcast
RMSE
Comcast fiber line in water filled drainage ditch
hit, line was 3.5 off of locate marks.
2101242010013 Verderamo, Alexis
2104201909319 JASINSKI, KRISTEN
RMSE
Kristen Jasinski suffered personal injuries when
she tripped and fell on a raised/uneven portion
of the sidewalk near Katemore Lane and Green
Tree Drive in the Pelican Bay community.
16.E.3.a
Packet Pg. 797 Attachment: All Lines Closed Claim Report 2nd QTR FY 20 (12233 : Ratification of Claim FIles Closed by
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
1/1/2019 2/1/2019 2/25/2020 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
20 5500
0.00 0.00 11,347.49 0.00 0.00 0.00 0.00 11,347.49
2/10/2019 2/11/2019 2/14/2020 0.00 0.00 11,347.49 0.00 0.00 0.00 0.00 11,347.49
22 5300
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
11/19/2019 11/22/2019 2/14/2020 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
22 2150
2,237.00 0.00 11,959.01 0.00 0.00 0.00 0.00 14,196.01
2,237.00 0.00 11,959.01 0.00 0.00 0.00 0.00 14,196.01
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
10/4/2019 10/4/2019 1/7/2020 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
32 3000
0.00 0.00 3,905.85 0.00 0.00 0.00 0.00 3,905.85
1/31/2020 1/31/2020 2/29/2020 0.00 0.00 3,905.85 0.00 0.00 0.00 0.00 3,905.85
32 3000
0.00 0.00 1,465.75 0.00 0.00 0.00 0.00 1,465.75
1/21/2020 1/21/2020 2/29/2020 0.00 0.00 1,465.75 0.00 0.00 0.00 0.00 1,465.75
32 3000
0.00 0.00 2,544.37 584.93 0.00 0.00 0.00 2,544.37
4/10/2019 4/11/2019 2/11/2020 0.00 0.00 2,544.37 584.93 0.00 0.00 0.00 2,544.37
32 3000
0.00 1,018.50 3,061.35 0.00 0.00 0.00 0.00 4,079.85
1/24/2020 1/24/2020 2/29/2020 0.00 1,018.50 3,061.35 0.00 0.00 0.00 0.00 4,079.85
32 3000
WATE
While driving South on Livingston Road, team
member struck the rear of the car ahead of it.
3204101904016 Sally TSE
WWTE
Vehicle #CC2-1624 was hit by another vehicle
while pulling out of a parking space. The other
vehicle was traveling the wrong direction in a
one way lane.
3201242010015 Ramirez, Joselyn
EMSE
Medic 44 was responding to a 911 call and hit
the back of Mrs. Killoran's vehicle traveling
northbound on Tamiami Trl N at approx 2-3
mph per EMT.
3201212009995 Hartwick, Joshua
UESE
Employee was stopped in traffic on Immokalee
Road east of I75 heading west and we were in
the middle lane and my foot slipped off the
brake and my bumper tapped the bumper of the
person in front of me.
3210041909685 SNIDER, DAVID
ASAE
M02 Truck 43 made contact with the (R)
sideview mirror of a Chevy Cobolt while driving
north on Goodlette Rd.
3201312010041 Killoran, Betty
2211191909823 MILLER, TROY
CENE
County Employee was doing an inspection in
the garage attic, and his foot went through the
garage ceiling.
Total by Major Coverage 18 Claims
Major Coverage: 30 - Auto Liability
RMSE
Notice of claim from Attorney Justin Hales
stating there was negligence regarding personal
injuries sustained in a shooting and/or stabbing
wherein Schimael Deroses died. Negligence
includes lack of security, inadequate lighting,
wrongful death.
2202101908780 Rybacki, John
WWTE
Sewer backup caused by main line stoppage.
2101011908741 DEROSES, SCHIMAEL 16.E.3.a
Packet Pg. 798 Attachment: All Lines Closed Claim Report 2nd QTR FY 20 (12233 : Ratification of Claim FIles Closed by
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
2/10/2020 2/10/2020 2/29/2020 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
32 3000
0.00 0.00 1,067.07 0.00 0.00 0.00 0.00 1,067.07
2/19/2020 2/19/2020 2/29/2020 0.00 0.00 1,067.07 0.00 0.00 0.00 0.00 1,067.07
32 3000
0.00 1,018.50 12,044.39 584.93 0.00 0.00 0.00 13,062.89
0.00 1,018.50 12,044.39 584.93 0.00 0.00 0.00 13,062.89
0.00 0.00 13,180.31 0.00 0.00 0.00 0.00 13,180.31
12/22/2019 12/23/2019 3/31/2020 0.00 0.00 13,180.31 0.00 0.00 0.00 0.00 13,180.31
41 3100
1,029.80 0.00 0.00 0.00 0.00 0.00 0.00 1,029.80
12/30/2019 12/30/2019 1/16/2020 1,029.80 0.00 0.00 0.00 0.00 0.00 0.00 1,029.80
41 3100
0.00 0.00 1,294.74 0.00 0.00 0.00 0.00 1,294.74
12/21/2019 12/23/2019 2/19/2020 0.00 0.00 1,294.74 0.00 0.00 0.00 0.00 1,294.74
41 3000
0.00 0.00 2,522.52 0.00 0.00 0.00 0.00 2,522.52
8/2/2019 12/18/2019 3/30/2020 0.00 0.00 2,522.52 0.00 0.00 0.00 0.00 2,522.52
41 3000
0.00 0.00 4,058.43 0.00 0.00 0.00 0.00 4,058.43
8/18/2019 9/16/2019 3/31/2020 0.00 0.00 4,058.43 0.00 0.00 0.00 0.00 4,058.43
41 2150
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
12/30/2019 12/30/2019 2/26/2020 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
41 3000
DASE
While pulling into parking lot drove over uneven
asphalt and scrapped a low hanging branch.
4112301909919 EMS
EMSE
Garage door malfunctioned and came down on
top of ambulance knocking antenna off.
4108021909898 Bayshore CRA
CRAE
Employee trying to exit Courthouse Garage
making a right hand turn to exit out, another
County Vehicle heading up into the level 2 took
a left(wrong way) as I was taking a right, near
miss head on collision yanked my steering
wheel and hit wall.
4108181909617 DAS
WATE
While attempting to unload a piece of
equipment from trailer number CC2-2348. A
hydraulic piston broke off underneath the trailer.
No fluid was spilled, just bracket broke and
piston fell to ground.
4112211909905 Code Enforcement
CENE
Employee clipped a wood telephone pole while
exiting the right-of-way.
4112221909906 EMS
EMSE
Ambulance #44 drove into ditch.
4112301909915 Water Division
3202192010107 FOWEL, CLAY
WATE
While exiting the parking lot of the Public
Utilities Operations Center, a Maintenance F450
with trailer struck a personel vehicle in the
parking lot.
Total by Major Coverage 7 Claims
Major Coverage: 40 - Auto Physical Damage
3202102010073 DEREZICK, ANTHONY
WATE
Miguel was driving CC2-1006 out of Indigo
Lakes turning onto Collier Blvd south bound as
a red pickup truck was turning from the middle
lane to the right lane. CC2-1006 left front
bumper contacted with the right rear of the red
pickup
16.E.3.a
Packet Pg. 799 Attachment: All Lines Closed Claim Report 2nd QTR FY 20 (12233 : Ratification of Claim FIles Closed by
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
2/4/2020 2/4/2020 3/31/2020 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
41 3000
0.00 0.00 4,508.29 0.00 0.00 0.00 0.00 4,508.29
6/13/2019 6/13/2019 2/24/2020 0.00 0.00 4,508.29 0.00 0.00 0.00 0.00 4,508.29
41 3000
0.00 0.00 4,060.85 0.00 0.00 0.00 0.00 4,060.85
9/5/2019 9/5/2019 1/27/2020 0.00 0.00 4,060.85 0.00 0.00 0.00 0.00 4,060.85
41 3000
0.00 0.00 1,278.00 0.00 0.00 0.00 0.00 1,278.00
8/21/2019 8/21/2019 2/19/2020 0.00 0.00 1,278.00 0.00 0.00 0.00 0.00 1,278.00
41 3000
0.00 202.03 40,356.67 5,869.00 0.00 0.00 0.00 40,558.70
9/5/2019 9/5/2019 1/31/2020 0.00 202.03 40,356.67 5,869.00 0.00 0.00 0.00 40,558.70
41 3000
1,841.54 0.00 0.00 0.00 0.00 0.00 0.00 1,841.54
12/6/2019 1/13/2020 1/31/2020 1,841.54 0.00 0.00 0.00 0.00 0.00 0.00 1,841.54
42 2000
0.00 0.00 529.80 0.00 0.00 0.00 0.00 529.80
1/3/2020 1/6/2020 2/19/2020 0.00 0.00 529.80 0.00 0.00 0.00 0.00 529.80
41 3000
443.53 0.00 0.00 0.00 0.00 0.00 0.00 443.53
2/3/2020 2/3/2020 3/31/2020 443.53 0.00 0.00 0.00 0.00 0.00 0.00 443.53
41 3000
TECM
Was stopped at a stop sign when a dump truck
came speeding down the street and a rock
bounced out and hit my driver side mirror.
A rock was kicked up while an employee was
driving the vehicle and made a crack in the
windshield.
4101032009933 Transportation Engineering Division
TECM
Scratches on the passenger side of the rear
bumper of county vehicle. The damage was
discovered when I was gassing the vehicle. It
looks like someone scratched it when the
vehicle was parked.
4102032010048 Traffic operations
RMSE
Employee was driving an F250 supercrew and
claimed he stopped at the stop sign on
Stockade Rd, looked both ways and was turning
West onto Immokalee Rd when he was struck
by a Nissan Murano in his left rear
door/truckbed.
4212061909965 Supervisor Of Elections BCC
SOEE
4108211909489 EMS
EMSE
Crew was backing up after a call and struck a
tree limb with the top left rear of the box.
4109051909570 Road Maintenance Division
EMSE
While washing the truck this morning, the off
going crew found damage to the right side of
the rear bumper of Tk30. Reporting crews do
not know how this happened.
4109051909530 EMS
EMSE
EMT pulled the ambulance into the driveway of
the Naples Inn and the driver's side corner of
the ambulance box struck the overhang.
4102042010059 EMS
EMSE
Truck #5 was found to have damage to the left
rear lower rub rail and body tube by the small
comp door. Unknown how it got there.
4106131909260 EMS
16.E.3.a
Packet Pg. 800 Attachment: All Lines Closed Claim Report 2nd QTR FY 20 (12233 : Ratification of Claim FIles Closed by
0.00 0.00 2,833.19 0.00 0.00 0.00 0.00 2,833.19
8/27/2019 8/27/2019 3/16/2020 0.00 0.00 2,833.19 0.00 0.00 0.00 0.00 2,833.19
41 3000
701.67 0.00 0.00 0.00 0.00 0.00 0.00 701.67
2/20/2020 2/20/2020 3/31/2020 701.67 0.00 0.00 0.00 0.00 0.00 0.00 701.67
42 5500
0.00 0.00 2,089.20 0.00 0.00 0.00 0.00 2,089.20
1/2/2020 1/3/2020 3/6/2020 0.00 0.00 2,089.20 0.00 0.00 0.00 0.00 2,089.20
41 3000
4,016.54 202.03 76,712.00 5,869.00 0.00 0.00 0.00 80,930.57
4,016.54 202.03 76,712.00 5,869.00 0.00 0.00 0.00 80,930.57
4,340.00 0.00 0.00 0.00 0.00 0.00 0.00 4,340.00
11/26/2019 12/1/2019 3/30/2020 4,340.00 0.00 0.00 0.00 0.00 0.00 0.00 4,340.00
50 3000
2,558.17 849.58 0.00 0.00 0.00 0.00 0.00 3,407.75
12/3/2019 12/3/2019 2/29/2020 2,558.17 849.58 0.00 0.00 0.00 0.00 0.00 3,407.75
50 5500
10,453.20 60.00 0.00 14,350.81 0.00 0.00 0.00 10,513.20
9/10/2017 12/15/2017 3/10/2020 10,453.20 60.00 0.00 14,350.81 0.00 0.00 0.00 10,513.20
51 5400
5109101707295 Parks & Recreation (Vineyards Community
Park)
MHCP
Hurricane Irma damaged a section of the
exterior wall of the bldg. There are leaks and
damaged ceiling tiles throughout, and the metal
and garage door are damaged.
FMGE
The DJJ van, while dropping off juvenile
inmates hit the Judges parking lot wall and
caused damage.
5012031909857 Sugden Park
MHCP
Subject(s) unknown entered county building by
breaking window with a sturdy trash can liner.
Vandalized inside contents of building, causing
extensive damage to contents, as well as
vandalizing adjacent public bathrooms.
FMGE
Employee was doing a repair at Sugden Park.
When finished he noticed damage to the back
of his company van. It looks like someone
backed into it.
Total by Major Coverage 17 Claims
Major Coverage: 50 - Property
5011261909847 Facilities Management Division
4202202010112 Parks and Recreation
MHCP
Dump Trailer Plate TD3049, asset CC2-1295
was vandalized. The battery compartment was
open. The battery and the cables were ripped
off and thrown on the ground. The remote
control was missing hydraulic container.
4101022009928 Facilities Management
4108271909505 Water Division
WATE
While driving down Golden Parkway, employee
reports phone slipped and fell on floor of
vehicle. When he went to pick it up, he
accelerated striking a curb.
16.E.3.a
Packet Pg. 801 Attachment: All Lines Closed Claim Report 2nd QTR FY 20 (12233 : Ratification of Claim FIles Closed by
154,191.81 60.00 0.00 202,812.26 0.00 0.00 0.00 154,251.81
9/10/2017 12/15/2017 3/10/2020 154,191.81 60.00 0.00 202,812.26 0.00 0.00 0.00 154,251.81
53 5400
23,510.01 60.00 0.00 11,242.20 0.00 0.00 0.00 23,570.01
9/10/2017 11/29/2017 2/29/2020 23,510.01 60.00 0.00 11,242.20 0.00 0.00 0.00 23,570.01
51 5400
2,498.78 0.00 0.00 0.00 0.00 0.00 0.00 2,498.78
9/10/2017 12/21/2018 3/27/2020 2,498.78 0.00 0.00 0.00 0.00 0.00 0.00 2,498.78
55 5400
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
9/10/2017 9/25/2017 3/31/2020 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
53 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 9/29/2017 3/3/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
51 5400
406,900.14 60.00 0.00 0.00 0.00 0.00 0.00 406,960.14
9/10/2017 9/12/2017 3/10/2020 406,900.14 60.00 0.00 0.00 0.00 0.00 0.00 406,960.14
51 5400
43,667.24 60.00 0.00 0.00 0.00 0.00 0.00 43,727.24
9/10/2017 9/25/2017 2/29/2020 43,667.24 60.00 0.00 0.00 0.00 0.00 0.00 43,727.24
51 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 9/26/2017 3/9/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400
LIBE
Hurricane Irma winds caused roof and soffit
damage to the building. West side roof leak,
several metal soffits off. Ceiling tile and carpet
damaged.
5309101706598 Library Division (Estates Branch)
LIBE
Hurricane Irma winds damaged fence around
chiller and water pump; light post down.
5109101706429 Facilities Management (Bldg. L - L1
Courthouse & Annex)
FMGE
Exhaust unit duct & hood blown off; damaged
mini split fans .Fascia & gutters knocked down.
Water stains on window sills; wet carpet,
damaged ceiling tiles due to leaks.
5109101706589 Naples Regional Library
LIBE
Hurricane Irma winds damaged nine light poles.
5109101706699 Domestic Animal Services (Adoption Kennel,
Bldg 3)
DASE
Damage to gutters during Hurricane Irma.
Interior insulation exposed in some areas.
5509101708587 Facilities Management (Lake Trafford Memorial
Garden)
FMGE
Hurricane Irma scattered debris throughout the
property
5309101706590 Library Division (Naples Regional Branch)
MHCP
Hurricane Irma damaged several sections of
fence throughout various areas of the park;
damaged to several signs, benches,and
bleachers; walkways/sidewalks damaged by
uprooted trees. Damage to soccer fields and
water fixture awning, and ballfield lights.
5109101707206 Parks & Recreation (Maxx Hasse Community
Park)
MHCP
Hurricane Irma caused minor damages to the
flashing, shutters, roof, and windows of the
community center.
5309101707301 Parks & Recreation (Vineyards Community
Park)16.E.3.a
Packet Pg. 802 Attachment: All Lines Closed Claim Report 2nd QTR FY 20 (12233 : Ratification of Claim FIles Closed by
36,341.99 60.00 0.00 0.00 0.00 0.00 0.00 36,401.99
9/10/2017 10/13/2017 2/29/2020 36,341.99 60.00 0.00 0.00 0.00 0.00 0.00 36,401.99
50 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 9/29/2017 3/3/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
51 5400
4,008.00 60.00 0.00 0.00 0.00 0.00 0.00 4,068.00
9/10/2017 9/26/2017 3/27/2020 4,008.00 60.00 0.00 0.00 0.00 0.00 0.00 4,068.00
55 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 9/29/2017 3/3/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
51 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 9/29/2017 3/3/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
51 5400
7,728.02 60.00 0.00 0.00 0.00 0.00 0.00 7,788.02
9/10/2017 9/28/2017 3/27/2020 7,728.02 60.00 0.00 0.00 0.00 0.00 0.00 7,788.02
55 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 9/29/2017 3/3/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
51 5400
405.00 60.00 0.00 0.00 0.00 0.00 0.00 465.00
9/10/2017 9/29/2017 3/27/2020 405.00 60.00 0.00 0.00 0.00 0.00 0.00 465.00
55 5400
6,474.37 570.30 0.00 0.00 0.00 0.00 0.00 7,044.67
8/3/2019 8/14/2019 2/28/2020 6,474.37 570.30 0.00 0.00 0.00 0.00 0.00 7,044.67
50 5900
DASE
Trees removal.
5008031909468 Cocohatchee Parks And Recreation
MHCP
Electrical component damage due to an FPL
transformer blown from a lightning strike.
Damage to electrical equipment in Coast Guard
Auxilliary Building and to the Marina and marina
facilities. Fuel computer, vessel pump out
station, radio & A/V equip
5109101706703 Domestic Animal Services (Stable, Bldg 6)
DASE
Damage to soffit, fascia, and gutters caused by
Hurricane Irma. Stall door facing ripped off door.
5509101706708 Domestic Animal Services ( Immokalee Facility)
DASE
Damage to gutters, downspouts, and outer
insulation of the building caused by Hurricane
Irma
5509101706686 Facilities Management (Duplex Ranch House)
FMGE
Un-rooted tree fell on roof, severe damage to
landscaping.
5109101706701 Domestic Animal Services (Stray Kennel, Bldg
4)
DASE
Insulation exposed and damage to gutters
during the Hurricane Irma.
5109101706702 Domestic Animal Services (Isolation Kennel,
Bldg 5)
DASE
During Hurricane Irma, gutters were damaged
and the outer insulation of the building exposed.
5509101706636 Library Division (South Regional Branch)
LIBE
Hurricane Irma winds knocked down trees and
branches throughout property.
5309101706933 Tony Rosbough Park
MHCP
Hurricane Irma caused damage at Tony
Rosbough Park.
5109101706697 Domestic animal Services (Vet Clinic, Bldg 2)
16.E.3.a
Packet Pg. 803 Attachment: All Lines Closed Claim Report 2nd QTR FY 20 (12233 : Ratification of Claim FIles Closed by
6,228.00 0.00 0.00 0.00 0.00 0.00 0.00 6,228.00
9/10/2017 11/22/2017 3/27/2020 6,228.00 0.00 0.00 0.00 0.00 0.00 0.00 6,228.00
55 5400
1,125.00 0.00 0.00 0.00 0.00 0.00 0.00 1,125.00
9/10/2017 1/28/2019 3/27/2020 1,125.00 0.00 0.00 0.00 0.00 0.00 0.00 1,125.00
55 5400
585.00 60.00 0.00 0.00 0.00 0.00 0.00 645.00
9/10/2017 9/28/2017 3/31/2020 585.00 60.00 0.00 0.00 0.00 0.00 0.00 645.00
55 5400
50,249.35 60.00 0.00 0.00 0.00 0.00 0.00 50,309.35
9/10/2017 10/16/2017 2/29/2020 50,249.35 60.00 0.00 0.00 0.00 0.00 0.00 50,309.35
53 5400
108,245.03 60.00 0.00 64,030.78 0.00 0.00 0.00 108,305.03
9/10/2017 12/5/2017 2/29/2020 108,245.03 60.00 0.00 64,030.78 0.00 0.00 0.00 108,305.03
53 5400
138,943.85 60.00 0.00 7,199.98 0.00 0.00 0.00 139,003.85
9/10/2017 12/15/2017 2/29/2020 138,943.85 60.00 0.00 7,199.98 0.00 0.00 0.00 139,003.85
51 5400
3,480.00 0.00 0.00 0.00 0.00 0.00 0.00 3,480.00
9/10/2017 11/17/2017 3/27/2020 3,480.00 0.00 0.00 0.00 0.00 0.00 0.00 3,480.00
55 5400
39,995.01 60.00 0.00 39,995.01 0.00 0.00 0.00 40,055.01
9/10/2017 10/20/2017 2/29/2020 39,995.01 60.00 0.00 39,995.01 0.00 0.00 0.00 40,055.01
51 5400
1,039.50 0.00 0.00 0.00 0.00 0.00 0.00 1,039.50
9/10/2017 11/28/2018 3/27/2020 1,039.50 0.00 0.00 0.00 0.00 0.00 0.00 1,039.50
55 5400
168,000.66 60.00 0.00 0.00 0.00 0.00 0.00 168,060.66
9/10/2017 10/20/2017 2/29/2020 168,000.66 60.00 0.00 0.00 0.00 0.00 0.00 168,060.66
51 5400
5109101707013 Parks & Recreation Division (ENCP)
MHCP
Hurricane Irma damaged the walls and siding of
the Pickleball Bldg. There is also a broken
window and damage to the flooring.
MHCP
Soffit missing from the field house between the
baseball and softball field after Hurricane Irma.
5509101708506 Golden Gate Government Center
FMGE
Hurricane Irma debris cleanup.
5509101704007 Immokalee Jail Center
FMGE
Hurricane Irma scattered tree debris at the
property.
5109101707018 Parks & Recreation Division (ELCP)
MHCP
Hurricane Irma winds damaged the roof of the
picnic pavilion, fences, netting, dugouts and
bleachers of the baseball fields, light poles, and
playground equipment.
5109101707294 Parks & Recreation (Vineyards Community
Park)
MHCP
During Hurricane Irma several leaks were
discovered throughout the community center,
damages to ceiling tiles, and water intrusion
through front entrance doors and glass
windows.
5309101706960 Cindy Mysels Park
MHCP
Hurricane Irma caused damage at Cindy Mysels
Park.
5309101707223 Parks & Recreations (Maxx Hasse Park)
FMGE
Hurricane Irma scattered trees debris
throughout the property.
5509101706668 Emergency Management Service (Station 21)
EMSE
Minor debris removal from parking lot
5509101707176 Emergency Management Services
EMSE
Debris cleanup required after Hurricane Irma.
5509101704012 Facilities Management (Marco Island Tax
Collector)
16.E.3.a
Packet Pg. 804 Attachment: All Lines Closed Claim Report 2nd QTR FY 20 (12233 : Ratification of Claim FIles Closed by
9,621.14 60.00 0.00 0.00 0.00 0.00 0.00 9,681.14
9/10/2017 9/26/2017 2/29/2020 9,621.14 60.00 0.00 0.00 0.00 0.00 0.00 9,681.14
51 5400
139,228.47 60.00 0.00 71,533.99 0.00 0.00 0.00 139,288.47
9/10/2017 10/20/2017 2/29/2020 139,228.47 60.00 0.00 71,533.99 0.00 0.00 0.00 139,288.47
53 5400
124,966.77 60.00 0.00 36,425.55 0.00 0.00 0.00 125,026.77
9/10/2017 9/25/2017 3/9/2020 124,966.77 60.00 0.00 36,425.55 0.00 0.00 0.00 125,026.77
51 5400
8,780.00 60.00 0.00 0.00 0.00 0.00 0.00 8,840.00
9/10/2017 9/27/2017 3/27/2020 8,780.00 60.00 0.00 0.00 0.00 0.00 0.00 8,840.00
55 5400
24,129.21 60.00 0.00 0.00 0.00 0.00 0.00 24,189.21
9/10/2017 12/18/2017 2/29/2020 24,129.21 60.00 0.00 0.00 0.00 0.00 0.00 24,189.21
51 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 12/18/2017 3/9/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400
15,862.50 60.00 0.00 2,734.34 0.00 0.00 0.00 15,922.50
9/10/2017 10/17/2017 2/29/2020 15,862.50 60.00 0.00 2,734.34 0.00 0.00 0.00 15,922.50
55 5400
22,661.13 60.00 0.00 0.00 0.00 0.00 0.00 22,721.13
9/10/2017 11/16/2017 2/29/2020 22,661.13 60.00 0.00 0.00 0.00 0.00 0.00 22,721.13
51 5400
MHCP
Trees down/ debris at Caxambas Park due to
Hurricane Irma.
5109101707150 Parks & Recreation Div. (NCRP Exhibit Hall)
MHCP
Hurricane Irma caused damages to green
shade panels. There are missing wall boards, a
broken window, wet carpet due to water
intrusion, scrupper down, and electrical lines
down.
5309101707311 Library Division (Headquarters Branch)
LIBE
Hurricane Irma damaged the irrigation cover
and broke various light pole globes at the
courtyard.
5509101706981 Caxambas Park
LIBE
Hurricane Irma winds knocked down numerous
trees, branches and scattered debris throughout
property.
5109101707310 Library Division (Headquarters Branch)
LIBE
Hurricane Irma caused damages to the ceramic
roof tiles at the library headquarters .
5109101706594 Library Division (Senior Resouce Center)
LIBE
Hurricane Irma wind tore off multiple roof
shingles and multiple gutters.
5509101706646 Library Division (Marco Island Branch)
LIBE
Hurricane Irma winds blew off parts of the
aluminum roof off, soffit on the east side of
building and gutters on east side of building;
ceiling tile damaged.
5309101707014 Parks & Recreation Division (ENCP)
MHCP
Hurricane Irma destroyed the bleachers; the
roof of the pavilion has missing shingles and
leaks; damage to pickleball shade structure and
soccer fields fences; shingles missing from
shuffleboard pavilion; small shade structure
panels ripped, light poles.
5109101706597 Library Divison (Estates Branch)16.E.3.a
Packet Pg. 805 Attachment: All Lines Closed Claim Report 2nd QTR FY 20 (12233 : Ratification of Claim FIles Closed by
25,661.00 60.00 0.00 26,245.53 0.00 0.00 0.00 25,721.00
9/10/2017 10/20/2017 2/29/2020 25,661.00 60.00 0.00 26,245.53 0.00 0.00 0.00 25,721.00
53 5400
232,999.20 4,860.00 0.00 108,271.78 0.00 0.00 0.00 237,859.20
9/10/2017 11/6/2017 2/29/2020 232,999.20 4,860.00 0.00 108,271.78 0.00 0.00 0.00 237,859.20
53 5400
82,580.26 60.00 0.00 74,604.67 0.00 0.00 0.00 82,640.26
9/10/2017 11/6/2017 3/9/2020 82,580.26 60.00 0.00 74,604.67 0.00 0.00 0.00 82,640.26
51 5400
4,512.77 60.00 0.00 1,604.12 0.00 0.00 0.00 4,572.77
9/10/2017 11/16/2017 3/9/2020 4,512.77 60.00 0.00 1,604.12 0.00 0.00 0.00 4,572.77
51 5400
1,943.40 60.00 0.00 0.00 0.00 0.00 0.00 2,003.40
9/10/2017 12/5/2017 3/10/2020 1,943.40 60.00 0.00 0.00 0.00 0.00 0.00 2,003.40
51 5400
4,121.45 60.00 0.00 0.00 0.00 0.00 0.00 4,181.45
9/10/2017 12/5/2017 3/10/2020 4,121.45 60.00 0.00 0.00 0.00 0.00 0.00 4,181.45
51 5400
26,355.65 60.00 0.00 9,701.42 0.00 0.00 0.00 26,415.65
9/10/2017 10/20/2017 3/27/2020 26,355.65 60.00 0.00 9,701.42 0.00 0.00 0.00 26,415.65
55 5400
4,479.46 60.00 0.00 2,760.45 0.00 0.00 0.00 4,539.46
9/10/2017 12/18/2017 3/31/2020 4,479.46 60.00 0.00 2,760.45 0.00 0.00 0.00 4,539.46
53 5400
MHCP
Hurricane Irma blew away the ceiling tiles at
shuffleboard pavilion 2.
5509101707020 Parks & Recreation Division (ELCP)
MHCP
Hurricane Irma knocked down several trees
through out the property.
5309101707309 Parks & Recreation (Vineyards Community
Park)
MHCP
Hurricane Irma winds damaged the roof of the
maintenance building.
5109101707222 Parks & Recreation (Maxx Hass Basketball
Shelter)
MHCP
Hurricane Irma damaged the roof and pylons
cushions of the basketball shelter.
5109101707151 Parks & Recreation Div. (NCRP Rec Plex Bldg)
MHCP
Hurricane Irma caused leaks inside the building
damaging ceiling tiles, hardi board missing from
exterior walls, water intrusion, several panels
down.
5109101707220 Parks & Recreation (Maxx Hasse Maintenance
Bldg)
MHCP
During Hurricane Irma the mechanical pit
containing the electrical panel and 2 motors
flooded. Damaged fences from fallen trees,
misc. gates out of alignment. Damages to pool
tower, benches, pool slides, electric boxes, and
misc. property in the open.
5109101707100 Parks & Recreation Div. (NCRP Admin Bldg)
MHCP
Hurricane Irma caused multiple ceiling and
window leaks staining windows, damaged
ceiling tiles and venetian blinds. Destroyed the
exterior green shade panels and some of the
building sidings were blown off.
5309101707019 Parks & Recreation Division (ELCP)
MHCP
Hurricane Irma caused damages to several
sections of fences through the property; the
bleachers on fields # 2,3,& 4, a bench, a sign,
athletic lights, light fixtures and bulbs; athletic
light pole base was breached on West soccer
field.
5309101707101 Parks & Recreation Div. (NCRP)
16.E.3.a
Packet Pg. 806 Attachment: All Lines Closed Claim Report 2nd QTR FY 20 (12233 : Ratification of Claim FIles Closed by
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 10/10/2017 2/26/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400
78,939.48 60.00 0.00 61,274.07 0.00 0.00 0.00 78,999.48
9/10/2017 10/10/2017 2/29/2020 78,939.48 60.00 0.00 61,274.07 0.00 0.00 0.00 78,999.48
51 5400
9/10/2017 10/11/2017 3/27/2020 8,012.64 0.00 0.00 0.00 0.00 0.00 0.00 8,012.64
55 5400
2,295.00 60.00 0.00 0.00 0.00 0.00 0.00 2,355.00
9/10/2017 9/22/2017 3/30/2020 2,295.00 60.00 0.00 0.00 0.00 0.00 0.00 2,355.00
55 5400
73,850.61 60.00 0.00 0.00 0.00 0.00 0.00 73,910.61
9/10/2017 9/22/2017 2/29/2020 73,850.61 60.00 0.00 0.00 0.00 0.00 0.00 73,910.61
51 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 9/22/2017 2/29/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
51 5400
206,167.84 60.00 0.00 235,276.89 0.00 0.00 0.00 206,227.84
9/10/2017 9/25/2017 2/29/2020 206,167.84 60.00 0.00 235,276.89 0.00 0.00 0.00 206,227.84
51 5400
13,142.17 60.00 0.00 11,783.87 0.00 0.00 0.00 13,202.17
9/10/2017 9/25/2017 3/5/2020 13,142.17 60.00 0.00 11,783.87 0.00 0.00 0.00 13,202.17
53 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 10/9/2017 3/10/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
51 5400
720.00 60.00 0.00 0.00 0.00 0.00 0.00 780.00
9/10/2017 10/13/2017 3/27/2020 720.00 60.00 0.00 0.00 0.00 0.00 0.00 780.00
55 5400
WWTE
Hurricane Irma winds pulled metal double door
from hinges.
5509101706932 Best Friend Park
MHCP
Hurricane Irma winds blew down trees and
scattered debris.
5309101706585 CAT Transfer Station (Davis Blvd)
PTNE
Gate control boxes damaged - covers need
replacement and gates non-operational
5109101706836 Sludge Building #2 (NCWRF-22)
ORMD
Fire extinguisher housings damaged on third
floor. Lightning rod broken off. Convex "blind
spot" mirror separated from mount.
5109101706584 CAT Transfer Station (Davis Blvd)
PTNE
Multiple leaks found in building interior ceiling,
gutters fell off building and need replacement;
west perimeter wall damaged in multiple places.
5109101706562 Growth Management Div. (2800 Horseshoe Dr.
Bldg)
ORMD
During Hurricane Irma, 6 areas of ceiling leaks
were found that caused damages to some
areas of the bldg.
5109101706567 Growth Management Div. (Parking Garage)
MUSE
Hurricane Irma winds knocked down trees and
scattered debris throughout property. Multiple
fruit trees damaged.
5509101706566 Growth Management Div. (C&M Transportation)
OPRS
Multiple trees in parking lot and landscaped
areas have broken or missing limbs. Several
palm trees missing crowns or with spear
damage.
5109101706871 Everglades Museum
MUSE
Raised floor boards; mud throughout interior of
building.
Immokalee Pioneer Museum General Site
5309101706867 Everglades Museum (Grounds)
MUSE
Multiple signs damaged.
16.E.3.a
Packet Pg. 807 Attachment: All Lines Closed Claim Report 2nd QTR FY 20 (12233 : Ratification of Claim FIles Closed by
1,468.22 60.00 0.00 0.00 0.00 0.00 0.00 1,528.22
9/10/2017 10/13/2017 3/27/2020 1,468.22 60.00 0.00 0.00 0.00 0.00 0.00 1,528.22
55 5400
9,261.92 60.00 0.00 7,397.94 0.00 0.00 0.00 9,321.92
9/10/2017 10/19/2017 3/27/2020 9,261.92 60.00 0.00 7,397.94 0.00 0.00 0.00 9,321.92
55 5400
157.50 60.00 0.00 0.00 0.00 0.00 0.00 217.50
9/10/2017 12/5/2017 3/27/2020 157.50 60.00 0.00 0.00 0.00 0.00 0.00 217.50
55 5400
3,827.48 60.00 0.00 0.00 0.00 0.00 0.00 3,887.48
9/10/2017 12/8/2017 3/27/2020 3,827.48 60.00 0.00 0.00 0.00 0.00 0.00 3,887.48
55 5400
1,827.73 0.00 0.00 0.00 0.00 0.00 0.00 1,827.73
9/10/2017 12/6/2018 3/30/2020 1,827.73 0.00 0.00 0.00 0.00 0.00 0.00 1,827.73
55 5400
900.00 0.00 0.00 0.00 0.00 0.00 0.00 900.00
9/10/2017 9/27/2017 3/30/2020 900.00 0.00 0.00 0.00 0.00 0.00 0.00 900.00
55 5400
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
9/10/2017 6/26/2019 2/28/2020 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
51 5400
3,757.50 60.00 0.00 0.00 0.00 0.00 0.00 3,817.50
9/10/2017 3/1/2018 3/27/2020 3,757.50 60.00 0.00 0.00 0.00 0.00 0.00 3,817.50
55 5400
8,864.50 0.00 0.00 0.00 0.00 0.00 0.00 8,864.50
9/10/2017 10/24/2017 3/27/2020 8,864.50 0.00 0.00 0.00 0.00 0.00 0.00 8,864.50
55 5400
334.50 60.00 0.00 0.00 0.00 0.00 0.00 394.50
9/10/2017 10/12/2017 3/30/2020 334.50 60.00 0.00 0.00 0.00 0.00 0.00 394.50
55 5400
5509101706906 Airport Park (Grounds)
MHCP
Hurricane Irma winds scattered tree limbs and
debris throughout property.
MHCP
Debris clean up at Rich King Memorial
Greenway due to Hurricane Irma.
5509101707047 Gordon River Greenway
MHCP
Hurricane Irma's winds knocked down several
trees throughout the property.
5109101709310 Wastewater Division - NCWRF Tanks
Damages
WWTE
Loss of power causing raw sewage to backup at
lift stations, vacuum trucks collected sewage
and transported to plant for treatment,
downstream plant components subjected to
excessive amounts of grit & debris which has
caused a reduction of capacity.
5509101707736 Parks & Recreation Div. (Rich King Greenway)
MHCP
Hurricane Irma scattered debris throughout the
property.
5509101704010 Immokalee Government Center
SOWE
Hurricane Irma scattered debris throughout the
property.
5509101707244 Parks & Recreation (Palm Springs Park)
MHCP
Hurricane Irma knocked down some trees and
scattered tree debris through out the park
property.
5509101708537 Parks & Recreation Division (Oil Well Park)
MHCP
Lots of tree debris brought by Hurricane Irma
winds.
5509101707230 Parks & Recreation (Naples Manor Tot Park)
MHCP
Hurricane Irma knocked down a tree at the
park.
5509101706940 Bluebill Beach Access #8
MHCP
Hurricane Irma caused damage at Bluebill
Beach Access
5509101706995 Parks & Recreation Div. (Goodland Boat Park)
16.E.3.a
Packet Pg. 808 Attachment: All Lines Closed Claim Report 2nd QTR FY 20 (12233 : Ratification of Claim FIles Closed by
2,000.00 60.00 0.00 0.00 0.00 0.00 0.00 2,060.00
9/10/2017 10/10/2017 3/30/2020 2,000.00 60.00 0.00 0.00 0.00 0.00 0.00 2,060.00
55 5400
28,078.77 0.00 0.00 76,195.27 0.00 0.00 0.00 28,078.77
9/10/2017 10/9/2017 3/10/2020 28,078.77 0.00 0.00 76,195.27 0.00 0.00 0.00 28,078.77
51 5400
112,343.65 60.00 0.00 0.00 0.00 0.00 0.00 112,403.65
9/10/2017 10/9/2017 3/10/2020 112,343.65 60.00 0.00 0.00 0.00 0.00 0.00 112,403.65
53 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 10/9/2017 3/10/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
51 5400
6,106.50 0.00 0.00 0.00 0.00 0.00 0.00 6,106.50
9/10/2017 9/22/2017 3/30/2020 6,106.50 0.00 0.00 0.00 0.00 0.00 0.00 6,106.50
55 5400
57,401.91 60.00 0.00 0.00 0.00 0.00 0.00 57,461.91
9/10/2017 9/20/2017 2/29/2020 57,401.91 60.00 0.00 0.00 0.00 0.00 0.00 57,461.91
51 5400
2,550.50 0.00 0.00 0.00 0.00 0.00 0.00 2,550.50
9/10/2017 9/20/2017 3/30/2020 2,550.50 0.00 0.00 0.00 0.00 0.00 0.00 2,550.50
55 5400
98,840.56 60.00 0.00 0.00 0.00 0.00 0.00 98,900.56
9/10/2017 10/5/2017 3/17/2020 98,840.56 60.00 0.00 0.00 0.00 0.00 0.00 98,900.56
53 5400
5,076.50 60.00 0.00 54,283.45 0.00 0.00 0.00 5,136.50
9/10/2017 10/5/2017 2/29/2020 5,076.50 60.00 0.00 54,283.45 0.00 0.00 0.00 5,136.50
51 5400
5109101706771 Public Utilities Department, Water, PUOC -
West Building, Location #755
WATE
Water intrusion, ceiling tiles, walls, roof leaks
on N/S sections of building, ceiling tiles,
windows/walls, baseboards, exterior window
awnings, garage doors, interior flooring,
elevator, & AC all sustaining damage. Mold
remediation & IAQ test needed.
TXCE
Hurricane Irma caused tree & shrub damage.
5309101706766 PUD (NE Service Area)
PSVE
Hurricane Irma winds blew down trees
damaging multiple areas of fencing. Ladder on
storage tanks damaged
5109101706521 Property Appraiser (Radio Rd)
PRAE
Hurricane Irma damaged the exterior east
porch, se corner of roof, porch door and porte
cochere.
5509101706516 Tax Collector
WWTE
Steel roll down stainless door broken by
Hurricane Irma wind.
5509101706559 Growth Management Div. (Transportation
Wilson House)
OPRS
Tree limbs and debris, tree down on water well
head.
5309101706833 NCWRF General Site & Solar Panels
WWTE
Hurricane Irma winds damaged gate. Entry and
exit gates damaged; fencing broken; solar
panels
5109101706835 Pretreatment Building 53
MUSE
Trees and branches knocked down by
Hurricane Irma winds; debris scattered
throughout grounds.
5109101706832 Operations Building (61) NCWRF
WWTE
Several area of roof tile and soffit are damaged.
Wind driven rain damaged louver roof vents,
plywood, and double doors..
5509101706856 Rosemary Cemetery Site 16.E.3.a
Packet Pg. 809 Attachment: All Lines Closed Claim Report 2nd QTR FY 20 (12233 : Ratification of Claim FIles Closed by
142,091.00 60.00 0.00 0.00 0.00 0.00 0.00 142,151.00
9/10/2017 10/5/2017 3/23/2020 142,091.00 60.00 0.00 0.00 0.00 0.00 0.00 142,151.00
51 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 10/5/2017 3/23/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400
226,114.13 60.00 0.00 210,024.27 0.00 0.00 0.00 226,174.13
9/10/2017 10/3/2017 2/26/2020 226,114.13 60.00 0.00 210,024.27 0.00 0.00 0.00 226,174.13
51 5400
6,519.10 60.00 0.00 0.00 0.00 0.00 0.00 6,579.10
9/10/2017 10/3/2017 2/29/2020 6,519.10 60.00 0.00 0.00 0.00 0.00 0.00 6,579.10
53 5400
247.50 60.00 0.00 0.00 0.00 0.00 0.00 307.50
9/10/2017 10/4/2017 3/30/2020 247.50 60.00 0.00 0.00 0.00 0.00 0.00 307.50
55 5400
1,535.00 60.00 0.00 0.00 0.00 0.00 0.00 1,595.00
9/10/2017 10/4/2017 3/30/2020 1,535.00 60.00 0.00 0.00 0.00 0.00 0.00 1,595.00
55 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 10/3/2017 3/16/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
51 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 2/15/2018 3/16/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
51 5400
WATE
Hurricane Irma winds damaged the roof,
causing ceiling tile to be damaged. Garage
rollup doors damaged. All wind socks
destroyed.
5109101707664 Public Utilities Department, SCRWTP, Annex
Building, Location #665
WATE
Ceiling tiles damaged. Warehouse several
leaks.
5509101706756 Public Utilities Dept. (N Collier Recycling Drop-
off)
SOWE
Hurricane Irma winds caused minor tree
damage.
5109101706735 Public Utilities Department, Water Division,
SCRWTP Operations Building
SHEE
Fence damaged by fallen trees and wind during
Hurricane Irma.
5509101706752 Public Utilities Dept. (Marco Island Recycling
Ctr.)
SOWE
Hurricane Irma winds knocked down trees and
scattered debris throughout property.
5109101706740 Collier County Sheriff Office ( Marco Joint
Marine Op. Center)
SHEE
Hurricane Irma caused significant damage to
the roof and gutters of the building. Water
intrusion through structural damage caused
significant damage to the carpet.
5309101706742 Collier County Sheriff Office (Marco Joint Op.
Center)
WATE
Hurricane Irma winds damaged roof, causing
leaks in ceiling on north & south of building.
Water intrusion through walls & windows,
ceiling tile & carpet damaged in multiple
locations. Window awnings damaged. Elevators
making loud noise, and roll-up doors
5309101706774 Public Utilities Department, Water, PUOC -
West Building, Location #755
WATE
Fence, signs, and posts damaged as a result of
Hurricane IRMA.
5109101706767 Public Utilities Department (OC East Bldg)16.E.3.a
Packet Pg. 810 Attachment: All Lines Closed Claim Report 2nd QTR FY 20 (12233 : Ratification of Claim FIles Closed by
0.00 0.00 0.00 21,537.71 0.00 0.00 0.00 0.00
10/6/2018 10/7/2018 3/16/2020 0.00 0.00 0.00 21,537.71 0.00 0.00 0.00 0.00
53 5900
2,800.00 60.00 0.00 0.00 0.00 0.00 0.00 2,860.00
9/10/2017 2/6/2018 2/29/2020 2,800.00 60.00 0.00 0.00 0.00 0.00 0.00 2,860.00
55 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 10/6/2017 3/10/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
51 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 10/6/2017 3/10/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
51 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 10/6/2017 3/10/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
51 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 2/6/2018 3/10/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
51 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 4/17/2018 3/10/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
51 5400
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
9/10/2017 4/17/2018 3/10/2020 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
51 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 2/6/2018 3/23/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
51 5400
WWTE
Existing roof needs cleaned and freed of all
debris.
5109101707489 Public Utilities Department, NESA, Location
#519
WWTE
Extensive damages to RO building exterior
panels, roll-up doors, roof, and light fixtures.
Superstructure roof, interior finishes, lighting,
and HVAC units sustained damages.
5109101707880 Public Utilities Department, Wastewater,
NCWRF Bldg 16 - Electrical Building, Location
#473
WWTE
Roof and gutters contain debris needing
removal, damage to downspouts.
5109101707888 Public Utilities Department, Wastewater,
NCWRF - Building 26 Reuse Pump Station,
Location #486
WWTE
SW corner door loosened and out of alignment
by Hurricane Irma winds.
5109101707486 Public Utilities Department, Wastwater Capital,
NCWRF - Bldg 81 - Press Building, Location
#489
WWTE
Overhead Garage Door Damage
5109101706824 Injection Well Building NCWRF 25
WWTE
Hurricane Irma wind broke two scupper and
downspouts; broken steel door SE corner.
5109101706825 Generator Elec. Building NCWRF 20
WWTE
Landscaping and tree removal needed.
5109101706822 NCWRF Blower Bldg. 83
WWTE
Double steel door dented and flashing blown off
from Hurricane Irma winds.
5310061808349 Wellfield
WATE
Sometime after Staff left Well No. 5 in the
Tamiami Well Field Fri. & early Sat. morning
when a neighbor informed us of a flood coming
from a well house the check valve in the well
failed causing major damage to the well house
& equipment.
5509101707491 Public Utilities Department, NESA, General Site
16.E.3.a
Packet Pg. 811 Attachment: All Lines Closed Claim Report 2nd QTR FY 20 (12233 : Ratification of Claim FIles Closed by
109.00 60.00 0.00 0.00 0.00 0.00 0.00 169.00
9/10/2017 2/6/2018 3/23/2020 109.00 60.00 0.00 0.00 0.00 0.00 0.00 169.00
53 5400
3,670.90 60.00 0.00 0.00 0.00 0.00 0.00 3,730.90
9/10/2017 10/5/2017 3/27/2020 3,670.90 60.00 0.00 0.00 0.00 0.00 0.00 3,730.90
55 5400
517.50 60.00 0.00 0.00 0.00 0.00 0.00 577.50
9/10/2017 10/5/2017 3/30/2020 517.50 60.00 0.00 0.00 0.00 0.00 0.00 577.50
55 5400
642.50 0.00 0.00 0.00 0.00 0.00 0.00 642.50
9/10/2017 1/15/2019 3/27/2020 642.50 0.00 0.00 0.00 0.00 0.00 0.00 642.50
55 5400
247.50 0.00 0.00 0.00 0.00 0.00 0.00 247.50
9/10/2017 1/15/2019 3/27/2020 247.50 0.00 0.00 0.00 0.00 0.00 0.00 247.50
55 5400
1,530.00 60.00 0.00 0.00 0.00 0.00 0.00 1,590.00
9/10/2017 10/6/2017 3/30/2020 1,530.00 60.00 0.00 0.00 0.00 0.00 0.00 1,590.00
55 5400
360.00 60.00 0.00 0.00 0.00 0.00 0.00 420.00
9/10/2017 10/6/2017 3/30/2020 360.00 60.00 0.00 0.00 0.00 0.00 0.00 420.00
55 5400
630.00 60.00 0.00 0.00 0.00 0.00 0.00 690.00
9/10/2017 10/6/2017 3/30/2020 630.00 60.00 0.00 0.00 0.00 0.00 0.00 690.00
55 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 2/13/2018 1/21/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400
4,800.00 60.00 0.00 0.00 0.00 0.00 0.00 4,860.00
9/10/2017 2/6/2018 1/30/2020 4,800.00 60.00 0.00 0.00 0.00 0.00 0.00 4,860.00
54 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 2/12/2018 1/30/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400
25,746.37 60.00 0.00 0.00 0.00 0.00 0.00 25,806.37
9/10/2017 9/20/2017 1/30/2020 25,746.37 60.00 0.00 0.00 0.00 0.00 0.00 25,806.37
53 5400
WWTE
Antenna damage.
5309101706524 Property Appraiser (Radio Rd)
PRAE
Hurricane Irma winds knocked down five
parking lot street lights.
5409101707504 Pelican Bay Services Division, Location #541
PELB
Major tree damage needing replacement.
5309101707592 Public Utilities Department, Wastewater
Collections, PS 308.02
WWTE
Hurricane Irma winds blew down several trees.
5309101707614 Public Utilities Department, Wastewater
Collections, PS 312.28
WWTE
Antenna damage.
5509101706816 Master Pump Station #316
WWTE
Hurricane Irma winds blew down several trees.
5509101706817 Master Pump Station #318
WWTE
Trees down/damaged needing removal.
5509101706806 PUD Master Pump Station 310
WWTE
Hurricane Irma winds knocked down trees and
scattered debris throughout property.
5509101708655 Wastewater Division (PS 108.07)
WWTE
Trees needing removal
5509101708658 Wastewater Division (PS 313.04)
WWTE
Hurricane Irma winds knocked down trees and
scattered debris throughout property.
5509101706776 PUD Master Pumpt Station 102
WWTE
Hurricane Irma winds knocked over several
trees.
5309101707490 Public Utilities Department, NESA - East
Generator Shelter
WWTE
East Generator Shelter roof damage, ~100 lf of
perimeter fence damage, and gate damage.
5509101706779 PUD Master Pump Station 103
16.E.3.a
Packet Pg. 812 Attachment: All Lines Closed Claim Report 2nd QTR FY 20 (12233 : Ratification of Claim FIles Closed by
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 10/5/2017 3/23/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
55 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 2/5/2018 3/17/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 2/5/2018 3/10/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
51 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 5/2/2018 1/21/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 2/15/2018 1/21/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
51 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 2/13/2018 1/21/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 2/15/2018 3/16/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
51 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 2/5/2018 1/21/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 2/1/2018 1/21/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 2/8/2018 1/21/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 2/9/2018 1/15/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
51 5400
WWTE
Antenna damage from fallen tree.
5309101707551 Public Utilities Department, Wastewater
Collections, PS 300.22
WWTE
Antenna damage from tree falling.
5109101707571 Public Utilities Department, Wastewater
Collections, PS 303.03
WWTE
Fence Damage
5309101707436 PUD (Glades Pump Station)
WWTE
Fence damages
5109101707655 Public Utilities Department, South County
Regional Water Treatment Plant, Lime Building,
Location #677
WATE
Screening torn at backwash pump and other
areas in lime bldg, Louver damages reported,
Inspector office ceiling tile water damage, and
paint peeling in main entrance.
5309101707474 Public Utilities Department, Wastewater Capital,
MPS 312
WATE
Light fixture damages.
5309101707617 Public Utilities Department, Wastewater
Collections, PS 313.08
WWTE
Broken antenna.
5309101707940 Transportation Engineering Division
(Chokoloskee Bridge)
TECM
Hurricane Irma caused significant damages to
the Chokoloskee Bridge
5109101707662 Public Utilities Department, SCRWTP, Blending
System Building, Location #654
WATE
Approximately 20 lf of fence damage, broken
posts, and toptail damages.
5109101707484 Public Utilities Department, Wastewater Capital,
NCWRF, Location #486
WWTE
HVAC Exhaust Fan on roof damaged and roof
hatch damaged.
5509101706769 PUD Operations Center East Bldg.
WATE
Hurricane Irma winds blew down trees.
5309101707482 Public Utilities Department, Wellfield, NESA
Well B, Location #524
16.E.3.a
Packet Pg. 813 Attachment: All Lines Closed Claim Report 2nd QTR FY 20 (12233 : Ratification of Claim FIles Closed by
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 2/9/2018 1/30/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
51 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 2/9/2018 1/15/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
51 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 2/9/2018 1/15/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
51 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 2/12/2018 1/30/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 2/13/2018 1/21/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400
0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
9/10/2017 2/13/2018 1/21/2020 0.00 60.00 0.00 0.00 0.00 0.00 0.00 60.00
53 5400
3,092,356.52 12,219.88 0.00 1,351,286.36 0.00 0.00 0.00 3,104,576.40
3,092,356.52 12,219.88 0.00 1,351,286.36 0.00 0.00 0.00 3,104,576.40
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
7/5/2018 7/19/2018 2/6/2020 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
60
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
3,124,660.55 17,360.72 107,953.86 1,357,740.29 0.00 0.00 0.00 3,249,975.13
3,124,660.55 17,360.72 107,953.86 1,357,740.29 0.00 0.00 0.00 3,249,975.13
Major Coverage: 60 - Public Officials Errors and Ommissions
6007051808136 LAND MANAGEMENT, SERVICES
ASSOCIATES LLC
LDSD
Action involves a portion of the approved
Development of Regional Impact known as Pine
Air Lakes and the construction of certain
businesses without the requisite Development
Rights.
Total by Major Coverage 1 Claim
WWTE
Antenna damage and leaning panel.
Total by Major Coverage 121 Claims
Grand Totals: 191 Claims
5309101707608 Public Utilities Department, Wastewater
Collections, PS 312.02
WWTE
Antenna damage
5309101707612 Public Utilities Department, Wastewater
Collections, PS 312.15
WWTE
Antenna damage.
5309101707585 Public Utilities Department, Wastewater
Collections, PS 304.15
WWTE
Antenna damage.
5109101707576 Public Utilities Department, Wastewater
Collections, PS 303.06
WWTE
Antenna damage.
5109101707578 Public Utilities Department, Wastewater
Collections, PS 304.02
5109101707567 Public Utilities Department, Wastewater
Collections, PS 302.31
WWTE
Antenna damage
16.E.3.a
Packet Pg. 814 Attachment: All Lines Closed Claim Report 2nd QTR FY 20 (12233 : Ratification of Claim FIles Closed by
Collier County Government
Subrogation Closed Claim Report
2nd QTR FY 2020
Valued as of:4/14/2020
Total Inc Ind/PD/CollExpense RecoveryMed/BI/Comp Deductible Legal Other
Claim Number Claimant Name Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total
Coverage Carrier
Division
Cause
Date of Loss
Accident 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 0.00Code Enforcement Division v.
USAA
4111021808428
1/8/202011/2/2018 11/2/2018 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00CENE
41 Employee Sherri Patterson was
driving west bound on Golden
Gate Blvd. at a slow speed with
flashers on. Another vehicle hit
her from behind, sending the
county vehicle into the County
right-of-way area when it came
to a stop.
3000
1,229.84 0.00 0.00 0.00 1,075.78 0.00 0.00 1,229.84CRA v Assurance America5004231909763
1/31/20204/23/2019 10/31/2019 1,229.84 0.00 0.00 1,075.78 1,229.84 0.00 0.00 0.00CRAE
50 Vehicle accident caused one of
the vehicles to swerve onto our
triangle (median) which led them
to hit pole #8.
3000
0.00 0.00 0.00 0.00 3,860.63 0.00 0.00 0.00Road Maintenance v Allstate
Insurance
5007121909771
2/10/20207/12/2019 11/4/2019 0.00 0.00 0.00 3,860.63 0.00 0.00 0.00 0.00RMSE
50 D1 advised his trac-control
turned off and he lost control . he
attempted to correct this but over
corrected causing the vehicle to
spin. The vehicle spun to the
right about 90 degrees and the
front left bumper/wheel struck
the guardrail.
3000
0.00 0.00 0.00 0.00 302.17 0.00 0.00 0.00Traffic Operations v Infinity
Commercial Auto
5010261909765
2/10/202010/26/2019 10/31/2019 0.00 0.00 0.00 302.17 0.00 0.00 0.00 0.00TECM
50 Stop Sign down due to car
accident.
3000
-1-
7:43:23AM
4/14/2020
16.E.3.b
Packet Pg. 815 Attachment: Subrogation Closed Claim Report 2nd QTR FY 20 (12233 : Ratification of Claim FIles Closed
Collier County Government
Subrogation Closed Claim Report
2nd QTR FY 2020
Valued as of:4/14/2020
Total Inc Ind/PD/CollExpense RecoveryMed/BI/Comp Deductible Legal Other
Claim Number Claimant Name Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total
Coverage Carrier
Division
Cause
Date of Loss
Accident Desc.
Date Report to RiskStatus Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total
6,654.82 0.00 0.00 0.00 0.00 0.00 340.00 6,314.82Road Maintenance v. Jose Elias
Ayala J
5005051909699
2/18/20205/5/2019 10/9/2019 6,314.82 0.00 340.00 0.00 6,654.82 0.00 0.00 0.00RMSE
50 V01 failed to stop at the stop
sign and continued traveling in a
southerly direction. V01 crossed
all lanes of Oil Well Rd and the
front of V01 struck a guardrail
located on the south shoulder of
Oil Well Rd. V01 continued
traveling and ended in a ditch.
3000
6,287.98 0.00 0.00 0.00 6,275.01 0.00 0.00 6,287.98Traffic Operations v. Progressive
Insurance
5006181909730
3/30/20206/18/2019 10/21/2019 6,287.98 0.00 0.00 6,275.01 6,287.98 0.00 0.00 0.00TECM
50 Street light hit.3000
0.00 0.00 0.00 0.00 3,399.90 0.00 0.00 0.00Landscape Operations v
Peachtree Insurance
5008071709816
1/31/20208/7/2017 11/20/2019 0.00 0.00 0.00 3,399.90 0.00 0.00 0.00 0.00RMSE
50 Vehicle 1 failed to yield while
turning & hit Vehicle 2 causing
Vehicle 2 to enter the median
and hit the palm tree and
vegetation. V1 at fault; V2 also
holds some responsibility for
speeding and driving with a
learners license.
3000
0.00 0.00 0.00 0.00 890.00 0.00 0.00 0.00Landscape Operations v Geico5004171709836
1/31/20204/17/2017 11/27/2019 0.00 0.00 0.00 890.00 0.00 0.00 0.00 0.00RMSE
50 Vehicle 1 was traveling
southbound on Collier Blvd & fell
asleep at the wheel. Vehicle 1
left the roadway, went over the
curb and the front center bumper
impacted a medium size palm
tree in the median, knocking it
over.
3000
-2-
7:43:23AM
4/14/2020
16.E.3.b
Packet Pg. 816 Attachment: Subrogation Closed Claim Report 2nd QTR FY 20 (12233 : Ratification of Claim FIles Closed
Collier County Government
Subrogation Closed Claim Report
2nd QTR FY 2020
Valued as of:4/14/2020
Total Inc Ind/PD/CollExpense RecoveryMed/BI/Comp Deductible Legal Other
Claim Number Claimant Name Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total
Coverage Carrier
Division
Cause
Date of Loss
Accident Desc.
Date Report to RiskStatus Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total
0.00 0.00 0.00 0.00 4,451.64 0.00 0.00 0.00Wastewater Division v .
Progressive Insurance
4111111909794
3/30/202011/11/2019 11/12/2019 0.00 0.00 0.00 4,451.64 0.00 0.00 0.00 0.00WWTE
41 Stopped at a Stop sign in the
corner of Collier Blvd (951) and
Championship Dr. A third party
claimant vehicle hit county
vehicle in the rear.
3000
0.00 0.00 0.00 0.00 500.00 0.00 0.00 0.00Traffic Operations v Assurance
America
5304231909107
1/31/20204/23/2019 5/2/2019 0.00 0.00 0.00 500.00 0.00 0.00 0.00 0.00TECM
53 Street light hit.3000
0.00 0.00 0.00 0.00 1,097.86 0.00 0.00 0.00Wastewater Division v. Allstate4108201909485
3/30/20208/20/2019 8/20/2019 0.00 0.00 0.00 1,097.86 0.00 0.00 0.00 0.00WWTE
41 County truck was traveling South
on Santa Barbara. As county
employee approched the
intersection of Santa Barbara
and Davis he stopped before
making a right turn on Davis.
The vehicle behind him failed to
stop, hitting the rear bumper.
3000
35,135.63 0.00 0.00 0.00 2,166.00 35,135.63 0.00 0.00CC v. Jeffrey Nicol4108131808212
1/17/20208/13/2018 8/14/2018 0.00 35,135.63 0.00 2,166.00 35,135.63 0.00 0.00 0.00WWTE
41 Employee drove county vehicle
into a ditch. Damage unknown
reported as undriveable.
Employee was driving county
vehicle on personal time when
accident occurred.
3000
1,233.00 0.00 0.00 0.00 0.00 1,233.00 0.00 0.00EMS4106281909324
2/29/20206/28/2019 6/28/2019 0.00 1,233.00 0.00 0.00 1,233.00 0.00 0.00 0.00EMSE
41 CCEMS T24 driven by GNFD FF
Soto #GN172, made a right hand
turn too sharp and struck the
right rear of CCSO Patrol car
#843 with the right side of the
patient car compartment. Minor
damge to Patrol car.
3000
-3-
7:43:23AM
4/14/2020
16.E.3.b
Packet Pg. 817 Attachment: Subrogation Closed Claim Report 2nd QTR FY 20 (12233 : Ratification of Claim FIles Closed
Collier County Government
Subrogation Closed Claim Report
2nd QTR FY 2020
Valued as of:4/14/2020
Total Inc Ind/PD/CollExpense RecoveryMed/BI/Comp Deductible Legal Other
Claim Number Claimant Name Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total
Coverage Carrier
Division
Cause
Date of Loss
Accident 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 15,569.00 0.00 0.00 0.00EMS v. Geico4103201908943
3/19/20203/20/2019 3/21/2019 0.00 0.00 0.00 15,569.00 0.00 0.00 0.00 0.00EMSE
41 Medic 40 was responding to a
call heading south on Goodlette
Frank Road with their lights and
sirens on, and was rear ended
by a Black Nissan Sentra.
3000
0.00 0.00 0.00 0.00 752.02 0.00 0.00 0.00Public Services v. Safeco4101212010005
3/19/20201/21/2020 1/22/2020 0.00 0.00 0.00 752.02 0.00 0.00 0.00 0.00MHCP
41 While CC2-1248 was stopped
waiting to merge onto westbound
Pine Ridge Road traffic from
Goodlette Road, vehicle was
struck from behind, causing
damage to both vehicles. No
injuries.
3000
0.00 0.00 0.00 0.00 4,542.50 0.00 0.00 0.00Landscape Operations v Allstate5012191709838
3/19/202012/19/2017 11/27/2019 0.00 0.00 0.00 4,542.50 0.00 0.00 0.00 0.00RMSE
50 V1 began to rotate
counterclockwise and crossed
from the outside lane, across the
center lane and into the inside
lane. V01 continued to rotate
and the front right wheel struck
the curb of the raised median
knocking trees down.
3000
0.00 0.00 0.00 0.00 6,004.80 0.00 0.00 0.00Water Division v. Allstate4108221909495
3/19/20208/22/2019 8/22/2019 0.00 0.00 0.00 6,004.80 0.00 0.00 0.00 0.00WATE
41 While at a red light employee
was rear ended in vehicle
CC2-2067 by another driver.
3000
-4-
7:43:23AM
4/14/2020
16.E.3.b
Packet Pg. 818 Attachment: Subrogation Closed Claim Report 2nd QTR FY 20 (12233 : Ratification of Claim FIles Closed
Collier County Government
Subrogation Closed Claim Report
2nd QTR FY 2020
Valued as of:4/14/2020
Total Inc Ind/PD/CollExpense RecoveryMed/BI/Comp Deductible Legal Other
Claim Number Claimant Name Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total
Coverage Carrier
Division
Cause
Date of Loss
Accident 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 0.00Marco Island Executive Airport v .
Allianz Global
5303181908978
1/27/20203/18/2019 4/1/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00OPRS
53 Relates to aircraft incident that
occurred on 3/1/15
(22-03011503910). Aircraft has
been staged at MKY and has
since caused damage to
pavement upon
removal/teardown. See photos
attached.
5900
0.00 0.00 0.00 0.00 25,207.88 0.00 0.00 0.00Wastewater Division v . Cabana
Construction
5003201908939
1/7/20203/20/2019 3/20/2019 0.00 0.00 0.00 25,207.88 0.00 0.00 0.00 0.00WWTE
50 Cabana construction was core
boring and hit 8" county sewer
main along thomasson dr. Does
not appear contractor had a valid
locate ticket.
5900
0.00 0.00 0.00 0.00 38.62 0.00 0.00 0.00Traffic Operations v. Progressive
Insurance
5001082010001
1/24/20201/8/2020 1/22/2020 0.00 0.00 0.00 38.62 0.00 0.00 0.00 0.00TECM
50 Sign down due to car accident.3000
0.00 0.00 0.00 0.00 3,810.00 0.00 0.00 0.00Pelican Bay Servies Division v.
Ocean Harbor
5005311909206
1/2/20205/31/2019 6/3/2019 0.00 0.00 0.00 3,810.00 0.00 0.00 0.00 0.00PELB
50 Vehicle struck streetlight pole
#A66 in median of intersection of
Pelican Bay Blvd and Bay
Colony Dr.
3000
0.00 0.00 0.00 0.00 5,635.00 0.00 0.00 0.00Landscape Operations v LM
General
5011271609820
1/2/202011/27/2016 11/21/2019 0.00 0.00 0.00 5,635.00 0.00 0.00 0.00 0.00RMSE
50 V1 travled north on left lane of
951 Collier Blvd. V2 traveled
south on the left lane of 951
Collier Blvd. V01 traveled to the
left, exiting the road entering the
median. V1's front struck a palm
tree. After collision the tree fell
on top of V2.
3000
-5-
7:43:23AM
4/14/2020
16.E.3.b
Packet Pg. 819 Attachment: Subrogation Closed Claim Report 2nd QTR FY 20 (12233 : Ratification of Claim FIles Closed
Collier County Government
Subrogation Closed Claim Report
2nd QTR FY 2020
Valued as of:4/14/2020
Total Inc Ind/PD/CollExpense RecoveryMed/BI/Comp Deductible Legal Other
Claim Number Claimant Name Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total
Coverage Carrier
Division
Cause
Date of Loss
Accident Desc.
Date Report to RiskStatus Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total Paid Total
0.00 0.00 0.00 0.00 1,763.52 0.00 0.00 0.00Traffic Operations v Progressive
Insurance
5011051909789
1/2/202011/5/2019 11/8/2019 0.00 0.00 0.00 1,763.52 0.00 0.00 0.00 0.00TECM
50 Pedestrian pole down due to car
accident.
3000
0.00 0.00 0.00 0.00 1,477.75 0.00 0.00 0.00Landscape Operations v Allstate5012201709837
3/2/202012/20/2017 11/27/2019 0.00 0.00 0.00 1,477.75 0.00 0.00 0.00 0.00RMSE
50 Driver of vehicle 1 stated he was
talking on his cell phone, looked
down to retrieve his soda, and
drifted off the road hitting a tree .
3000
0.00 0.00 0.00 0.00 3,246.50 0.00 0.00 0.00Landscape Operations v
Standard Fire Insurance
5002111709811
3/19/20202/11/2017 11/19/2019 0.00 0.00 0.00 3,246.50 0.00 0.00 0.00 0.00RMSE
50 Vehicle accident resulting in
damage to median landscape.
3000
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00Landscape Operations v.
Windhaven Ins.
5404031808650
1/28/20204/3/2018 1/15/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00RMSE
54 There was a car accident which
damaged landscape materials
per police report.
3000
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00Road Maintenance Division v.
Hilin Etienne
5312261808813
1/28/202012/26/2018 2/21/2019 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00RMSE
53 There was a car accident which
damaged a Road Maintenace
guardrail. The claim form, OMS
labor tasks, police report and
photos are attached.
3000
949.73 0.00 0.00 0.00 0.00 0.00 45.00 904.73Traffic operations v. Hilin Etienne5312261808621
1/27/202012/26/2018 1/9/2019 904.73 0.00 45.00 0.00 949.73 0.00 0.00 0.00TECM
53 Ped pole, guardrail and
pavement damage from major
car accident.
3000
-6-
7:43:23AM
4/14/2020
16.E.3.b
Packet Pg. 820 Attachment: Subrogation Closed Claim Report 2nd QTR FY 20 (12233 : Ratification of Claim FIles Closed
Collier County Government
Subrogation Closed Claim Report
2nd QTR FY 2020
Valued as of:4/14/2020
Total Inc Ind/PD/CollExpense RecoveryMed/BI/Comp Deductible Legal Other
Claim Number Claimant Name Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total Incurred Total
Coverage Carrier
Division
Cause
Date of Loss
Accident 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 2,503.06 0.00 0.00 0.00Landscape Operations v State
Farm Insurance
5011161909899
2/28/202011/16/2019 12/18/2019 0.00 0.00 0.00 2,503.06 0.00 0.00 0.00 0.00RMSE
50 Vehicle 1 was traveling east on
Pine Ridge Rd, just east of
Airport Pulling Rd, when it drove
off the road and onto the
median. Once on the median, V1
drove over bushes & collided
into 2 trees before merging back
onto Pine Ridge Rd. Alchohol
impaired
3000
0.00 0.00 0.00 0.00 3,791.18 0.00 0.00 0.00Traffic Operations v. Allstate5012291909952
2/28/202012/29/2019 1/9/2020 0.00 0.00 0.00 3,791.18 0.00 0.00 0.00 0.00TECM
50 Street light hit by car.3000
1,049.09 0.00 0.00 0.00 1,742.00 0.00 0.00 1,049.09Traffic Operations v. The
General
5011221809644
1/17/202011/22/2018 9/23/2019 1,049.09 0.00 0.00 1,742.00 1,049.09 0.00 0.00 0.00TECM
50 Vehicle 1 fell asleep and woke
up when he hit the wall on the
south side of Rattlesnake
Hammock Blvd, and also made
contact with light pole.
3000
0.00 0.00 0.00 0.00 139.27 0.00 0.00 0.00Traffic Operations v State Farm
Insurance
5012031909864
3/4/202012/3/2019 12/6/2019 0.00 0.00 0.00 139.27 0.00 0.00 0.00 0.00TECM
50 Sign down from accident.3000
0.00 0.00 0.00 0.00 1,890.87 0.00 0.00 0.00Transportation Engineering
Division v. Granada Insurance
5301051908857
2/28/20201/5/2019 2/28/2019 0.00 0.00 0.00 1,890.87 0.00 0.00 0.00 0.00TECM
53 Mid block crosswalk down from
car accident.
3000
15,786.46
15,786.46
385.00
385.00
36,368.63
36,368.63
102,132.96
102,132.96 0.00
0.00 0.00
0.00
0.00
0.00
52,540.09
52,540.09Grand Totals: 33 Claims
-7-
7:43:23AM
4/14/2020
16.E.3.b
Packet Pg. 821 Attachment: Subrogation Closed Claim Report 2nd QTR FY 20 (12233 : Ratification of Claim FIles Closed
16.E.3.c
Packet Pg. 822 Attachment: Resolution 2004-15 PDF0001 (12233 : Ratification of Claim FIles Closed by the Risk Management Director for Second Quarter FY20)
16.E.3.c
Packet Pg. 823 Attachment: Resolution 2004-15 PDF0001 (12233 : Ratification of Claim FIles Closed by the Risk Management Director for Second Quarter FY20)
16.E.3.c
Packet Pg. 824 Attachment: Resolution 2004-15 PDF0001 (12233 : Ratification of Claim FIles Closed by the Risk Management Director for Second Quarter FY20)
16.E.3.c
Packet Pg. 825 Attachment: Resolution 2004-15 PDF0001 (12233 : Ratification of Claim FIles Closed by the Risk Management Director for Second Quarter FY20)
16.E.3.c
Packet Pg. 826 Attachment: Resolution 2004-15 PDF0001 (12233 : Ratification of Claim FIles Closed by the Risk Management Director for Second Quarter FY20)
16.E.3.c
Packet Pg. 827 Attachment: Resolution 2004-15 PDF0001 (12233 : Ratification of Claim FIles Closed by the Risk Management Director for Second Quarter FY20)