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Home My WebLink About07.a. Loss Control Report00+ 6\. Reserve Paid to Date Paid to $ 35,000.00 Ins Cc Counsel $ 293.80 ServiceMaster $ 3,578.64 ServiceMaster $ 990.00 Claimant 189.75 Round Hill Country Club Closed 4 CCCSD 2014 -15 Loss Control Report SSO New Incident Prior Fiscal Year Incident 25 El Mirador Walnut Creek Ongoing Incident Litigated Matter $ 6,277.98 OVERFLOWS AND PLUMBING REIMBURSEMENTS 9/8/2012 12/5/2013 Status # ID# Loss Type DOL Other Party Address City _ Claimant Open D Closed A 2014032 SSO 12/29/2013 Chubb for E. Sealy 52 Los Cerros Walnut Creek $ Closed 1 2015001 SSO 7/17/2014 Vini Ramsay 973 Hawthorne Dr. Walnut Creek $ Closed 2 2015002 SSO 7/22/2014 Bruce Moen 912 Hawthorne Dr. Walnut Creek $ Closed 3 2015003 PL 8/11/2014 Round Hill Country Club 3169 Round Hill Rd. Alamo $ 00+ 6\. Reserve Paid to Date Paid to $ 35,000.00 Ins Cc Counsel $ 293.80 ServiceMaster $ 3,578.64 ServiceMaster $ 990.00 Claimant 189.75 Round Hill Country Club Closed 4 2015005 SSO 8/25/2014 Hillside Apts. 25 El Mirador Walnut Creek $ - $ 6,277.98 ServiceMaster 9/8/2012 12/5/2013 Tannaz Heaney Bob Burke MH at 212 Ludell Dr. 1067 Glen Rd Uninc. CCC Lafayette $ $ 20,000.00 $ - $ 17,399.00 Claimant Open D 2014025 $ 6,000.17 ServiceMaster Closed 5 2015007 SSO 8/12/2014 LifeGate Church 535 Walnut Ave. Walnut Creek $ - $ 370.62 ServiceMaster Closed 6 2015008 PL 70 & 8/18114 John & Mary Kelly 450 Muller Rd Walnut Creek $ Scott Swinton $ 238.00 Claimant Closed 7 2015009 SSO 9/5/2014 Kidz Planet 2245 Morello Ave. Pleasant Hill $ 1140 Vallecito Ct $ 5,186.01 Claimant $ Denied Closed 1 2015004 GL 7/18/2014 RCR Property Mgt, 928 Main Street Martinez $ 23,376.45 ServiceMaster Closed 8 2015010 PL 8/18 & 8/28/14 Robert Vedovi 328 Camino Sobrante Orinda $ $ 275.00 Claimant Open 9 2015017 SSO 11/18/2014 Adele King 326 E Street Martinez $ 3,974.94 ServiceMaster $ 7,500.00 Open 10 2015020 SSO 12/22/2014 Michelle Hartman 1950 San Luis Rd Walnut Creek $ 6,500.00 2015021 12/22/2014 Mike Balmy 2010 San Luis Rd Walnut Creek $ 500.00 2015022 12/22/2014 Kozyreva Family 975 Wellborne Ct. Walnut Creek $ 15,000.00 Open 11 2015023 SSO 12/29/2014 Mike Dioquino 203- 031 La Salle Martinez $ 11500.00 Total - OF /PR $ 31,000.00 $ 90,937.37 LIABILITY INCIDENTS - OTHER Status # ID# Loss Type DOL Other Party Address City Reserve Paid to Date Paid to Open Inactive B C 2013006 2014018 GL GL 9/8/2012 12/5/2013 Tannaz Heaney Bob Burke MH at 212 Ludell Dr. 1067 Glen Rd Uninc. CCC Lafayette $ $ 20,000.00 $ - $ 17,399.00 Claimant Open D 2014025 GL 10/12/2013 Gilbert & Stacie Enrique: So Cal Resident Danville $ - $ - Inactive F 2014035 GL 7/13/2013 City of Lafayette 4120 Happy Valley Rd Lafayette $ $ - Closed G 2014039 GL 11/2/2013 Scott Swinton Loc: Sycamore Valley R Danville $ $ Denied Closed H 2014041 GL 5/20/2014 Mark DeBaca 1140 Vallecito Ct Lafayette $ $ Denied Closed 1 2015004 GL 7/18/2014 RCR Property Mgt, 928 Main Street Martinez $ $ 13,425.00 Claimant Closed 2 2015006 GL 8/27/2014 Jim Haman 1017 Hacienda Dr. Walnut Creek $ $ 3,470.81 Claimant $ 2,664.63 ServiceMaster $ 785.00 Roto Rooter $ 1,350.16 Claimant Closed 3 2015011 GL 10/27/2014 Bruce Reeves 1025 Hacienda Dr. Walnut Creek $ $ 1,554.00 Claimant Open 4 2015014 GL 10/28/2014 Andy Akay 85 La Espiral Orinda $ $ - Open 5 2015015 GL 11/7/2014 Kim Vogel 69 La Espiral Orinda $ 100.000.00 -r -•• 1 uVn uaiv JV La L.apllal v1111Ua 'D G,OUV.UU 'P Z,UVU.uu uiaimani Inactive 7 2015018 GL 5/23/2014 Valorie Rice 16 Dudley Ct. Pleasant Hill $ - $ - Closed 8 2015019 GL 11/18/2014 Tessa Clute 2379 Roundhill Drive Alamo $ $ 77.00 Claimant Total - Liab. $ 122,500.00 $ 42,725.60 CCCSD 2014 -15 Loss Control Report PROPERTY INCIDENTS Status # ID# Loss DOL Other Party Address City Reserve Paid to Date Paid to Tuna Total - Prop. $ - $ - AUTO INCIDENTS Status # ID# Loss DOL Other Party Location Veh# Reserve Paid to Date Paid to _ Type Inactive 1 2013015 AL BI 1/2/2013 Jocelyn Tam Lafayette #181 Hydro $ 5,000.00 $ Claimant Closed 1 2015012 APD 10/28/2014 Ross Goodheart Morello & Taylor, PH #247 $ $ Closed 2 2015013 APD 10/23/2014 None Treatment Plant #214 $ - $ 2,993.77 Mike's Auto Body Total - Auto $ 5,000.00 $ 2,993.77 Note: Prior fiscal year closed claims have been removed from report. 1212212014