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HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Risk Management; 2013-10-24 (2)Sbred- it . 3801 Ocean Ranch Blvd Suite 101 Oceanside CA 920S6 Phone: 760- 598- 5700 SERVICE RECORD SUMMARY CKRTIFICATE OF DKSTRUCTION PLEASE KEEP THIS FOR YOUR RECORDS (THIS IS NOT AN INVOICE) Customer: 0011889293 CITY OF CARLSBAD- RECORDS .MANAGEMENT 5815 EL CAMINO REAL CARLSBAD CA 92008- SSOl Order #: 8009700753 Order Date: 24.10.2013 Service Type; SHRED - ON- SITE PURGE Contact: PAT DOWNIE Time In: 07:52 AM Time Out: 10:49 AM Material Collected HANKERS/ARCHIVE BOX 141 FILE DRAWER 2 Total: 143 Service Time: 176 Min Customer Signature: PAT DOWNIE CSR Signature: RUBEN JACOBO RECORDS DESTRUCTION AUTHORIZATION FORM DATE: j^ 1113 PAGE 1 OF 15 REQUESTING DEPARTMENT: RISK MANAGEMENT REQUESTER: TERIE ROWLEY DESTRUCTION APPROVALS: / We certify that the records listed below have been retained for the scheduled retention period, required audits have been completed, and no pending or ongoing litigation or investigation involving these records is known to exist. DEPARTMENT HEAD: RECORDS MANAGEMENT: CITY ATTORNEY: BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS PERIOD SMEADSOFT BARCODE (if applicable) RM15 Risk Manager correspondence 2005- 2007 RM16 Incident Reports 2005- 2007 0120-23 CL+2 RM16 Vehicle Accident Reports 2006- 2007 0120-23 CL+2 RM16 Potential Claims 2007 RM16 Potential Loss Recoveries 2007 CU+2 RM16 -• Facility Use Insurance Review Requests 2007 0120-18 CL+2 2004- 2007 RKM19 Allen, Barbara - Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKIVI19 Angels Are From Heaven Closed 2005 0745-20 CL+5 To be filled out once records have been destroyed. ^YES • NO SMEADSOFT BARCODES DELETED BY: RECORD DESTRUaiON COMPLETED BY CERTIFICATE OF DESTRUCTION? DATE: DATE: lO-^B'/^ ^ CARLSBAD This form documents tbe destruction of City records in accordance with the City of Carlsbad Records Management Program. Revised: 7/31/2013 RECORDS DESTRUCTION AUTHORIZATION FORM DATE: PAGE 2 OF 15 REQUESTING DEPARTMENT: RISK MANAGEMENT REQUESTER: TERIE ROWLEY DESTRUCTION APPROVALS: We certify that the records listed below have been retained for the scheduled retention period, required audits have been completed, and no pending or ongoing litigation or investigation involving these records is known to exist. DEPARTMENT HEAD: RECORDS MANAGEMENT: CITY ATTORNEY: BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS PERIOD SMEADSOFT BARCODE (if applicable) RKM19 Armstrong, Thomas-Claim, Other, Violation of Due Process Closed 2005 0745^ CL+5 RKM19 Bantoft, Christina - Claim, Other, Dust due to blasting Closed 2005 0745-20 CL+5 RKM19 Bellaver, John - Claim, Vehicle Comprehensive Closed 2005 0745-20 CL+5 RKM19 Beninatto and Spacinsky-Claim, Tree branch fell Closed 2005 0745-20 CL+5 RKM19 Bennett, Lindsay - Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKM19 Berkuti, Marie - Claim, Tree Roots Closed 2005 0745-20 CL+5 RKM19 Bernard, Glenn - Claim, Tree Roots Closed 2005 0745-20 CL+5 RKM19 Bernard, Glenn - Claim, Tree Root removal damaged mailbox Closed 2005 0745-20 CL+5 RKM19 Bernard, Glenn - Claim, Trip and Fall Closed 2005 0745-20 CL+5 To be filled out once records have been destroyed. RECORD DESTRUCTION COMPLETED BY: CERTIFICATE OF DESTRUCTION? SMEADSOFT BARCODES DELETED BY: • YES • NO DATE: DATE: This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program. Revised: 7/31/2013 CARLSBAD RECORDS DESTRUCTION AUTHORIZATION FORM DATE: PAGE 3 OF 15 REQUESTING DEPARTMENT: RISK MANAGEMENT REQUESTER: TERIE ROWLEY DESTRUCTtON APPROVALS: We certify that the records listed below have been retained for the scheduled retention period, required audits have been completed, and no pending or ongoing litigation or investigation involving these records is known to exist. DEPARTMENT HEAD: RECORDS MANAGEMENT: CITY ATTORNEY: BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS PERIOD SMEADSOFT BARCODE (if applicable) RKM19 Besecker, Megan - Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKM19 Bio-Hydration Research Lab-Claim, Sewer/Water, Tree related Closed 2005 0745-20 CL+5 RKM19 Blacic, Henrietta-Claim, Sewer/Water, Tree related Closed 2005 0745-20 CL+5 RKM19 Bray, Suzanne - Claim, Personal Injury Closed 2005 CL+5 RKM19 Broadway, Gwen - Claim, Other, Emotional and Physical Distress Closed 2005 0745-20 CL+5 RKM19 Budget Rent-A-Car - Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKM19 Bujas, Ann - Claim, Law Enforcement Closed 2005 0745-20 CL+5 RKM19 C. San Dieguito Water Dist. - Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKM19 Carlsbad Comm. Church - Claim, Sewer/Water, Tree related Closed 2005 0745-20 CL+5 To be filled out once records have been destroyed. RECORD DESTRUCTION COMPLETED BY: CERTIFICATE OF DESTRUCTION? • YES SMEADSOFT BARCODES DELETED BY: • NO DATE: DATE: This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program. Revised: 7/31/2013 ,^<^N cn, o, ^ CARLSBAD RECORDS DESTRUCTION AUTHORIZATION FORM DATE: PAGE 4 OF 15 REQUESTING DEPARTMENT: RISK MANAGEMENT REQUESTER: TERIE ROWLEY DESTRUCTION APPROVALS: We certify that the records listed below have been retained for the scheduled retention period, required audits have been completed, ond no pending or ongoing litigation or investigation involving these records is known to exist. DEPARTMENT HEAD: RECORDS MANAGEMENT: CITY ATTORNEY: BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS PERIOD SMEADSOFT BARCODE (if applicable) RKM19 Clute, Mavis-Ciaim, Other, Emotional Distress Closed 2005 0745-20 CL+5" RKM19 Colby, Aldon-Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKM19 Coobatis, Christy-Claim, Sewer/Water, Tree Related Closed 2005 0745-20 CL+5 RKM19 Coon, Kevin-Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKM19 Delaney, Zanita-Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKM19 Desai, Pragnya-Claim, Vehicle Comprehensive Closed 2005 0745-20 CL+5 RKM19 Di Landri, Garett-Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKM19 Dillon, Joseph-Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKM19 Dineen, Kristen-Claim, Vehicle Collision Closed 2005 - 0745-20 CL+5 To be filled out once records have been destroyed. RECORD DESTRUCTION COMPLETED BY: CERTIFICATE OF DESTRUCTION? SMEADSOFT BARCODES DELETED BY: • YES • NO DATE: DATE: ^ CARLSBAD This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program. Revised: 7/31/2013 RECORDS DESTRUCTION AUTHORIZATION FORM DATE: PAGE 5 OF 15 REQUESTING DEPARTMENT: RISK MANAGEMENT REQUESTER: TERIE ROWLEY DESTRUCTION APPROVALS: We certify that the records listed below have been retained for the scheduled retention period, required audits have been completed, and no pending or ongoing litigation or investigation involving these records is known to exist. DEPARTMENT HEAD: RECORDS MANAGEMENT: CITY ATTORNEY: BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS PERIOD SMEADSOFT BARCODE (if applicable) RKM19 Endo, Kristina-Claim, Vehicle Collision Closed 2005 0745-20 CL+5 ^ RKM20 Farmers Ins. Nguyen-Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKM20 Favano, Daniel-Claim, Vehicle Comprehensive Closed 2005 0745-20 CL+5 RKM20 Flower Fields, LLC-Claim, Sewer/Water-Tree related Closed 2005 0745-20 CL+5 RKM20 Gil, Abraham-Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKM20 Gonzalez, Alvaro-Claim, Trip/Fall Closed 2005 CL+5 RKM20 Gonzalez, Martha-Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKM20 Gonzalez, Ruben-Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKM20 Green, Rick-Claim, Vehicle Comprehensive Closed 2005 0745-20 CL+5 To be filled out once records have been destroyed. RECORD DESTRUCTION COMPLETED BY: CERTIFICATE OF DESTRUCTION? SMEADSOFT BARCODES DELETED BY: • YES • NO DATE: DATE: This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program. Revised: 7/31/2013 CARLSBAD RECORDS DESTRUCTION AUTHORIZATION FORM DATE: PAGE 6 OF 15 REQUESTING DEPARTMENT: RISK MANAGEMENT REQUESTER: TERIE ROWLEY DESTRUCTION APPROVALS: We certify that the records listed below have been retained for the scheduled retention period, required audits have been completed, and no pending or ongoing litigation or investigation involving these records is known to exist. DEPARTMENT HEAD: RECORDS MANAGEMENT: CITY ATTORNEY: BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS PERIOD SMEADSOFT BARCODE (if applicable) RKM20 Greenland, Mark-Claim, Vehicle Comprehensive Closed 2005 0745-20 CL+5 RKM20 Heinz & Block, Jessica-Claim, Other, Emotional & Physical Distress Closed 2005 0745-20 CL+5 RKM20 Hjelt, John & Cathy-Claim, Other, Damaged landscape Closed 2005 0745-20 CL+5 RKM20 Ivanovich, Arso-Claim, Law Enforcement - Property Closed 2005 0745-20 CL+5 RKM20 Ivanovich, Arso-Claim,Law Enforcement-Medical Closed 2005 0745-20 CL+5 RKM20 Jamal & Desai, Hanif & Nilam-Claim Vehicle Collision Closed 2005 0745-20 CL+5 RKM20 Jordan, Toby & Brian-Claim, Vehicle Comprehensive Closed 2005 0745-20 CL+5 RKM20 Kaprielian, Gary & Dimitra-Claim, Other, Property Damage and Emotional distress Closed 2005 0745-20 CL+5 RKM20 Kearns, Joseph-Claim, Trip & Fall Closed 2005 CL+5 To be filled out once records have been destroyed. RECORD DESTRUCTION COMPLETED BY: CERTIFICATE OF DESTRUCTION? • YES SMEADSOFT BARCODES DELETED BY: • NO DATE: DATE: ^ CARLSBAD This form documents tbe destruction of City records in accordance with the City of Carlsbad Records Management Program. Revised: 7/31/2013 RECORDS DESTRUCTION AUTHORIZATION FORM DATE: PAGE 7 OF 15 REQUESTING DEPARTMENT: RISK MANAGEMENT REQUESTER; TERIE ROWLEY DESTRUCTION APPROVALS: , We certify that the records listed below have been retained for the scheduled retention period, required audits have been compteted, and no pending or ongoing litigation or investigation involving these records is known to exist. DEPARTMENT HEAD: RECORDS MANAGEMENT: CITY ATTORNEY: BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS PERIOD SMEADSOFT BARCODE (if applicable) RKM20 Kelly, Colleen-Ctaim, Trip and Fall Closed 2005 0746 0745-2O CL+5 RKM20 Kent, Elizabeth-Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKM20 Knudsen, Frank and Judith-Claim, Other, Emotional & Physical Distress Closed 2005 0745-20 CL+5 RKM20 Kovsky, Gregory Alan-Claim, Vehicle Collision Closed 2005 0745-20 CL+5 1/ RKM21 Laguna Terrace, Maggi Barboza- Claim, Sewer/Water, Tree related Closed 2005 0745-20 CL+5 RKM21 Lanphear, William-Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKM21 Launder, Diane-Claim, Tree, Other than Sewer/Water related Closed 2005 0745-20 CL+5 RKM21 Lawrenson, Kenneth-Claim, Sewer/Water, tree related Closed 2005 0745-20 CL+5 RKM21 Leader, Jeff-Claim, Other, Destroyed tires Closed 2005 0745-20 CL+5 To be filled out once records have been destroyed. RECORD DESTRUCTION COMPLETED BY: CERTIFICATE OF DESTRUCTION? • YES SMEADSOFT BARCODES DELETED BY: • NO DATE: DATE: This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program. cn. ^ CARLSBAD Revised: 7/31/2013 RECORDS DESTRUCTION AUTHORIZATION FORM DATE: PAGE 8 OF 15 REQUESTING DEPARTMENT: RISK MANAGEMENT REQUESTER: TERIE ROWLEY DESTRUCTION APPROVALS: We certify that the records listed below have been retained for the scheduled retention period, required audits have been completed, and no pending or ongoing litigation or investigation involving these records Is known to exist. DEPARTMENT HEAD: RECORDS MANAGEMENT: CITY ATTORNEY: BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS PERIOD SMEADSOFT BARCODE (if applicable) RKM21 Levy, Bertha-Claim, Other, Plant damage Closed 2005 0745-20 CL+5 RKM21 Lewis, Thad & Mia-Claim, Tree, Other than Sewer/Water Related Closed 2005 0745-20 CL+5 RKM21 Licata, William-Claim, Vehicle Comprehensive Closed 2005 0745-20 CL+5 RKM21 Loughran, Chris-Claim, Sewer/Water, Tree related Closed 2005 0745-20 CL+5 RKM21 Lukas, Shari-Claim, Other, Drainage Pipe Closed 2005 0745-20 CL+5 RKM21 Marja Acres-Claim, Other, Water run-off Closed 2005 0745-20 CL+5 RKM21 Mason Jacquelyn-Claim, Trip & Fall Closed 2005 0745-20 CL+5 RKM21 Massery, George & Mary-Claim, Tree other than Sewer/Water related Closed 2005 0745-20 CL+5 RKM21 McAnally, Tamara-Claim, Vehicle Collision Closed 2005 0745-20 CL+5 To be filled out once records have been destroyed. RECORD DESTRUCTION COMPLETED BY: CERTIFICATE OF DESTRUCTION? SMEADSOFT BARCODES DELETED BY: • YES • NO DATE: DATE: This form documents the destruction of City records in accordance with tbe City of Carlsbad Records Management Program. Revised: 7/31/2013 CARLSBAD RECORDS DESTRUCTION AUTHORIZATION FORM DATE: PAGE 9 OF 15 REQUESTING DEPARTMENT: RISK MANAGEMENT REQUESTER: TERIE ROWLEY DESTRUCTION APPROVALS: We certify that the records listed below have been retained for the scheduled retention period, required audits have been completed, and no pending or ongoing litigation or investigation involving these records is known to exist. DEPARTMENT HEAD: RECORDS MANAGEMENT: CITY ATTORNEY: BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS PERIOD SMEADSOFT BARCODE (if applicable) RKM21 McComas, Audrey-Claim, Sewer/Water Related Closed 2005 0745-20 CL+5 RKM21 Mercury Insurance Co.-Clatm, Tree Other than Sewer/Water related Closed 2005 0745-20 CL+5 RKM2i Mertes, Robert-Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKM21 Montgomery, Ronatd-Claim, Tree, Other than Sewer/Water related Closed 2005 0745-20 CL+5 RKM21 Morgan, Bruce & Andrea-Claim, Other, Property damage Closed 2005 0745-20 CL+5 RKM21 Murrell, Teresa-Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKM21 Nakaji, Connie-Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKM21 Nash, Norman-Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKM21 Niemi, Jeff-Claim, Tree, Other than Sewer/Water related Closed 2005 0745-20 CL+5 To be filled out once records have been destroyed. RECORD DESTRUCTION COMPLETED BY: CERTIFICATE OF DESTRUCTION? • YES SMEADSOFT BARCODES DELETED BY: • NO DATE: DATE: This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program. 4cAi<[sBAD Revised: 7/31/2013 RECORDS DESTRUCTION AUTHORIZATION FORM DATE: PAGE 10 OF 15 REQUESTING DEPARTMENT: RISK MANAGEMENT REQUESTER: TERIE ROWLEY DESTRUCTION APPROVALS: We certify that the records listed below have been retained for the scheduled retention period, required audits have been completed, and no pending or ongoing litigation or investigation involving these records is known to exist. DEPARTMENT HEAD: RECORDS MANAGEMENT: CITY ATTORNEY: BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS PERIOD SMEADSOFT BARCODE (if applicable) RKM21 Obenberger, Bob-Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKM21 O'Donoghue, William-Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKM21 Olson, Lester-Claim, Tree, other than Sewer/Water related Closed 2005 0745-20 CL+5 RKM21 Palay, Susan & Elliott-Claim, Other, Emotional and Physical distress Closed 2005 0745-20 CL+5 RKM21 Peck, Edna-Claim, Tree, Other than Sewer/Water related Closed 2005 0745-20 CL+5 RKM21 Pelican Cove Inn B&B-Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKM21 Porter, Cynthia-Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKM21 Prentice, Angela-Claim, Vehicle Collision Cfosed 2005 0745-20 CL+5 RKM21 Rancho Carlsbad HOA-Claim, Other, Defective Construction Closed 2005 0745-20 CL+5 To be filled out once records have been destroyed. RECORD DESTRUCTION COMPLETED BY: CERTIFICATE OF DESTRUCTION? • YES SMEADSOFT BARCODES DELETED BY: • NO DATE: DATE: 4fc This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program. Revised: 7/31/2013 CARLSBAD RECORDS DESTRUCTION AUTHORIZATION FORM DATE: PAGE 11 OF 15 REQUESTING DEPARTMENT: RISK MANAGEMENT REQUESTER: TERIE ROWLEY DESTRUCTJON APPROVALS; We certify that the records listed below have been retained for the scheduled retention period, required audits have been completed, and no pending or ongoing litigation or investigation involving these records is known to exist. DEPARTMENT HEAD: RECORDS MANAGEMENT: CITY ATTORNEY: BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS PERIOD SMEADSOFT BARCODE (if applicable} RKM21 Robinson, Donna-Claim, Trip and Fall Closed 2005 0745-20 . CL+5 RKM21 Rogers, Christopher-Claim, Vehicle Comprehensive Closed 2005 0745-20 CL+5 RKM21 Ross, Kira-Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKM21 r —— Rue, Allison-Claim, Other, personal property destroyed Closed 2005 0745-20 CL+5 / RKM22 Salazar, Ernest-Claim Vehicle Collision Closed 2005 0745-20 CL+5 RKM22 Salisbury, David-Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKM22 Saltz, Joel & L. Gayle-Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKM22 SDG&E-Claim, Tree, Other than Sewer/Water related Closed 2005 0745-20 CL+5 To be filled out once records have been destroyed. RECORD DESTRUCTION COMPLETED BY: CERTIFICATE OF DESTRUCTION? SMEADSOFT BARCODES DELETED BY: • YES • NO DATE: DATE: ^ CARLSBAD This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program. Revised: 7/31/2013 RECORDS DESTRUCTION AUTHORIZATION FORM DATE: PAGE 12 OF 15 REQUESTING DEPARTMENT: RISK MANAGEMENT REQUESTER: TERIE ROWLEY DESTRUCTION APPROVALS: We certify that the records listed below have been retained for the scheduled retention period, required audits have been completed, and no pending or ongoing litigation or investigation involving these records is known to exist DEPARTMENT HEAD: RECORDS MANAGEMENT: CITY ATTORNEY: BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS PERIOD SMEADSOFT BARCODE (if applicable) RKM22 Sangster, Lolly-Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKM22 Schubert, Maureen-Claim, Vehicle Comprehensive Closed 2005 0745-20 CL+5 RKM22 Sheedy, Stephen-Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKM22 Sielaff, Donald-Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKM22 Silliphant, Jr., Donald C.-Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKM22 Singer, Ricardo-Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKM22 Singleton, Kerry-Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKM22 St. Austin, Bob & Judy-Claim, Other. Emotional and Physical distress Closed 2005 0745-20 CL+5 RKM22 State Farm Closed 2005 0745-20 CL+5 To be filled out once records have been destroyed. RECORD DESTRUCTION COMPLETED BY: CERTIFICATE OF DESTRUCTION? • YES SMEADSOFT BARCODES DELETED BY: • NO DATE: DATE: ^ CARLSBAD This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program. Revised: 7/31/2013 RECORDS DESTRUCTION AUTHORIZATION FORM DATE: PAGE 13 OF 15 REQUESTING DEPARTMENT: RISK MANAGEMENT REQUESTER: TERIE ROWLEY DESTRUCTION APPROVALS: We certify that the records listed below have been retained for the scheduled retention period, required audits have been completed, and no pending or ongoing litigation or investigation involving these records is known to exist. DEPARTMENT HEAD: RECORDS MANAGEMENT: CITY ATTORNEY: BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS PERIOD SMEADSOFT BARCODE (if applicable) RKM22 Steers, Stephanie-Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKM22 Stevens, Scott-Claim, Tree, other than Sewer/Water related Closed 2005 0745-20 CL+5 RKM22 Stevenson, Debora-Claim, vehicle collision Closed 2005 0745-20 CL+5 RKM22 Steward Barbara-Claim, Vehicle Comprehensive Closed 2005 0745-20 CL+5 RKM22 Stovall, Jan & Roseanna-Claim, Tree, other than Sewer/Water related Closed 2005 0745-20 CL+5 RKM22 Straus, Judy Ann-Claim, Vehicle Comprehensive Closed 2005 0745-20 CL+5 RKM22 Stuempfig, J. David-Claim, Vehicle Comprehensive Closed 2005 0745-20 CL+5 - RKM22 Sullivan, Edward-Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKM22 Tamagni, Charles-Claim, Vehicle Comprehensive Closed 2005 0745-20 CL+5 To be filled out once records have been destroyed. RECORD DESTRUCTION COMPLETED BY: CERTIFICATE OF DESTRUCTION? • YES SMEADSOFT BARCODES DELETED BY: • NO DATE: DATE: ^ CARLSBAD This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program. Revised: 7/31/2013 RECORDS DESTRUCTION AUTHORIZATION FORM DATE: PAGE 14 OF 15 REQUESTING DEPARTMENT: RISK MANAGEMENT REQUESTER: TERIE ROWLEY DESTRUCTION APPROVALS: We certify that the records listed below have been retained for the scheduled retention period, required audits have been completed, and no pending or ongoing litigation or investigation involving these records is known to exist. DEPARTMENT HEAD: RECORDS MANAGEMENT: CITY ATTORNEY: BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS PERIOD SMEADSOFT BARCODE (if applicable) RKM22 Thomas, Bruce-Claim, Law Enforcement Closed 2005 0745-20 CL+5 RKM22 Thomas, Bruce-Claim, Other, Requested Grant payout Closed 2005 0745-20 CL+5 RKM22 Thomas, Bruce-Claim, Law Enforcement Closed 2005 0745-20 CL+5 RKM22 Thorogood, Scott-Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKM22 USAA, Crescini-Claim, Vehicle Collision Closed 2005 0745-20 . CL+5 RKM22 Van Sittert, Kelly-Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKM22 Violi, Joseph-Claim, Vehicle Comprehensive Closed 2005 0745-20 CL+5 RKM22 Webber, Micah-Claim, Vehicle Collision Closed 2005 0745-20 CL+5 RKM22 White, Scott-Claim, Vehicle Collision Closed 2005 0745-20 CL+5 To be filled out once records have been destroyed. RECORD DESTRUCTION COMPLETED BY: CERTIFICATE OF DESTRUCTION? SMEADSOFT BARCODES DELETED BY: • YES • NO DATE: DATE: •A This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program. Revised: 7/31/2013 CARLSBAD RECORDS DESTRUCTION AUTHORIZATION FORM DATE: PAGE 15 OF 15 REQUESTING DEPARTMENT: RISK MANAGEMENT REQUESTER: TERIE ROWLEY DESTRUCTION APPROVALS: We certify that the records listed below have been retained for the scheduled retention period, required audits have been completed, and no pending or ongoing litigation or investigation involving these records is known to exist. DEPARTMENT HEAD: RECORDS MANAGEMENT: CITY ATTORNEY: BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS PERIOD SMEADSOFT BARCODE (if applicable) RKM22 Wilmott, Steve-Claim, Tree, Other than Sewer/Water related Closed 2005 0745-20 CL+5 RKM22 Wilson, Randy-Claim, Trip/Fall Closed 2005 0745-20 CL+5 RKM22 Wittkoski, Tom-Claim, Sewer/Water, tree related Closed 2005 0745-20 CL+5 RKM22 Wolinski, Marc-Claim, Vehicle Comprehensive Closed 2005 0745-20 CL+5 RKM22 World Savings Bank, Jennifer Stinson-Claim, Other, Damaged Landscaping Closed 2005 0745-20 CL+5 RKM22 Zaplata, Mitch-Ciaim, Law Enforcement Closed 2005 0745-20 CL+5 To be filled out once records have been destroyed. RECORD DESTRUCTION COMPLETED BY: CERTIFICATE OF DESTRUCTION? • YES SMEADSOFT BARCODES DELETED BY: • NO DATE: DATE: This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program. CARLSBAD Revised: 7/31/2013 city of Carlsbad Loss Ron Report Date of Ms Qosed between DI/QW and 12/31/2D05 Date Date Date Loss Expense Loss Expense ClaimName Loss Received Closed Cateqorv Litigate Reserve Reserve Payment Payment Incurred Status 1 ALLEN, BARBARA 01/14/2005 01/31/2005 08/31/2005 VEHICLE COLLISION 0.00 0.00 0.00 0.00 0.00 CLOSED 2 ANGELS ARE FROM HE 01/01/2005 06/20/2005 10/19/2005 OTHER 0,00 0.00 1,500,00 741 -40 2,241-40 CLOSED 3 ARMSTRONG, THOMAS 12/04/2000 01/02/2001 05/31/2005 OTHER 06/26/2001 0,00 0.00 3,205.00 23,135-20 26,340.20 CLOSED 4 BANTOFT, CHRISTINA 07/01/2003 06/17/2004 01/31/2005 OTHER 0.00 0.00 0,00 0.00 0,00 CLOSED 5 BELLAVER, JOHN 07/15/2004 08/02/2004 02/28/2005 VEHICLE COMPREHEN 0,00 0.00 0,00 0.00 0,00 CLOSED 6 BENINATTO AND SPACI 01/11/2005 02/16/2005 08/31/2005 TREE (OTHER THAN SE 0.00 0.00 0,00 0,00 0,00 CLOSED 7 BENNETT, LINDSAY 03/08/2005 03/17/2005 09/30/2005 VEHICLE COLLISION 0.00 0,00 0.00 0.00 0,00 CLOSED 8 BERKUTI, MARIE 09/24/2003 11/25/2003 09/30/2005 TREE (OTHER THAN SE 0.00 0.00 0,00 0,00 0,00 CLOSED 9 BERNARD, GLENN 05/14/2004 09/10/2004 02/28/2005jTREE (OTHER THAN SE 0.00 0,00 0,00 0.00 0,00 CLOSED 10 BERNARD/GLENN 12/01/2003 09/10/2004 02/28/2005|TREE (OTHER THAN SE 0.00 0,00 0,00 0,00 0,00 CLOSED 11 BERNARD, GLENN 08/28/2004 02/09/2005 09/30/2005 TRIP/FALL 0.00 0,00 0,00 0,00 0,00 CLOSED 12 BESECKER, MEGAN 01/17/2005 02/10/2005 09/13/2005 VEHICLE COLLISION 0,00 0,00 892,11 0,00 892.11 CLOSED 13 BIO-HYDRATfON RESE 09/06/2005 09/15/2005 10/19/2005 SEWER/WATER (TREE 0.00 0.00 180,00 0,00 180.00 CLOSED 14 BLACIC, HENRIETTA 01/02/2005 01/27/2005 02/28/2005 SEWERAWATER (TREE 0.00 0,00 5,130,86 0.00 5,130,86 CLOSED 15 BRAY, SUZANNE 12/16/2002 01/24/2003 03/03/2005 OTHER 11/21/2003 0.00 0,00 0.00 25,00 25.00 CLOSED 16 BROADWAY, GWEN 07/01/2003 06/29/2004 01/31/2005 OTHER 0.00 0.00 0,00 0,00 0-00 CLOSED 17 BUDGET RENTACAR 09/12/2005 10/21/2005 11/30/2005 VEHICLE COLLISION 0,00 0,00 2,897.80 0,00 2,897.80 CLOSED 18 BUJAS,'ANN 06/24/2004 07/14/2004 01/31/2005 LAW ENFORCEMENT 0.00 0,00 0.00 0,00 0.00 CLOSED 19 C. San Dieguito Water Di 06/10/2005 08/02/2005 08/23/2005 VEHICLE COLLISION 0.00 0,00 1,389.49 0,00 1,389.49 CLOSED 20 CARLSBAD COMMUNIT 11/23/2003 11/24/2003 11/30/2005 SEWERAft/ATER (TREE 0,00 0,00 6,911.20 500-00 7,411.20 CLOSED 21 CLARKE, CATHERINE & 08/08/2004 08/18/2004 10/27/2005 TREE (OTHER THAN SE 0.00 0,00 2,300.00 246-50 2,546.50 CLOSED 22 CLUTE, MAVIS 07/01/2003 06/29/2004 01/31/2005 OTHER 0.00 0.00 0,00 0.00 0,00 CLOSED 23 COLBY, ALDON 03/31/2005 03/31/2005 05/13/2005 VEHICLE COLLISION 0,00 0,00 1,456,02 0,00 1,456.02 CLOSED 24 COOBATIS, CHRISTY 05/07/2005 05/31/2005 08/23/2005 SEWERA/VATER (TREE 0.00 0,00 918,50 418,50 1,337.00 CLOSED 25 COON, KEVIN 03/03/2005 03/09/2005 09/30/2005 VEHICLE COLLISION' 0.00 0,00 0,00 0,00 0,00 CLOSED 26 DELANEY, ZANITA 04/02/2004 04/23/2004 05/31/2005 VEHICLE COLLISION 0.00 0.00 0,00 0.00 0,00 CLOSED 27 DESAI, PRAGNYA 10/07/2004 11/03/2004 05/31/2005 VEHICLE COMPREHEN 0.00 0.00 0.00 0,00 0,00 CLOSED 28 Dl LANDRI, GARETT 01/09/2005 01/18/2005 08/31/2005 VEHICLE COLLISION 0.00 0.00 0,00 0,00 0.00 CLOSED 29 DILLON, JOSEPH 01/07/2005 01/25/2005 08/31/2005 VEHICLE COLLISION 0.00 0.00 0.00 0,00 0.00 CLOSED 30 DINEEN, KRISTEN 07/05/2005 09/14/2005 10/19/2005 VEHICLE COLLISION 0.00 0-00 1,301,17 0.00 1,301,17 CLOSED '3l| .D0RNICK; LESLIE-ASfG"" 03/25/2005 05/17/2005 12/30/2005 OTHER 0.00 0.00 0,00 0,00 0-00 CLOSED 32 ENDO, KRISTINA 04/05/2005 04/27/2005 05/24/2005 VEHICLE COLLISION 0.00 0.00 837,23 0,00 837.23 CLOSED LossRunCiosed Monday, August 05, 2013 ^^^7 i/Kv^r cWXd^ - U^va W^-NXO ^^V^ a Page 1 of 5 City of Carlsbad Loss Run Report CMS raised betw^ 0l/0V20ie end 12/31/2005 Date of Date Date Date Loss Expense Loss Expense 33 FARMERS INSURANCE, 10/07/2004 12/14/2004 01/11/2005 VEHICLE COLLISION 0,00 0,00 3,960,25 0.00 3,960,25 CLOSED 34 FAVANO, DANIEL 09/29/2004 10/15/2004 04/29/2005 VEHICLE COMPREHEN SEWERAWATER (TREE 0,00 0,00 0,00 0.00 0.00 CLOSED 35 FLOWER FIELDS LLC, 03/21/2005 06/13/2005 09/21/2005 VEHICLE COMPREHEN SEWERAWATER (TREE 0,00 0,00 3,540.00 0.00 3,540,00 CLOSED 36 GIL, ABRAHAM 05/21/2005 06/03/2005 08/17/2005 VEHICLE COLLISION 0,00 0,00 1,029,90 0.00 1,029,90 CLOSED 37 GONZALEZ, ALVARO 08/21/2004 10/01/2004 04/29/2005 TRIP/FALL 04/11/2005 0,00 0,00 0,00 0.00 0,00 CLOSED 38 GONZALEZ, MARTHA 12/04/2004 12/15/2004 08/31/2005 VEHICLE COLLISION 0,00 0,00 0,00 0,00 0,00 CLOSED 39 GONZALEZ, RUBEN 05/02/2005 05/06/2005 06/07/2005 VEHICLE COLLISION 0,00 0,00 219.47 0,00 219.47 CLOSED 40 GREEN, RICK 09/20/2004 10/04/2004 04/29/2005|VEHICLE COMPREHEN 0,00 0,00 0,00 0,00 0,00 CLOSED 41 GREENLAND, MARK 05/28/2004 07/01/2004 01/31/2005 VEHICLE COMPREHEN i\ II— /A-1-1 1 f--r-l 1 r, k 1 0,00 0,00 0,00 0,00 0,00 CLOSED 42 HEINZ AND BLOCK, JES 07/01/2003 06/17/2004 01/31/2005 OTHER 0.00 0,00 0-00 0,00 0,00 CLOSED 43 HJELT, JOHN & CATHY 02/19/2005 03/31/2005 10/31/2005 OTHER 0.00 0-00 0.00 0.00 0.00 CLOSED 44 HOUSTON, BRITTENY 11/01/2004 11/10/2004 06/30/2005 LAW ENFORCEMENT 0-00 0.00 0.00 0.00 0,00 CLOSED 45 HOUSTON,CASANDRA 11/01/2004 11/10/2004 06/30/2005 LAW ENFORCEMENT 0-00 0.00 0.00 0,00 0.00 CLOSED 46 HOUSTON, CLAUDIA 11/01/2004 11/10/2004 06/30/2005 LAW ENFORCEMENT 0.00 0.00 0,00 0-00 0,00 CLOSED 47 HOUSTON, JONES 11/01/2004 11/10/2004 06/30/2005 U\W ENFORCEMENT 0.00 0.00 0.00 0.00 0.00 CLOSED 48 IVANOVICH, ARSO 11/12/2002 06/17/2005 12/30/2005 LAW ENFORCEMENT 0.00 0,00 0.00 0.00 0,00 CLOSED 49 IVANOVICH, ARSO 11/12/2002 06/17/2005 12/30/2005 LAW ENFORCEMENT 0,00 0,00 0.00 0.00 0,00 CLOSED 50 JAMAL & DESAI, HANIF 07/09/2004 08/09/2004 02/28/2005 VEHICLE COLLISION 0,00 0,00 0.00 0,00 0,00 CLOSED 51 JORDAN, TOBY & BRIA 02/24/2005 03/03/2005 09/30/2005 VEHICLE COMPREHEN 0,00 0.00 0,00 0,00 0,00 CLOSED 52 KAPRIELIAN, GARY & D 07/01/2003 08/13/2004 02/28/2005 OTHER 0.00 0,00 0.00 0,00 0,00 CLOSED 53 KEARNS, JOSEPH -06/19/2003 08/29/2003 04/18/2005 TRIP/FALL 04/13/2004 0,00 0.00 9,999.00 24,588.78 34,587.78 CLOSED 54 KELLY, COLLEEN 12/26/2003 05/20/2004 09/22/2005 TRIP/FALL 11/17/2004 0,00 0,00 75,000.00 7,138-11 82,138,11 CLOSED 55 KENT, ELIZABETH 01/09/2005 03/08/2005 09/30/2005 VEHICLE COLLISION 0,00 0-00 0.00 0.00 0.00 CLOSED 56 KNUDSEN, FRANK AND •ii.ir>u:u 07/01/2003 06/30/2004 01/31/2005 OTHER 0.00 0-00 0.00 0.00 0.00 CLOSED 57 KOVSKY, GREGORY AL n k 1 02/21/2005 03/07/2005 09/30/2005 VEHICLE COLLISION 0.00 0,00 0.00 0.00 0,00 CLOSED 58 LAGUNA TERRACE HO -Jl—luii-^fi I-, n r-tn/~--r A 09/22/2004 01/20/2005 02/28/2005 SEWER/WATER (TREE 0.00 0,00 1,798.00 0,00 1,798.00 CLOSED 59 LANPHEAR, WILLIAM 07/06/2005 08/05/2005 09/27/2005 VEHICLE COLLISION 0.00 0,00 545.44 0,00 545,44 CLOSED 60 LAUNDER, DIANE 04/14/2004 04/09/2004 07/12/2005 TREE (OTHER THAN SE 0.00 0,00 350.00 0,00 350,00 CLOSED 61 LAWRENSON, KENNET L-l . . 06/08/2005 06/17/2005 07/27/2005 SEWERAWATER (TREE 0,00 0,00 205.00 0,00 205.00 CLOSED 62 LEADER, JEFF 06/22/2004 06/28/2004 01/31/2005 OTHER 0,00 0,00 0,00 0,00 0.00 CLOSED 63 LEVY, BERTHA 02/02/2005 03/09/2005 09/30/2005 OTHER 0,00 0.00 0.00 0-00 0.00 CLOSED 64 LEWIS, THAD AND MIA 12/31/2002 12/31/2002 01/31/2005 TREE (OTHER THAN SE 0,00 0.00 0.00 0-00 0.00 CLOSED Monday, August 05, 2013 LossRunCiosed Page 2 of 5 City of Carlsbad Loss Run Report mvim and 12/31/2005 ClaimName Date of Loss Date Received Date Date Litigate Loss Reserve Expense Reserve Loss Payment Expense Payment Incurred Status 65 LICATA, WILLIAM 06/18/2004 06/29/2004 01/31/2005 VEHICLE COMPREHEN 0,00 0.00 0.00 0.00 0,00 CLOSED 66 LOUGHRAN, CHRIS 02/10/2005 04/20/2005 05/13/2005 SEWERAWATER (TREE 0,00 0.00 335.00 0.00 335,00 CLOSED 67 LUKAS, SHARI 03/01/2005 04/06/2005 10/31/2005 OTHER 0,00 0,00 0-00 0.00 0,00 CLOSED 68 MARJA ACRES, 01/12/2005 01/12/2005 08/31/2005 OTHER 0,00 0.00 0-00 0.00 0,00 CLOSED 69 MASON, JACQUELYN 01/03/2005 02/01/2005 08/31/2005|TRIP/FALL 0,00 0,00 0-00 0.00 0,00 CLOSED 70 MASSERY. GEORGE & 08/01/2003 08/28/2003 08/29/2005|TREE (OTHER THAN SE 0,00 0.00 0.00 0.00 0,00 CLOSED 71 McANALLY, TAMARA 10/01/2004 11/04/2004 01/26/2005 VEHICLE COLLISION 0,00 0.00 1,175.47 0.00 1,175.47 CLOSED 72 MCCOMAS, AUDREY 03/01/2005 06/10/2005 07/12/2005 SEWERAWATER (TREE 0.00 0.00 340-00 0.00 340,00 CLOSED 73 MERCURY INSURANCE 09/12/2004 03/03/2005 04/18/2005|TREE (OTHER THAN SE 0.00 0.00 3,831.02 0.00 3,831.02 CLOSED 74 MERTES, ROBERT 09/15/2005 10/03/2005 11/30/2005 VEHICLE COLLISION 0.00 0.00 0.00 0.00 0,00 CLOSED 75 MONTGOMERY, RONAL 11/03/2004 01/20/2005 03/08/2005 TREE (OTHER THAN SE OTHER 0,00 0.00 525.00 0.00 525.00 CLOSED 76 MORGAN, BRUCE & AN 12/01/2003 08/12/2004 02/28/2005 TREE (OTHER THAN SE OTHER 0-00 0.00 0.00 0.00 0.00 CLOSED 77 MURRELL, TERESA 09/05/2004 01/03/2005 08/29/2005|VEHICLE COLLISION 0-00 0.00 0.00 0.00 0.00 CLOSED 78 NAKAJI, CONNIE 03/26/2005 05/10/2005 11/30/2005|VEHICLE COLLISION 0-00 0.00 0.00 0.00 0-00 CLOSED 79 NASH, NORMAN 01/09/2005 01/20/2005 08/31/2005 VEHICLE COLLISION 0.00 0.00 0.00 0.00 0.00 CLOSED 80 NIEMI, JEFF 01/11/2005 02/14/2005 08/31/2005 TREE (OTHER THAN SE t IL tw— W-* A H t tk -i-w— W-* 1—11— • « -T-r- r-w 0,00 0,00 0.00 0.00 0.00 CLOSED 81 OBENBERGER, BOB 01/08/2005 02/01/2005 08/31/2005|VEHICLE COLLISION 0,00 0,00 0.00 0.00 0.00 CLOSED 82 O'DONOGHUE, WILLIA 04/11/2005 05/02/2005 11/30/2005 VEHICLE COLLISION 0,00 0.00 0.00 0.00 0.00 CLOSED 83 OLSON, LESTER 08/22/2005 08/24/2005 12/30/2005 TREE (OTHER THAN SE 0,00 0.00 2,396.27 0.00 2,396,27 CLOSED 84 PALAY, SUSAN AND EL 07/01/2003 06/30/2004 01/31/2005 OTHER 0,00 0.00 0.00 0.00 0.00 CLOSED 85 PECK, EDNA 04/10/2005 05/24/2005 06/28/2005|TREE (OTHER THAN SE |i A II—r-i ft ft 1 A-T-l—n i-vr—1 A-rr—rs 0,00 0.00 4,660.75 0.00 4,660.75 CLOSED 86 PELICAN COVE INN B& 01/29/2005 05/02/2005 12/30/2005|VEHICLE COLLISION 0,00 0-00 0.00 0,00 0.00 CLOSED 87 PORTER, CYNTHIA 06/18/2004 12/03/2004 06/30/2005 VEHICLE COLLISION 0,00 0.00 0.00 0,00 0.00 CLOSED 88 PRENTICE, ANGELA 10/30/2004 11/10/2004 05/31/2005 VEHICLE COLLISION 0,00 0.00 0.00 0,00 0.00 CLOSED 89 RANCHO CARLSBAD 0 03/01/2005 07/29/2005 09/30/2005 OTHER 0,00 0.00 0.00 0,00 0.00 CLOSED 90 ROBINSON, DONNA 02/23/2004 07/07/2004 01/31/2005 TRIP/FALL 0,00 0.00 0.00 0,00 0.00 CLOSED 91 ROGERS, CHRISTOPHE 10/08/2004 10/19/2004 05/31/2005 VEHICLE COMPREHEN 0,00 0.00 0.00 0,00 0.00 CLOSED 92 ROSS, KIRA 04/27/2005 05/10/2005 11/30/2005 VEHICLE COLLISION 0.00 0.00 0.00 0.00 0.00 CLOSED 93 RUE, ALLISON 11/24/2003 08/13/2004 02/28/2005 OTHER 0.00 0.00 0.00 0.00 0,00 CLOSED 94 SALAZAR, ERNEST 01/21/2005 02/15/2005 03/28/2005 VEHICLE COLLISION 0-00 0.00 208.23 0.00 208.23 CLOSED 95 SALISBURY, DAVID 11/23/2004 03/11/2005 11/15/2005 VEHICLE COLLISION 0-00 0.00 160,089.19 9,512-34 169,601.53 CLOSED 96 SALTZ, JOEL & L, GAYL 01/01/2005 05/23/2005 12/30/2005 VEHICLE COLLISION 0-00 0.00 0-00 0-00 0,00 CLOSED Monday, August 05, 2013 LossRunCiosed Page 3 of 5 City of Carlsbad Loss Ron Report (Mns Closed bstween 01/01/2005 and 12/31/2005 ClaimName Date of Loss Date Received Date Date Loss Resen^e Expense Reserve Loss Payment Expense Payment Incurred Status 97 SAN DIEGO GAS & ELE 07/01/2004 08/02/2004 02/28/2005|TREE (OTHER THAN SE lAii—r-iBA*A-i-i—n 1—I r— i A -w-r—w-% 0.00 0,00 0-00 0.00 0.00 CLOSED 98 SANGSTER, LOLLY 09/30/2004 11/19/2004 06/20/2005 VEHICLE COLLISION 0,00 0.00 2,147,80 0.00 2,147.80 CLOSED 99 SCHUBERT, MAUREEN 09/24/2004 10/01/2004 04/29/2005 VEHICLE COMPREHEN 0,00 0-00 0,00 0.00 0.00 CLOSED 100 SHEEDY, STEPHEN 06/25/2004 08/23/2004 02/24/2005|VEHICLE COLLISION 0,00 0,00 0,00 0.00 0.00 CLOSED 101 SIELAFF, DONALD 01/08/2005 01/18/2005 08/31/2005 VEHICLE COLLISION 0,00 0,00 0.00 0-00 0.00 CLOSED 102 103" SILLIPHANT, JR-, DONA 02/22/2005 04/12/2005 10/31/2005|VEHICLE COLLISION 0,00 0.00 0,00 0.00 0.00 CLOSED 102 103" SINGER, RICARDO 08/29/2004 08/31/2004 02/24/2005 VEHICLE COLLISION 0,00 0.00 0,00 0.00 0.00 CLOSED 104 SINGLETON, KERRY 11/13/2004 12/08/2004 06/30/2005 VEHICLE COLLISION 0,00 0.00 0,00 0.00 0.00 CLOSED 105 ST. AUSTIN, BOB AND J 07/01/2003 06/22/2004 01/31/2005 OTHER 0,00 0.00 0,00 0.00 0.00 CLOSED 106 STATE FARM, 01/17/2005 06/29/2005 08/23/2005 VEHICLE COLLISION 0,00 0.00 2,068.78 0.00 2,068.78 CLOSED 107 STEERS, STEPHANIE 03/06/2004 09/07/2004 06/30/2005 VEHICLE COLLISION 0,00 0.00 0,00 0.00 0.00 CLOSED 108 STEVENS, SCOTT 11/02/2004 11/10/2004 02/11/2005|TREE (OTHER THAN SE 0,00 0.00 2,600.00 617.28 3,217.28 CLOSED 109 STEVENSON, DEBORA 02/25/2005 06/01/2005 07/12/2005 VEHICLE COLLISION 0.00 0.00 69,98 0.00 69.98 CLOSED 110 STEWART, BARBARA 04/01/2004 07/08/2004 01/31/2005 VEHICLE COMPREHEN 0-00 • 0.00 0,00 0.00 0.00 CLOSED 11 12 STOVALL, JAN AND RO 01/11/2005 03/04/2005 09/30/2005 TREE (OTHER THAN SE 0.00 0.00 0.00 0.00 0.00 CLOSED 11 12 STRAUS, JUDY ANN 08/23/2005 08/30/2005 09/27/2005|VEHICLE COMPREHEN 0.00 0,00 151,00 0-00 151.00 CLOSED 13 STUEMPFIG, J. DAVID 12/08/2004 12/30/2004 08/31/20051VEHICLE COMPREHEN 0.00 0,00 0,00 0-00 0.00 CLOSED 14 SULLIVAN, EDWARD 11/02/2005 12/05/2005 12/27/2005 VEHICLE COLLISION 0,00 0.00 1,471,38 0-00 1,471.38 CLOSED 15 TAMAGNI, CHARLES 02/14/2005 02/18/2005 10/31/2005 VEHICLE COMPREHEN LAW ENFORCEMENT 0,00 0.00 0.00 0.00 0.00 CLOSED :i6 THOMAS, BRUCE 06/26/2004 10/08/2004 04/29/2005 VEHICLE COMPREHEN LAW ENFORCEMENT 03/23/2005 0,00 0.00 0.00 0.00 0,00 CLOSED THOMAS, BRUCE 11/18/2004 05/13/2005 11/30/2005 OTHER 0,00 0.00 0.00 0.00 0.00 CLOSED |18 THOMAS, BRUCE 08/29/2004 09/17/2004 04/29/2005 LAW ENFORCEMENT 0,00 0,00 0.00 0.00 0.00 CLOSED 119 THOROGOOD, SCOTT 01/29/2005 05/24/2005 12/30/2005 VEHICLE COLLISION 0.00 0.00 0.00 0,00 0,00 CLOSED 120 [JSAA, CRESCINI 01/07/2005 04/25/2005 07/18/2005 VEHICLE COLLISION 0,00 0.00 7,027,04 0.00 7,027,04 CLOSED 121 VAN SITTERT, KELLY 01/02/2005 01/06/2005 08/29/2005 VEHICLE COLLISION 0,00 0.00 0-00 0-00 0.00 CLOSED 122 VIOLI, JOSEPH 02/13/2005 02/13/2005 08/31/2005 VEHICLE COLLISION 0,00 0,00 0.00 0.00 0.00 CLOSED 123 WEBBER, MICAH 01/22/2005 04/06/2005 10/19/2005 VEHICLE COMPREHEN VEHTCLE COLLISION 0.00 0,00 823.19 . . 0.00 823,19 CLOSED 124 WHITE, SCOTT 08/24/2004 10/01/2004 04/29/2005 VEHICLE COMPREHEN VEHTCLE COLLISION 0.00 0,00 0.00 0.00 0,00 CLOSED 125 WILMOTT, STEVE 05/27/2004 08/26/2004 01/11/2005 TREE (OTHER THAN SE 0.00 0,00 623.09 0.00 623.09 CLOSED 126 WILSON, RANDY 12/26/2003 04/06/2004 04/29/2005 TRip/FALL 10/15/2004 0.00 0.00 9,999.99 472.52 10,472,51 CLOSED 127 WITTKOSKI, TOM 07/07/2004 07/13/2004 01/31/2005 SEWER/WATER (TREE 0-00 0.00 0.00 0.00 0,00 CLOSED 128 WOLINSKI, MARC 10/15/2004 10/25/2004 05/31/2005 VEHICLE COMPREHEN 0,00 0-00 0.00 0.00 0,00 CLOSED Monday, August 05, 2013 LossRunCiosed Page 4 of 5 City of Carlsbad IMeGlDSfid between 01/01/2005 and 12/31/2005 Date of Date Date Date Loss Expense Loss Expense t29 1 WORLD SAVINGS BANK 08/16/2004 11/23/2004 05/31/2005 OTHER 0.00 0-00 0.00 0.00 0,00 CLOSED 130 1 ZAPLATA, MITCH 11/22/2004 12/17/2004 01/11/2005 LAW ENFORCEMENT 0,00 0-00 230,00 0,00 230,00 CLOSED Totals 0,00 0.00 326.339,62 67,395,63 393,735.25 Monday, August 05, 2013 LossRunCiosed Page 5 of 5