Attachment D Sample Company vehicle Loss History Report.pdf
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- Solicitation number
- S000000426
- Issued by
- Pulaski County, Arkansas
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APSIT Fleet Loss Run | Policy Year: - ARKANSAS PUBLIC SCHOOL Policy Number Liability Limit $100,0005248660
07/01/2016 07/01/2017
Policy Number Liability Limit $100,0000682996 Effective 7/2023+
Effective Prior to 7/2023
Policy Effective Year 2016 Claim Number
2705992
Claim Status
Closed
Date of Loss
07/12/2016
Claim Changes
Reserve
Loss Reporting Location Code
04-01-BENTONVILLE SCHOOL DISTRICT
Net Expense Paid
TURNING - IV WAS ATTEMPTING A LEFT TURN PAST OV, WHICH WAS
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Liability - Property Damage $0.00 $0.00$4,517.03 $0.00 $0.00 $4,517.03
Claim Total $4,517.03$0.00 $0.00$4,517.03 $0.00 $0.00
Liability Subtotal $0.00 $4,517.03 $0.00 $0.00 $4,517.03$0.00
Claim Number
2707364
Claim Status
Closed
Date of Loss
07/12/2016
Claim Changes
Reserve
Loss Reporting Location Code
04-01-BENTONVILLE SCHOOL DISTRICT
Net Expense Paid
TURNING -IN THE PROCESS OF MAKING A VERY SHARP TURN, THE
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$4,425.78 $0.00 $0.00 $4,425.78
Claim Total $4,425.78$0.00 $0.00$4,425.78 $0.00 $0.00
Liability Subtotal $0.00 $0.00 $0.00 $0.00 $0.00$0.00
Page 1 of 1012Monday, March 3, 2025
Attachment D
07/01/2016 07/01/2017
Policy Number Liability Limit $100,0000682996 Effective 7/2023+
Effective Prior to 7/2023
Claim Number
2707788
Claim Status
Closed
Date of Loss
07/14/2016
Claim Changes
Reserve
Loss Reporting Location Code
56-05-TRUMANN SCHOOL DISTRICT
Net Expense Paid
STRUCK OBJECT - THE INSURED VEHICLE STRUCK A LOW BRIDGE
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $2,211.50$18,384.92 $0.00 $0.00 $18,384.92
Liability - Medical Payments $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Claim Total $18,384.92$0.00 $2,211.50$18,384.92 $0.00 $0.00
Liability Subtotal $0.00 $0.00 $0.00 $0.00 $0.00$0.00
Claim Number
2711479
Claim Status
Closed
Date of Loss
07/20/2016
Claim Changes
Reserve
Loss Reporting Location Code
10-02-ARKADELPHIA SCHOOL DISTRICT
Net Expense Paid
REAR ENDED - STEVE PATTERSON WAS AT A RED LIGHT IN
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $979.75$0.00 $0.00 $0.00 $0.00
Claim Total $0.00$0.00 $979.75$0.00 $0.00 $0.00
Liability Subtotal $0.00 $0.00 $0.00 $0.00 $0.00$0.00
Claim Number
2715370
Claim Status
Closed
Date of Loss
07/25/2016
Claim Changes
Reserve
Loss Reporting Location Code
35-05-PINE BLUFF SCHOOL DISTRICT
Net Expense Paid
THEFT/VANDALISM - TOTAL THEFT OF ONE INSURED VEHICLE AND
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Comp $0.00 $74.60$21,683.68 ($4,933.61) $0.00 $16,750.07
Claim Total $16,750.07$0.00 $74.60$21,683.68 ($4,933.61) $0.00
Liability Subtotal $0.00 $0.00 $0.00 $0.00 $0.00$0.00
Page 2 of 1012Monday, March 3, 2025
07/01/2016 07/01/2017
Policy Number Liability Limit $100,0000682996 Effective 7/2023+
Effective Prior to 7/2023
Claim Number
2716901
Claim Status
Closed
Date of Loss
07/27/2016
Claim Changes
Reserve
Loss Reporting Location Code
60-02-NORTH LITTLE ROCK SCHOOL DISTRICT
Net Expense Paid
NOT AT FAULT - BACKING - OV BACKED INTO IV WHILE IV WAS
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Claim Total $0.00$0.00 $0.00$0.00 $0.00 $0.00
Liability Subtotal $0.00 $0.00 $0.00 $0.00 $0.00$0.00
Claim Number
2721440
Claim Status
Closed
Date of Loss
08/03/2016
Claim Changes
Reserve
Loss Reporting Location Code
17-04-MULBERRY/PLEASANT VIEW BI-COUNTRY
Net Expense Paid
NOT AT FAULT - SIDESWIPED - OV SIDESWIPED IV AT THE
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Liability - Property Damage $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Claim Total $0.00$0.00 $0.00$0.00 $0.00 $0.00
Page 3 of 1012Monday, March 3, 2025
07/01/2016 07/01/2017
Policy Number Liability Limit $100,0000682996 Effective 7/2023+
Effective Prior to 7/2023
Claim Number
2721448
Claim Status
Closed
Date of Loss
08/03/2016
Claim Changes
Reserve
Loss Reporting Location Code
26-06-LAKESIDE SCHOOL DISTRICT
Net Expense Paid
BACKING - IV BACKED INTO A PARKED AND UNOCCUPIED VEHICLE AT
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Liability - Property Damage $0.00 $53.25$2,777.47 $0.00 $0.00 $2,777.47
Claim Total $2,777.47$0.00 $53.25$2,777.47 $0.00 $0.00
Liability Subtotal $0.00 $2,777.47 $53.25 $0.00 $2,777.47$0.00
Claim Number
2725581
Claim Status
Closed
Date of Loss
08/10/2016
Claim Changes
Reserve
Loss Reporting Location Code
72-03-FAYETTEVILLE SCHOOL DISTRICT
Net Expense Paid
STUDENT INJURY - A STUDENT SLIPPED AND FELL ON THE BUS STEP
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Liability - Medical Payments $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Claim Total $0.00$0.00 $0.00$0.00 $0.00 $0.00
Page 4 of 1012Monday, March 3, 2025
07/01/2016 07/01/2017
Policy Number Liability Limit $100,0000682996 Effective 7/2023+
Effective Prior to 7/2023
Claim Number
2725871
Claim Status
Closed
Date of Loss
08/10/2016
Claim Changes
Reserve
Loss Reporting Location Code
22-03-MONTICELLO SCHOOL DISTRICT
Net Expense Paid
FAILURE TO YIELD - THE INSURED VEHICLE TO THE ONCOMING
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$7,127.27 $0.00 $0.00 $7,127.27
Liability - Property Damage $0.00 $2,088.30$8,168.84 $0.00 $0.00 $8,168.84
Claim Total $15,296.11$0.00 $2,088.30$15,296.11 $0.00 $0.00
Liability Subtotal $0.00 $8,168.84 $2,088.30 $0.00 $8,168.84$0.00
Claim Number
2727312
Claim Status
Closed
Date of Loss
08/11/2016
Claim Changes
Reserve
Loss Reporting Location Code
72-03-FAYETTEVILLE SCHOOL DISTRICT
Net Expense Paid
STUDENT INJURY - A STUDENT PASSENGER WAS PUSHED BY A SIBLING
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Liability - Medical Payments $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Claim Total $0.00$0.00 $0.00$0.00 $0.00 $0.00
Liability Subtotal $0.00 $0.00 $0.00 $0.00 $0.00$0.00
Claim Number
2729529
Claim Status
Closed
Date of Loss
08/15/2016
Claim Changes
Reserve
Loss Reporting Location Code
04-01-BENTONVILLE SCHOOL DISTRICT
Net Expense Paid
NOT AT FAULT - OV RAN STOP SIGN; NO CHILDREN ON BUS; NO
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $508.13$7,552.42 $0.00 ($7,552.42) $0.00
Claim Total $0.00$0.00 $508.13$7,552.42 $0.00 ($7,552.42)
Page 5 of 1012Monday, March 3, 2025
07/01/2016 07/01/2017
Policy Number Liability Limit $100,0000682996 Effective 7/2023+
Effective Prior to 7/2023
Claim Number
2730256
Claim Status
Closed
Date of Loss
08/15/2016
Claim Changes
Reserve
Loss Reporting Location Code
58-05-RUSSELLVILLE SCHOOL DISTRICT
Net Expense Paid
NOT AT FAULT - THE CLAIMANT CAME THROUGH A STOP SIGN AND
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Claim Total $0.00$0.00 $0.00$0.00 $0.00 $0.00
Liability Subtotal $0.00 $0.00 $0.00 $0.00 $0.00$0.00
Claim Number
2728866
Claim Status
Closed
Date of Loss
08/16/2016
Claim Changes
Reserve
Loss Reporting Location Code
23-07-VILONIA SCHOOL DISTRICT
Net Expense Paid
BACKING - THE INSURED BUS ROLLED BACK INTO THE CLAIMANT
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Liability - Property Damage $0.00 $29.82$3,461.85 $0.00 $0.00 $3,461.85
Claim Total $3,461.85$0.00 $29.82$3,461.85 $0.00 $0.00
Liability Subtotal $0.00 $3,461.85 $29.82 $0.00 $3,461.85$0.00
Claim Number
2729559
Claim Status
Closed
Date of Loss
08/16/2016
Claim Changes
Reserve
Loss Reporting Location Code
04-04-GRAVETTE SCHOOL DISTRICT
Net Expense Paid
CLMT STATES THE BUS CROSSING ARM SWUNG OUT AND HIT CV IN THE
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Liability - Property Damage $0.00 $23.43$861.59 $0.00 $0.00 $861.59
Claim Total $861.59$0.00 $23.43$861.59 $0.00 $0.00
Liability Subtotal $0.00 $861.59 $23.43 $0.00 $861.59$0.00
Page 6 of 1012Monday, March 3, 2025
07/01/2016 07/01/2017
Policy Number Liability Limit $100,0000682996 Effective 7/2023+
Effective Prior to 7/2023
Claim Number
2730246
Claim Status
Closed
Date of Loss
08/16/2016
Claim Changes
Reserve
Loss Reporting Location Code
23-07-VILONIA SCHOOL DISTRICT
Net Expense Paid
NOT AT FAULT - THE INSURED HAD STOPPED TO TURN LEFT INTO HER
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Liability - Medical Payments $0.00 $0.00$5,000.00 $0.00 $0.00 $5,000.00
Liability - Underinsured Motor $0.00 $18.00$100,000.00 $0.00 $0.00 $100,000.00
Claim Total $105,000.00$0.00 $18.00$105,000.00 $0.00 $0.00
Liability Subtotal $0.00 $105,000.00 $18.00 $0.00 $105,000.00$0.00
Claim Number
2731019
Claim Status
Closed
Date of Loss
08/16/2016
Claim Changes
Reserve
Loss Reporting Location Code
26-06-LAKESIDE SCHOOL DISTRICT
Net Expense Paid
STRUCK OBJECT - STOP ARM BROKE LOOSE AND CAME DOWN AND HIT A
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Liability - Property Damage $0.00 $23.43$643.32 $0.00 $0.00 $643.32
Claim Total $643.32$0.00 $23.43$643.32 $0.00 $0.00
Liability Subtotal $0.00 $643.32 $23.43 $0.00 $643.32$0.00
Page 7 of 1012Monday, March 3, 2025
07/01/2016 07/01/2017
Policy Number Liability Limit $100,0000682996 Effective 7/2023+
Effective Prior to 7/2023
Claim Number
2730461
Claim Status
Closed
Date of Loss
08/17/2016
Claim Changes
Reserve
Loss Reporting Location Code
04-05-ROGERS SCHOOL DISTRICT
Net Expense Paid
STRUCK OBJECT - IV PULLING THRU COMPLEX AND STRUCK A LONG
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $19.92$7,145.09 $0.00 ($3,822.55) $3,322.54
Liability - Medical Payments $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Claim Total $3,322.54$0.00 $19.92$7,145.09 $0.00 ($3,822.55)
Liability Subtotal $0.00 $0.00 $0.00 $0.00 $0.00$0.00
Claim Number
2731041
Claim Status
Closed
Date of Loss
08/17/2016
Claim Changes
Reserve
Loss Reporting Location Code
32-01-BATESVILLE SCHOOL DISTRICT
Net Expense Paid
TAIL SWING - THE INSURED BUS STRUCK THE CLAIMANT VEHICLE
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Liability - Property Damage $0.00 $1,034.65$737.84 $0.00 $0.00 $737.84
Claim Total $737.84$0.00 $1,034.65$737.84 $0.00 $0.00
Liability Subtotal $0.00 $737.84 $1,034.65 $0.00 $737.84$0.00
Claim Number
2731611
Claim Status
Closed
Date of Loss
08/18/2016
Claim Changes
Reserve
Loss Reporting Location Code
32-01-BATESVILLE SCHOOL DISTRICT
Net Expense Paid
NOT AT FAULT - THE CLAIMANT RAN A RED LIGHT AND STRUCK THE
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $568.75$0.00 $0.00 $0.00 $0.00
Claim Total $0.00$0.00 $568.75$0.00 $0.00 $0.00
Page 8 of 1012Monday, March 3, 2025
07/01/2016 07/01/2017
Policy Number Liability Limit $100,0000682996 Effective 7/2023+
Effective Prior to 7/2023
Claim Number
2732018
Claim Status
Closed
Date of Loss
08/18/2016
Claim Changes
Reserve
Loss Reporting Location Code
26-06-LAKESIDE SCHOOL DISTRICT
Net Expense Paid
NOT AT FAULT - OV FAILED TO YIELD, TURNING IN FRONT OF IV;
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Liability - Property Damage $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Claim Total $0.00$0.00 $0.00$0.00 $0.00 $0.00
Liability Subtotal $0.00 $0.00 $0.00 $0.00 $0.00$0.00
Claim Number
2732048
Claim Status
Closed
Date of Loss
08/19/2016
Claim Changes
Reserve
Loss Reporting Location Code
16-08-JONESBORO SCHOOL DISTRICT
Net Expense Paid
TURNING - IV STRUCK DRIVER'S SIDE OF OV WHILE MAKING RIGHT
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Liability - Property Damage $0.00 $1,064.25$4,484.36 $0.00 $0.00 $4,484.36
Claim Total $4,484.36$0.00 $1,064.25$4,484.36 $0.00 $0.00
Liability Subtotal $0.00 $4,484.36 $1,064.25 $0.00 $4,484.36$0.00
Page 9 of 1012Monday, March 3, 2025
07/01/2016 07/01/2017
Policy Number Liability Limit $100,0000682996 Effective 7/2023+
Effective Prior to 7/2023
Claim Number
2732086
Claim Status
Closed
Date of Loss
08/19/2016
Claim Changes
Reserve
Loss Reporting Location Code
02-03-HAMBURG SCHOOL DISTRICT
Net Expense Paid
TURNING - IV CLIPPED THE CORNER OF A BUILDING, DAMAGING THE
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $1,320.55$6,713.36 $0.00 $0.00 $6,713.36
Liability - Property Damage $0.00 $0.00$827.00 $0.00 $0.00 $827.00
Claim Total $7,540.36$0.00 $1,320.55$7,540.36 $0.00 $0.00
Liability Subtotal $0.00 $827.00 $0.00 $0.00 $827.00$0.00
Claim Number
2732677
Claim Status
Closed
Date of Loss
08/19/2016
Claim Changes
Reserve
Loss Reporting Location Code
05-03-HARRISON SCHOOL DISTRICT
Net Expense Paid
IV PULLED AWAY FROM STOP AND REAR SWUNG WIDE AND HIT CV
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Liability - Property Damage $0.00 $150.00$1,653.11 $0.00 $0.00 $1,653.11
Claim Total $1,653.11$0.00 $150.00$1,653.11 $0.00 $0.00
Liability Subtotal $0.00 $1,653.11 $150.00 $0.00 $1,653.11$0.00
Page 10 of 1012Monday, March 3, 2025
07/01/2016 07/01/2017
Policy Number Liability Limit $100,0000682996 Effective 7/2023+
Effective Prior to 7/2023
Claim Number
2733456
Claim Status
Closed
Date of Loss
08/19/2016
Claim Changes
Reserve
Loss Reporting Location Code
16-08-JONESBORO SCHOOL DISTRICT
Net Expense Paid
TAILSWING-IV STOPPED BEHIND A VEHICLE THAT WAS PARKED ON THE
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Liability - Bodily Injury $0.00 $2,027.00$10,000.00 $0.00 $0.00 $10,000.00
Liability - Property Damage $0.00 $35.33$2,608.00 $0.00 $0.00 $2,608.00
Claim Total $12,608.00$0.00 $2,062.33$12,608.00 $0.00 $0.00
Liability Subtotal $0.00 $12,608.00 $2,062.33 $0.00 $12,608.00$0.00
Claim Number
2733468
Claim Status
Closed
Date of Loss
08/22/2016
Claim Changes
Reserve
Loss Reporting Location Code
16-08-JONESBORO SCHOOL DISTRICT
Net Expense Paid
STRUCK OBJECT - IV CAME OUT OF PARKING LOT AT JKC AND THAT
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Liability - Property Damage $0.00 $991.25$0.00 $0.00 $0.00 $0.00
Claim Total $0.00$0.00 $991.25$0.00 $0.00 $0.00
Liability Subtotal $0.00 $0.00 $991.25 $0.00 $0.00$0.00
Claim Number
2733471
Claim Status
Closed
Date of Loss
08/22/2016
Claim Changes
Reserve
Loss Reporting Location Code
10-02-ARKADELPHIA SCHOOL DISTRICT
Net Expense Paid
STRUCK OBJECT - IV WAS MAKING A LEFT TURN ON TO AR51/PINE
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Liability - Property Damage $0.00 $1,137.10$5,518.93 $0.00 $0.00 $5,518.93
Claim Total $5,518.93$0.00 $1,137.10$5,518.93 $0.00 $0.00
Liability Subtotal $0.00 $5,518.93 $1,137.10 $0.00 $5,518.93$0.00
Page 11 of 1012Monday, March 3, 2025
07/01/2016 07/01/2017
Policy Number Liability Limit $100,0000682996 Effective 7/2023+
Effective Prior to 7/2023
Claim Number
2733935
Claim Status
Closed
Date of Loss
08/22/2016
Claim Changes
Reserve
Loss Reporting Location Code
16-08-JONESBORO SCHOOL DISTRICT
Net Expense Paid
REARENDED - IV REARENDED OV NO INJURIES
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Liability - Property Damage $0.00 $887.30$911.88 $0.00 $0.00 $911.88
Claim Total $911.88$0.00 $887.30$911.88 $0.00 $0.00
Liability Subtotal $0.00 $911.88 $887.30 $0.00 $911.88$0.00
Claim Number
2734926
Claim Status
Closed
Date of Loss
08/23/2016
Claim Changes
Reserve
Loss Reporting Location Code
23-07-VILONIA SCHOOL DISTRICT
Net Expense Paid
BACKING - THE INSURED BACKED INTO THE CLAIMANT'S PARKED
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Liability - Property Damage $0.00 $23.43$1,082.88 $0.00 $0.00 $1,082.88
Claim Total $1,082.88$0.00 $23.43$1,082.88 $0.00 $0.00
Liability Subtotal $0.00 $1,082.88 $23.43 $0.00 $1,082.88$0.00
Claim Number
2735056
Claim Status
Closed
Date of Loss
08/23/2016
Claim Changes
Reserve
Loss Reporting Location Code
04-05-ROGERS SCHOOL DISTRICT
Net Expense Paid
SIDESWIPED - IV AND OV MET IN A CURVE & HIT LEFT FENDERS ON
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$4,526.30 $0.00 $0.00 $4,526.30
Claim Total $4,526.30$0.00 $0.00$4,526.30 $0.00 $0.00
Page 12 of 1012Monday, March 3, 2025
07/01/2016 07/01/2017
Policy Number Liability Limit $100,0000682996 Effective 7/2023+
Effective Prior to 7/2023
Claim Number
2735078
Claim Status
Closed
Date of Loss
08/23/2016
Claim Changes
Reserve
Loss Reporting Location Code
02-03-HAMBURG SCHOOL DISTRICT
Net Expense Paid
BACKING - THE INSURED VEHICLE BACKED INTO A LIGHT POLE.
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Liability - Property Damage $0.00 $411.25$1,698.16 $0.00 $0.00 $1,698.16
Claim Total $1,698.16$0.00 $411.25$1,698.16 $0.00 $0.00
Liability Subtotal $0.00 $1,698.16 $411.25 $0.00 $1,698.16$0.00
Claim Number
2735084
Claim Status
Closed
Date of Loss
08/25/2016
Claim Changes
Reserve
Loss Reporting Location Code
44-01-HUNTSVILLE SCHOOL DISTRICT
Net Expense Paid
FIRE - ELECTRICAL FIRE CAUSE DAMAGE TO THE INSURED BUS. FIRE
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Comp $0.00 $1,035.00$18,534.70 $0.00 $0.00 $18,534.70
Claim Total $18,534.70$0.00 $1,035.00$18,534.70 $0.00 $0.00
Page 13 of 1012Monday, March 3, 2025
07/01/2016 07/01/2017
Policy Number Liability Limit $100,0000682996 Effective 7/2023+
Effective Prior to 7/2023
Claim Number
2737822
Claim Status
Closed
Date of Loss
08/26/2016
Claim Changes
Reserve
Loss Reporting Location Code
73-07-RIVERVIEW SCHOOL DISTRICT
Net Expense Paid
INSURED DRIVER REAR ENDED VEHICLE WHO IN TURN REAR ENDED
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $475.00$3,499.59 $0.00 $0.00 $3,499.59
Liability - Bodily Injury $0.00 $490.00$16,796.01 $0.00 $0.00 $16,796.01
Liability - Property Damage $0.00 $58.62$18,801.92 $0.00 $0.00 $18,801.92
Claim Total $39,097.52$0.00 $1,023.62$39,097.52 $0.00 $0.00
Liability Subtotal $0.00 $35,597.93 $548.62 $0.00 $35,597.93$0.00
Claim Number
2740002
Claim Status
Closed
Date of Loss
08/30/2016
Claim Changes
Reserve
Loss Reporting Location Code
43-04-CABOT SCHOOL DISTRICT
Net Expense Paid
TURNING - THE INSURED BUS WAS TURNING RIGHT AT A THREE-WAY
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Liability - Bodily Injury $0.00 $0.00$13,765.00 $0.00 $0.00 $13,765.00
Liability - Property Damage $0.00 $23.43$6,021.30 $0.00 $0.00 $6,021.30
Claim Total $19,786.30$0.00 $23.43$19,786.30 $0.00 $0.00
Liability Subtotal $0.00 $19,786.30 $23.43 $0.00 $19,786.30$0.00
Page 14 of 1012Monday, March 3, 2025
07/01/2016 07/01/2017
Policy Number Liability Limit $100,0000682996 Effective 7/2023+
Effective Prior to 7/2023
Claim Number
2740145
Claim Status
Closed
Date of Loss
08/30/2016
Claim Changes
Reserve
Loss Reporting Location Code
36-01-CLARKSVILLE SCHOOL DISTRICT
Net Expense Paid
STRUCK OBJECT INSURED DRIVER EXITING BUS PARKING LOT AND
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Liability - Property Damage $0.00 $1,118.00$595.21 $0.00 $0.00 $595.21
Claim Total $595.21$0.00 $1,118.00$595.21 $0.00 $0.00
Liability Subtotal $0.00 $595.21 $1,118.00 $0.00 $595.21$0.00
Claim Number
2740345
Claim Status
Closed
Date of Loss
08/31/2016
Claim Changes
Reserve
Loss Reporting Location Code
04-06-SILOAM SPRINGS SCHOOL DISTRICT
Net Expense Paid
IV WAS REARENDED BY OV - 12 STUDENTS ON BOARD - NO INJURIES.
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Liability - Medical Payments $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Claim Total $0.00$0.00 $0.00$0.00 $0.00 $0.00
Page 15 of 1012Monday, March 3, 2025
07/01/2016 07/01/2017
Policy Number Liability Limit $100,0000682996 Effective 7/2023+
Effective Prior to 7/2023
Claim Number
2740693
Claim Status
Closed
Date of Loss
09/01/2016
Claim Changes
Reserve
Loss Reporting Location Code
01-01-DEWITT SCHOOL DISTRICT
Net Expense Paid
BACKING - THE INSURED STRUCK AN ONCOMING CLAIMANT VEHICLE
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$965.45 $0.00 $0.00 $965.45
Liability - Property Damage $0.00 $1,207.50$2,000.00 $0.00 $0.00 $2,000.00
Claim Total $2,965.45$0.00 $1,207.50$2,965.45 $0.00 $0.00
Liability Subtotal $0.00 $2,000.00 $1,207.50 $0.00 $2,000.00$0.00
Claim Number
2740946
Claim Status
Closed
Date of Loss
09/01/2016
Claim Changes
Reserve
Loss Reporting Location Code
05-06-LEAD HILL SCHOOL DISTRICT
Net Expense Paid
STRUCK OBJECT INSURED DRIVER HAD TO SWERVE TO AVOID HITTING
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$4,591.63 $0.00 $0.00 $4,591.63
Claim Total $4,591.63$0.00 $0.00$4,591.63 $0.00 $0.00
Liability Subtotal $0.00 $0.00 $0.00 $0.00 $0.00$0.00
Claim Number
2741624
Claim Status
Closed
Date of Loss
09/01/2016
Claim Changes
Reserve
Loss Reporting Location Code
28-08-PARAGOULD SCHOOL DISTRICT
Net Expense Paid
STRUCK OBJECT - IV STRUCK PIECE OF EQUIPMENT,
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $1,192.45$4,841.59 $0.00 $0.00 $4,841.59
Claim Total $4,841.59$0.00 $1,192.45$4,841.59 $0.00 $0.00
Page 16 of 1012Monday, March 3, 2025
07/01/2016 07/01/2017
Policy Number Liability Limit $100,0000682996 Effective 7/2023+
Effective Prior to 7/2023
Claim Number
2744305
Claim Status
Closed
Date of Loss
09/02/2016
Claim Changes
Reserve
Loss Reporting Location Code
03-03-MOUNTAIN HOME SCHOOL DISTRICT
Net Expense Paid
NOT AT FAULT - REARENDED - OV REARENDED IV AS IV WAS MAKING
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Claim Total $0.00$0.00 $0.00$0.00 $0.00 $0.00
Liability Subtotal $0.00 $0.00 $0.00 $0.00 $0.00$0.00
Claim Number
2742737
Claim Status
Closed
Date of Loss
09/06/2016
Claim Changes
Reserve
Loss Reporting Location Code
26-03-HOT SPRINGS SCHOOL DISTRICT
Net Expense Paid
TOWING - INSURED WAS TOWING A RENTED LIGHT TOWER BACK TO
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$995.81 $0.00 $0.00 $995.81
Claim Total $995.81$0.00 $0.00$995.81 $0.00 $0.00
Liability Subtotal $0.00 $0.00 $0.00 $0.00 $0.00$0.00
Claim Number
2744831
Claim Status
Closed
Date of Loss
09/06/2016
Claim Changes
Reserve
Loss Reporting Location Code
72-07-SPRINGDALE SCHOOL DISTRICT
Net Expense Paid
STUDENT THREW A WALNUT OUT OF THE BUS WINDOWN, HITTING CV
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Liability - Property Damage $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Claim Total $0.00$0.00 $0.00$0.00 $0.00 $0.00
Page 17 of 1012Monday, March 3, 2025
07/01/2016 07/01/2017
Policy Number Liability Limit $100,0000682996 Effective 7/2023+
Effective Prior to 7/2023
Claim Number
2744832
Claim Status
Closed
Date of Loss
09/06/2016
Claim Changes
Reserve
Loss Reporting Location Code
04-01-BENTONVILLE SCHOOL DISTRICT
Net Expense Paid
STRUCK OBJECT - IV STRUCK AWNING OF THE SONIC DRIVE-IN,
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Liability - Property Damage $0.00 $0.00$6,380.00 $0.00 $0.00 $6,380.00
Claim Total $6,380.00$0.00 $0.00$6,380.00 $0.00 $0.00
Liability Subtotal $0.00 $6,380.00 $0.00 $0.00 $6,380.00$0.00
Claim Number
2744812
Claim Status
Closed
Date of Loss
09/08/2016
Claim Changes
Reserve
Loss Reporting Location Code
23-03-GREENBRIER SCHOOL DISTRICT
Net Expense Paid
INSURED VEHICLE WAS INVOLVED IN AN AUTO ACCIDENT DAMAGE
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Liability - Property Damage $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Claim Total $0.00$0.00 $0.00$0.00 $0.00 $0.00
Liability Subtotal $0.00 $0.00 $0.00 $0.00 $0.00$0.00
Claim Number
2745647
Claim Status
Closed
Date of Loss
09/09/2016
Claim Changes
Reserve
Loss Reporting Location Code
44-01-HUNTSVILLE SCHOOL DISTRICT
Net Expense Paid
WEATHER - COMP - STORM CAUSED TREE TO FALL ON SCHOOL BUS.
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Comp $0.00 $0.00$3,083.45 $0.00 $0.00 $3,083.45
Claim Total $3,083.45$0.00 $0.00$3,083.45 $0.00 $0.00
Page 18 of 1012Monday, March 3, 2025
07/01/2016 07/01/2017
Policy Number Liability Limit $100,0000682996 Effective 7/2023+
Effective Prior to 7/2023
Claim Number
2745650
Claim Status
Closed
Date of Loss
09/09/2016
Claim Changes
Reserve
Loss Reporting Location Code
72-07-SPRINGDALE SCHOOL DISTRICT
Net Expense Paid
TAILSWING - INSURED VEHICLE PULLING OUT OF PARKING LOT, TAIL
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $475.00$7,961.87 $0.00 $0.00 $7,961.87
Claim Total $7,961.87$0.00 $475.00$7,961.87 $0.00 $0.00
Liability Subtotal $0.00 $0.00 $0.00 $0.00 $0.00$0.00
Claim Number
2747447
Claim Status
Closed
Date of Loss
09/09/2016
Claim Changes
Reserve
Loss Reporting Location Code
04-05-ROGERS SCHOOL DISTRICT
Net Expense Paid
TURNING - IV TURNED TOO SHORT AND HIT FRONT LEFT FENDER OF
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Liability - Property Damage $0.00 $23.43$3,002.00 $0.00 $0.00 $3,002.00
Claim Total $3,002.00$0.00 $23.43$3,002.00 $0.00 $0.00
Liability Subtotal $0.00 $3,002.00 $23.43 $0.00 $3,002.00$0.00
Claim Number
2747451
Claim Status
Closed
Date of Loss
09/09/2016
Claim Changes
Reserve
Loss Reporting Location Code
01-01-DEWITT SCHOOL DISTRICT
Net Expense Paid
BACKING - IV BACKED INTO INSURED FALCON UTILITY
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $945.25$1,412.67 $0.00 $0.00 $1,412.67
Claim Total $1,412.67$0.00 $945.25$1,412.67 $0.00 $0.00
Page 19 of 1012Monday, March 3, 2025
07/01/2016 07/01/2017
Policy Number Liability Limit $100,0000682996 Effective 7/2023+
Effective Prior to 7/2023
Claim Number
2750109
Claim Status
Closed
Date of Loss
09/09/2016
Claim Changes
Reserve
Loss Reporting Location Code
72-07-SPRINGDALE SCHOOL DISTRICT
Net Expense Paid
TURNING- IV CLIPPED THE BACK CORNER OF OV AS IT TURNED THE
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Liability - Property Damage $0.00 $70.00$1,132.00 $0.00 $0.00 $1,132.00
Claim Total $1,132.00$0.00 $70.00$1,132.00 $0.00 $0.00
Liability Subtotal $0.00 $1,132.00 $70.00 $0.00 $1,132.00$0.00
Claim Number
2746821
Claim Status
Closed
Date of Loss
09/10/2016
Claim Changes
Reserve
Loss Reporting Location Code
08-01-BERRYVILLE SCHOOL DISTRICT
Net Expense Paid
THEFT - SOMEONE BROKE INTO FENCED AND LOCKED BUS LOT AND
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Comp $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Claim Total $0.00$0.00 $0.00$0.00 $0.00 $0.00
Liability Subtotal $0.00 $0.00 $0.00 $0.00 $0.00$0.00
Claim Number
2768224
Claim Status
Closed
Date of Loss
09/12/2016
Claim Changes
Reserve
Loss Reporting Location Code
68-04-HIGHLAND SCHOOL DISTRICT
Net Expense Paid
STRUCK OBJECT - THE INSURED BUS BACKED INTO A UTILITY WIRE
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Liability - Property Damage $0.00 $623.25$3,759.90 $0.00 $0.00 $3,759.90
Claim Total $3,759.90$0.00 $623.25$3,759.90 $0.00 $0.00
Liability Subtotal $0.00 $3,759.90 $623.25 $0.00 $3,759.90$0.00
Page 20 of 1012Monday, March 3, 2025
07/01/2016 07/01/2017
Policy Number Liability Limit $100,0000682996 Effective 7/2023+
Effective Prior to 7/2023
Claim Number
2749071
Claim Status
Closed
Date of Loss
09/14/2016
Claim Changes
Reserve
Loss Reporting Location Code
35-05-PINE BLUFF SCHOOL DISTRICT
Net Expense Paid
STRUCK OBJECT - INSURED BUS HIT TEACHERS CAR IN PARKING LOT
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Liability - Property Damage $0.00 $23.43$2,838.85 $0.00 $0.00 $2,838.85
Claim Total $2,838.85$0.00 $23.43$2,838.85 $0.00 $0.00
Liability Subtotal $0.00 $2,838.85 $23.43 $0.00 $2,838.85$0.00
Claim Number
2749134
Claim Status
Closed
Date of Loss
09/14/2016
Claim Changes
Reserve
Loss Reporting Location Code
04-06-SILOAM SPRINGS SCHOOL DISTRICT
Net Expense Paid
TAILSWING - IV TAILSWING CAUGHT THE REAR RIGHT FENDER/BUMPER
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Liability - Property Damage $0.00 $0.00$967.27 $0.00 $0.00 $967.27
Claim Total $967.27$0.00 $0.00$967.27 $0.00 $0.00
Liability Subtotal $0.00 $967.27 $0.00 $0.00 $967.27$0.00
Claim Number
2751060
Claim Status
Closed
Date of Loss
09/14/2016
Claim Changes
Reserve
Loss Reporting Location Code
16-08-JONESBORO SCHOOL DISTRICT
Net Expense Paid
TAILSWING- RIGHT SIDE REAR OF IV HIT DRIVER SIDE OF PARKED
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Liability - Property Damage $0.00 $610.90$1,703.04 $0.00 $0.00 $1,703.04
Claim Total $1,703.04$0.00 $610.90$1,703.04 $0.00 $0.00
Liability Subtotal $0.00 $1,703.04 $610.90 $0.00 $1,703.04$0.00
Page 21 of 1012Monday, March 3, 2025
07/01/2016 07/01/2017
Policy Number Liability Limit $100,0000682996 Effective 7/2023+
Effective Prior to 7/2023
Claim Number
2749317
Claim Status
Closed
Date of Loss
09/15/2016
Claim Changes
Reserve
Loss Reporting Location Code
72-03-FAYETTEVILLE SCHOOL DISTRICT
Net Expense Paid
TURNING - THE INSURED BUS STRUCK THE CLAIMANT PARKED VEHICLE
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Liability - Property Damage $0.00 $0.00$1,738.36 $0.00 $0.00 $1,738.36
Claim Total $1,738.36$0.00 $0.00$1,738.36 $0.00 $0.00
Liability Subtotal $0.00 $1,738.36 $0.00 $0.00 $1,738.36$0.00
Claim Number
2751392
Claim Status
Closed
Date of Loss
09/19/2016
Claim Changes
Reserve
Loss Reporting Location Code
04-01-BENTONVILLE SCHOOL DISTRICT
Net Expense Paid
SIDESWIPED - IV CAME UPON CONSTRUCTION SITE AND STOPPED AS
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Liability - Property Damage $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Claim Total $0.00$0.00 $0.00$0.00 $0.00 $0.00
Liability Subtotal $0.00 $0.00 $0.00 $0.00 $0.00$0.00
Claim Number
2752136
Claim Status
Closed
Date of Loss
09/19/2016
Claim Changes
Reserve
Loss Reporting Location Code
35-09-WATSON CHAPEL SCHOOL DISTRICT
Net Expense Paid
NOT AT FAULT - THE INSURED MOVED FROM THE LEFT TO THE
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $475.00$0.00 $0.00 $0.00 $0.00
Liability - Medical Payments $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Claim Total $0.00$0.00 $475.00$0.00 $0.00 $0.00
Page 22 of 1012Monday, March 3, 2025
07/01/2016 07/01/2017
Policy Number Liability Limit $100,0000682996 Effective 7/2023+
Effective Prior to 7/2023
Claim Number
2753187
Claim Status
Closed
Date of Loss
09/21/2016
Claim Changes
Reserve
Loss Reporting Location Code
28-07 GREENE COUNTY TECH SCHOOL DISTRICT
Net Expense Paid
NOT AT FAULT - IV WAS STOPPED AT RED LIGHT; OV REARENDED IV
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $2,527.50$0.00 $0.00 $0.00 $0.00
Claim Total $0.00$0.00 $2,527.50$0.00 $0.00 $0.00
Liability Subtotal $0.00 $0.00 $0.00 $0.00 $0.00$0.00
Claim Number
2753642
Claim Status
Closed
Date of Loss
09/22/2016
Claim Changes
Reserve
Loss Reporting Location Code
43-04-CABOT SCHOOL DISTRICT
Net Expense Paid
NOT AT FAULT - THE INSURED BUS STOPPED AT A RED LIGHT AND
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Claim Total $0.00$0.00 $0.00$0.00 $0.00 $0.00
Liability Subtotal $0.00 $0.00 $0.00 $0.00 $0.00$0.00
Claim Number
2754267
Claim Status
Closed
Date of Loss
09/22/2016
Claim Changes
Reserve
Loss Reporting Location Code
16-08-JONESBORO SCHOOL DISTRICT
Net Expense Paid
FAILED TO YIELD - IV MERGED INTO RIGHT LANE OF TRAFFIC,
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Liability - Bodily Injury $0.00 $1,697.15$1,000.00 $0.00 $0.00 $1,000.00
Liability - Property Damage $0.00 $0.00$2,544.83 $0.00 $0.00 $2,544.83
Claim Total $3,544.83$0.00 $1,697.15$3,544.83 $0.00 $0.00
Liability Subtotal $0.00 $3,544.83 $1,697.15 $0.00 $3,544.83$0.00
Page 23 of 1012Monday, March 3, 2025
07/01/2016 07/01/2017
Policy Number Liability Limit $100,0000682996 Effective 7/2023+
Effective Prior to 7/2023
Claim Number
2754504
Claim Status
Closed
Date of Loss
09/23/2016
Claim Changes
Reserve
Loss Reporting Location Code
02-03-HAMBURG SCHOOL DISTRICT
Net Expense Paid
SIDESWIPED- IV WENT BETWEEN ANOTHER BUS AND A PARKED VEHICLE
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Liability - Property Damage $0.00 $810.95$1,460.16 $0.00 $0.00 $1,460.16
Claim Total $1,460.16$0.00 $810.95$1,460.16 $0.00 $0.00
Liability Subtotal $0.00 $1,460.16 $810.95 $0.00 $1,460.16$0.00
Claim Number
2755239
Claim Status
Closed
Date of Loss
09/26/2016
Claim Changes
Reserve
Loss Reporting Location Code
72-03-FAYETTEVILLE SCHOOL DISTRICT
Net Expense Paid
FAILURE TO YIELD - THE INSURED BUS PULLED THROUGH A STOP
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Liability - Bodily Injury $0.00 $0.00$2,000.00 $0.00 $0.00 $2,000.00
Liability - Property Damage $0.00 $160.19$2,300.95 $0.00 $0.00 $2,300.95
Claim Total $4,300.95$0.00 $160.19$4,300.95 $0.00 $0.00
Liability Subtotal $0.00 $4,300.95 $160.19 $0.00 $4,300.95$0.00
Page 24 of 1012Monday, March 3, 2025
07/01/2016 07/01/2017
Policy Number Liability Limit $100,0000682996 Effective 7/2023+
Effective Prior to 7/2023
Claim Number
2755552
Claim Status
Closed
Date of Loss
09/26/2016
Claim Changes
Reserve
Loss Reporting Location Code
52-04-CAMDEN FAIRVIEW SCHOOL DISTRICT
Net Expense Paid
TURNING - INSURED BUS TURNED INTO A PARKED VEHICLE WHILE
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Liability - Property Damage $0.00 $1,046.60$1,104.82 $0.00 $0.00 $1,104.82
Claim Total $1,104.82$0.00 $1,046.60$1,104.82 $0.00 $0.00
Liability Subtotal $0.00 $1,104.82 $1,046.60 $0.00 $1,104.82$0.00
Claim Number
2755652
Claim Status
Closed
Date of Loss
09/26/2016
Claim Changes
Reserve
Loss Reporting Location Code
23-07-VILONIA SCHOOL DISTRICT
Net Expense Paid
NOT AT FAULT - THE CLAIMANT VEHICLE CROSSED THE CENTER LINE
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Liability - Property Damage $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Claim Total $0.00$0.00 $0.00$0.00 $0.00 $0.00
Liability Subtotal $0.00 $0.00 $0.00 $0.00 $0.00$0.00
Claim Number
2756767
Claim Status
Closed
Date of Loss
09/27/2016
Claim Changes
Reserve
Loss Reporting Location Code
60-02-NORTH LITTLE ROCK SCHOOL DISTRICT
Net Expense Paid
NOT AT FAULT - RED DUMP TRUCK PASSED IV ON THE DRIVER SIDE
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Claim Total $0.00$0.00 $0.00$0.00 $0.00 $0.00
Page 25 of 1012Monday, March 3, 2025
07/01/2016 07/01/2017
Policy Number Liability Limit $100,0000682996 Effective 7/2023+
Effective Prior to 7/2023
Claim Number
2757441
Claim Status
Closed
Date of Loss
09/28/2016
Claim Changes
Reserve
Loss Reporting Location Code
72-03-FAYETTEVILLE SCHOOL DISTRICT
Net Expense Paid
ANIMAL - THE INSURED VEHICLE STRUCK A DEER.
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Comp $0.00 $23.43$2,789.32 $0.00 $0.00 $2,789.32
Claim Total $2,789.32$0.00 $23.43$2,789.32 $0.00 $0.00
Liability Subtotal $0.00 $0.00 $0.00 $0.00 $0.00$0.00
Claim Number
2758122
Claim Status
Closed
Date of Loss
09/29/2016
Claim Changes
Reserve
Loss Reporting Location Code
73-09-PANGBURN SCHOOL DISTRIC
Net Expense Paid
STRUCK OBJECT - IV WAS TURNING AROUND AND STRUCK A LIMB,
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $472.55$3,328.62 $0.00 $0.00 $3,328.62
Claim Total $3,328.62$0.00 $472.55$3,328.62 $0.00 $0.00
Liability Subtotal $0.00 $0.00 $0.00 $0.00 $0.00$0.00
Claim Number
2758152
Claim Status
Closed
Date of Loss
09/29/2016
Claim Changes
Reserve
Loss Reporting Location Code
01-01-DEWITT SCHOOL DISTRICT
Net Expense Paid
BACKING - IV BACKED INTO PARKED UNOCCUPIED IV. THE IV THAT
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $682.75$1,554.77 $0.00 $0.00 $1,554.77
Claim Total $1,554.77$0.00 $682.75$1,554.77 $0.00 $0.00
Page 26 of 1012Monday, March 3, 2025
07/01/2016 07/01/2017
Policy Number Liability Limit $100,0000682996 Effective 7/2023+
Effective Prior to 7/2023
Claim Number
2759911
Claim Status
Closed
Date of Loss
09/29/2016
Claim Changes
Reserve
Loss Reporting Location Code
68-04-HIGHLAND SCHOOL DISTRICT
Net Expense Paid
TIRE BLEW OUT - INSURED BUS THREW A SECTION OF TIRE AND IT
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Liability - Property Damage $0.00 $620.75$1,648.72 $0.00 $0.00 $1,648.72
Claim Total $1,648.72$0.00 $620.75$1,648.72 $0.00 $0.00
Liability Subtotal $0.00 $1,648.72 $620.75 $0.00 $1,648.72$0.00
Claim Number
2758641
Claim Status
Closed
Date of Loss
09/30/2016
Claim Changes
Reserve
Loss Reporting Location Code
63-03 BRYANT SCHOOL DISTRICT
Net Expense Paid
STRUCK OBJECT - THE INSURED BUS STRUCK AN EXTENTION LADDER
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Liability - Property Damage $0.00 $0.00$250.00 $0.00 $0.00 $250.00
Claim Total $250.00$0.00 $0.00$250.00 $0.00 $0.00
Liability Subtotal $0.00 $250.00 $0.00 $0.00 $250.00$0.00
Page 27 of 1012Monday, March 3, 2025
07/01/2016 07/01/2017
Policy Number Liability Limit $100,0000682996 Effective 7/2023+
Effective Prior to 7/2023
Claim Number
2759606
Claim Status
Closed
Date of Loss
09/30/2016
Claim Changes
Reserve
Loss Reporting Location Code
04-05-ROGERS SCHOOL DISTRICT
Net Expense Paid
TAIL SWING - THE INSURED BUS STRUCK A MAIL BOX WHILE
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Liability - Property Damage $0.00 $0.00$1,225.00 $0.00 $0.00 $1,225.00
Claim Total $1,225.00$0.00 $0.00$1,225.00 $0.00 $0.00
Liability Subtotal $0.00 $1,225.00 $0.00 $0.00 $1,225.00$0.00
Claim Number
2760493
Claim Status
Closed
Date of Loss
10/03/2016
Claim Changes
Reserve
Loss Reporting Location Code
03-03-MOUNTAIN HOME SCHOOL DISTRICT
Net Expense Paid
BACKING - THE INSURED BUS STRUCK THE CLAIMANT'S PARKED
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Liability - Property Damage $0.00 $23.43$2,965.68 $0.00 $0.00 $2,965.68
Claim Total $2,965.68$0.00 $23.43$2,965.68 $0.00 $0.00
Liability Subtotal $0.00 $2,965.68 $23.43 $0.00 $2,965.68$0.00
Page 28 of 1012Monday, March 3, 2025
07/01/2016 07/01/2017
Policy Number Liability Limit $100,0000682996 Effective 7/2023+
Effective Prior to 7/2023
Claim Number
2760497
Claim Status
Closed
Date of Loss
10/03/2016
Claim Changes
Reserve
Loss Reporting Location Code
12-02-HEBER SPRINGS SCHOOL DISTRICT
Net Expense Paid
BACKING - IV BACKED INTO A PARKED AND UNOCCUPIED IV. NO
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $475.00$1,130.41 $0.00 $0.00 $1,130.41
Claim Total $1,130.41$0.00 $475.00$1,130.41 $0.00 $0.00
Liability Subtotal $0.00 $0.00 $0.00 $0.00 $0.00$0.00
Claim Number
2760499
Claim Status
Closed
Date of Loss
10/03/2016
Claim Changes
Reserve
Loss Reporting Location Code
03-03-MOUNTAIN HOME SCHOOL DISTRICT
Net Expense Paid
BACKING - THE INSURED'S BUS DRIVER STRUCK HIS PERSONAL
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Liability - Property Damage $0.00 $23.43$2,149.95 $0.00 $0.00 $2,149.95
Claim Total $2,149.95$0.00 $23.43$2,149.95 $0.00 $0.00
Liability Subtotal $0.00 $2,149.95 $23.43 $0.00 $2,149.95$0.00
Page 29 of 1012Monday, March 3, 2025
07/01/2016 07/01/2017
Policy Number Liability Limit $100,0000682996 Effective 7/2023+
Effective Prior to 7/2023
Claim Number
2761355
Claim Status
Closed
Date of Loss
10/04/2016
Claim Changes
Reserve
Loss Reporting Location Code
04-01-BENTONVILLE SCHOOL DISTRICT
Net Expense Paid
REARENDED - IV REARENDED OV; NO INJURIES; NO STUDENTS ABOARD
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Liability - Property Damage $0.00 $70.00$1,625.00 $0.00 $0.00 $1,625.00
Claim Total $1,625.00$0.00 $70.00$1,625.00 $0.00 $0.00
Liability Subtotal $0.00 $1,625.00 $70.00 $0.00 $1,625.00$0.00
Claim Number
2761365
Claim Status
Closed
Date of Loss
10/05/2016
Claim Changes
Reserve
Loss Reporting Location Code
63-03 BRYANT SCHOOL DISTRICT
Net Expense Paid
BACKING - THE INSURED BUS BACKED INTO THE CLAIMANT PARKED
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Liability - Property Damage $0.00 $23.43$3,081.04 $0.00 $0.00 $3,081.04
Claim Total $3,081.04$0.00 $23.43$3,081.04 $0.00 $0.00
Liability Subtotal $0.00 $3,081.04 $23.43 $0.00 $3,081.04$0.00
Page 30 of 1012Monday, March 3, 2025
07/01/2016 07/01/2017
Policy Number Liability Limit $100,0000682996 Effective 7/2023+
Effective Prior to 7/2023
Claim Number
2761630
Claim Status
Closed
Date of Loss
10/06/2016
Claim Changes
Reserve
Loss Reporting Location Code
23-01-CONWAY SCHOOL DISTRICT
Net Expense Paid
FAILURE TO YIELD - THE INSURED BUS PULL PAST A STOP SIGN AND
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Liability - Property Damage $0.00 $23.43$2,056.42 $0.00 $0.00 $2,056.42
Claim Total $2,056.42$0.00 $23.43$2,056.42 $0.00 $0.00
Liability Subtotal $0.00 $2,056.42 $23.43 $0.00 $2,056.42$0.00
Claim Number
2763258
Claim Status
Closed
Date of Loss
10/06/2016
Claim Changes
Reserve
Loss Reporting Location Code
72-07-SPRINGDALE SCHOOL DISTRICT
Net Expense Paid
TAIL SWING - IV WAS TURNING LEFT AT INTERSECTION; RIGHT REAR
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Liability - Property Damage $0.00 $0.00$4,373.19 $0.00 $0.00 $4,373.19
Claim Total $4,373.19$0.00 $0.00$4,373.19 $0.00 $0.00
Liability Subtotal $0.00 $4,373.19 $0.00 $0.00 $4,373.19$0.00
Claim Number
2763822
Claim Status
Closed
Date of Loss
10/07/2016
Claim Changes
Reserve
Loss Reporting Location Code
32-01-BATESVILLE SCHOOL DISTRICT
Net Expense Paid
TAIL SWING - THE INSURED BUS STRUCK THE CLAIMANT'S PARKED
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Liability - Property Damage $0.00 $1,051.40$880.24 $0.00 $0.00 $880.24
Claim Total $880.24$0.00 $1,051.40$880.24 $0.00 $0.00
Liability Subtotal $0.00 $880.24 $1,051.40 $0.00 $880.24$0.00
Page 31 of 1012Monday, March 3, 2025
07/01/2016 07/01/2017
Policy Number Liability Limit $100,0000682996 Effective 7/2023+
Effective Prior to 7/2023
Claim Number
2765489
Claim Status
Closed
Date of Loss
10/07/2016
Claim Changes
Reserve
Loss Reporting Location Code
72-07-SPRINGDALE SCHOOL DISTRICT
Net Expense Paid
SIDESWIPED - IV WAS PULLING AROUND TO UNLOAD STUDENTS AND
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$3,434.18 $0.00 $0.00 $3,434.18
Liability - Property Damage $0.00 $70.00$1,051.00 $0.00 $0.00 $1,051.00
Claim Total $4,485.18$0.00 $70.00$4,485.18 $0.00 $0.00
Liability Subtotal $0.00 $1,051.00 $70.00 $0.00 $1,051.00$0.00
Claim Number
2764340
Claim Status
Closed
Date of Loss
10/08/2016
Claim Changes
Reserve
Loss Reporting Location Code
09-01-DERMOTT SCHOOL DISTRICT
Net Expense Paid
ANIMAL- IV STRUCK A DEER
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Comp $0.00 $760.45$2,713.67 $0.00 $0.00 $2,713.67
Claim Total $2,713.67$0.00 $760.45$2,713.67 $0.00 $0.00
Liability Subtotal $0.00 $0.00 $0.00 $0.00 $0.00$0.00
Claim Number
2764337
Claim Status
Closed
Date of Loss
10/10/2016
Claim Changes
Reserve
Loss Reporting Location Code
04-05-ROGERS SCHOOL DISTRICT
Net Expense Paid
TAIL SWING - THE INSURED BUS STRUCK THE CLAIMANT VEHICLE IN
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Liability - Property Damage $0.00 $150.00$3,280.51 $0.00 $0.00 $3,280.51
Claim Total $3,280.51$0.00 $150.00$3,280.51 $0.00 $0.00
Liability Subtotal $0.00 $3,280.51 $150.00 $0.00 $3,280.51$0.00
Page 32 of 1012Monday, March 3, 2025
07/01/2016 07/01/2017
Policy Number Liability Limit $100,0000682996 Effective 7/2023+
Effective Prior to 7/2023
Claim Number
2764338
Claim Status
Closed
Date of Loss
10/10/2016
Claim Changes
Reserve
Loss Reporting Location Code
63-03 BRYANT SCHOOL DISTRICT
Net Expense Paid
STRUCK OBJECT - THE INSURED VEHICLE STRUCK A GATE AT THE
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $475.00$16,826.46 $0.00 $0.00 $16,826.46
Claim Total $16,826.46$0.00 $475.00$16,826.46 $0.00 $0.00
Liability Subtotal $0.00 $0.00 $0.00 $0.00 $0.00$0.00
Claim Number
2764350
Claim Status
Closed
Date of Loss
10/10/2016
Claim Changes
Reserve
Loss Reporting Location Code
03-02-COTTER SCHOOL DISTRICT
Net Expense Paid
SIDESWIPED - INSURED DRIVER HIT TWO OTHER VEHICLES WHILE
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Liability - Property Damage $0.00 $532.58$4,781.31 $0.00 $0.00 $4,781.31
Claim Total $4,781.31$0.00 $532.58$4,781.31 $0.00 $0.00
Liability Subtotal $0.00 $4,781.31 $532.58 $0.00 $4,781.31$0.00
Claim Number
2767209
Claim Status
Closed
Date of Loss
10/11/2016
Claim Changes
Reserve
Loss Reporting Location Code
47-02-BLYTHEVILLE SCHOOL DISTRICT
Net Expense Paid
STRUCK OBJECT - THE INSURED VEHICLE STRUCK A TREE WHILE
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $23.43$2,726.60 $0.00 $0.00 $2,726.60
Claim Total $2,726.60$0.00 $23.43$2,726.60 $0.00 $0.00
Page 33 of 1012Monday, March 3, 2025
07/01/2016 07/01/2017
Policy Number Liability Limit $100,0000682996 Effective 7/2023+
Effective Prior to 7/2023
Claim Number
2766081
Claim Status
Closed
Date of Loss
10/12/2016
Claim Changes
Reserve
Loss Reporting Location Code
23-07-VILONIA SCHOOL DISTRICT
Net Expense Paid
STRUCK OBJECT - THE INSURED STRUCK A CONCRETE PILLAR WHILE
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $23.43$1,585.43 $0.00 $0.00 $1,585.43
Claim Total $1,585.43$0.00 $23.43$1,585.43 $0.00 $0.00
Liability Subtotal $0.00 $0.00 $0.00 $0.00 $0.00$0.00
Claim Number
2769635
Claim Status
Closed
Date of Loss
10/12/2016
Claim Changes
Reserve
Loss Reporting Location Code
72-07-SPRINGDALE SCHOOL DISTRICT
Net Expense Paid
NOT AT FAULT - IV WAS SITTING STILL, WAITING TO MAKE LEFT
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Claim Total $0.00$0.00 $0.00$0.00 $0.00 $0.00
Liability Subtotal $0.00 $0.00 $0.00 $0.00 $0.00$0.00
Claim Number
2768650
Claim Status
Closed
Date of Loss
10/13/2016
Claim Changes
Reserve
Loss Reporting Location Code
17-01-ALMA SCHOOL DISTRICT
Net Expense Paid
NOT AT FAULT - THE INSURED BUS WAS TURNING AND THE CLAIMANT
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Liability - Property Damage $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Claim Total $0.00$0.00 $0.00$0.00 $0.00 $0.00
Page 34 of 1012Monday, March 3, 2025
07/01/2016 07/01/2017
Policy Number Liability Limit $100,0000682996 Effective 7/2023+
Effective Prior to 7/2023
Claim Number
2768652
Claim Status
Closed
Date of Loss
10/13/2016
Claim Changes
Reserve
Loss Reporting Location Code
73-11-SEARCY SCHOOL DISTRICT
Net Expense Paid
STRUCK OBJECT - THE INSURED BUS WENT OVER A DIP/BUMP IN THE
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Claim Total $0.00$0.00 $0.00$0.00 $0.00 $0.00
Liability Subtotal $0.00 $0.00 $0.00 $0.00 $0.00$0.00
Claim Number
2779284
Claim Status
Closed
Date of Loss
10/13/2016
Claim Changes
Reserve
Loss Reporting Location Code
21-04-DUMAS SCHOOL DISTRICT
Net Expense Paid
STRUCK OBJECT - INSURED DRIVER SUFFERED A SEIZURE AND
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $2,342.65$7,984.10 $0.00 $0.00 $7,984.10
Claim Total $7,984.10$0.00 $2,342.65$7,984.10 $0.00 $0.00
Liability Subtotal $0.00 $0.00 $0.00 $0.00 $0.00$0.00
Claim Number
2769183
Claim Status
Closed
Date of Loss
10/14/2016
Claim Changes
Reserve
Loss Reporting Location Code
35-09-WATSON CHAPEL SCHOOL DISTRICT
Net Expense Paid
NOT AT FAULT - OV HIT IV IN THE INTERSECTION. IV HAD THE
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Claim Total $0.00$0.00 $0.00$0.00 $0.00 $0.00
Page 35 of 1012Monday, March 3, 2025
07/01/2016 07/01/2017
Policy Number Liability Limit $100,0000682996 Effective 7/2023+
Effective Prior to 7/2023
Claim Number
2779633
Claim Status
Closed
Date of Loss
10/14/2016
Claim Changes
Reserve
Loss Reporting Location Code
23-03-GREENBRIER SCHOOL DISTRICT
Net Expense Paid
NOT-AT-FAULT - OV PULLED INTO LEFT REAR FENDER OF IV NO
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Claim Total $0.00$0.00 $0.00$0.00 $0.00 $0.00
Liability Subtotal $0.00 $0.00 $0.00 $0.00 $0.00$0.00
Claim Number
2770409
Claim Status
Closed
Date of Loss
10/17/2016
Claim Changes
Reserve
Loss Reporting Location Code
04-01-BENTONVILLE SCHOOL DISTRICT
Net Expense Paid
NOT AT FAULT - IV WAS REARENDED BY OV 61 STUDENTS ABOARD,
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $475.00$2,390.48 $0.00 ($2,390.48) $0.00
Claim Total $0.00$0.00 $475.00$2,390.48 $0.00 ($2,390.48)
Liability Subtotal $0.00 $0.00 $0.00 $0.00 $0.00$0.00
Claim Number
2771022
Claim Status
Closed
Date of Loss
10/17/2016
Claim Changes
Reserve
Loss Reporting Location Code
16-08-JONESBORO SCHOOL DISTRICT
Net Expense Paid
NOT AT FAULT - OV BACKED INTO IV NO INJURIES
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $463.75$0.00 $0.00 $0.00 $0.00
Claim Total $0.00$0.00 $463.75$0.00 $0.00 $0.00
Page 36 of 1012Monday, March 3, 2025
07/01/2016 07/01/2017
Policy Number Liability Limit $100,0000682996 Effective 7/2023+
Effective Prior to 7/2023
Claim Number
2771037
Claim Status
Closed
Date of Loss
10/17/2016
Claim Changes
Reserve
Loss Reporting Location Code
58-05-RUSSELLVILLE SCHOOL DISTRICT
Net Expense Paid
TAIL SWING - IV WAS TRANSPORTING STUDENTS FROM JR. HIGH AND
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$0.00 $0.00 $0.00 $0.00
Liability - Property Damage $0.00 $23.43$3,930.20 $0.00 $0.00 $3,930.20
Claim Total $3,930.20$0.00 $23.43$3,930.20 $0.00 $0.00
Liability Subtotal $0.00 $3,930.20 $23.43 $0.00 $3,930.20$0.00
Claim Number
2771548
Claim Status
Closed
Date of Loss
10/19/2016
Claim Changes
Reserve
Loss Reporting Location Code
02-03-HAMBURG SCHOOL DISTRICT
Net Expense Paid
TURNING - THE INSURED BUS MADE A RIGHT TURN AND SIDESWIPED
Paid Salvage Rec Subro Rec
Liability Limit
$100,000
Net Paid less Subro/Sal
Collision $0.00 $0.00$968.75 $0.00 $0.00 $968.75
Liability - Bodily Injury $0.00 $9,570.50$0.00 $0.00 $0.00 $0.00
Liability - Property Damage $0.00 $0.00$4,183.20 $0.00 $0.00 $4,183.20
Claim Total…
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