City_of_Green_Cove_Springs_PL_Loss_Report_01.01.2021_-_06.30.2026.xlsx
XLSX spreadsheet 38 KB Posted
- Solicitation number
- 2026-05
- Issued by
- Clay County, Harold CDP, Florida
About this file
This is a Property and Casualty Insurance Loss Report for the City of Green Cove Springs, Florida, covering the period from January 1, 2021 through June 30, 2026. The report documents claims activity across multiple insurance coverages including General Liability (GL), Automobile (APD and AL), Property (RPP), Police Liability (POL), and Employment Practices Liability (EO). The City seeks insurance quotes for fiscal year October 1, 2026 through September 30, 2027, with coverage needs spanning General Liability, Errors & Omissions, Law Enforcement Liability, Breach Response & Cyber Liability, Automobile, Property, Inland Marine, Storage Tank Liability, and Workers Compensation. The contract will be awarded for an initial one-year term with the possibility of four additional one-year renewal options subject to mutually agreed upon rate adjustments.
The loss report reflects 149 claims with total indemnity and expense payments of $1,551,216.97 and reserves of $426,805.59 as of June 30, 2026. Notable claim categories include premises liability incidents (slip and falls, tree damage), vehicle collisions, property damage from city maintenance operations, and recent high-value claims including a police custody claim for $102,000, a slip and fall claim for $181,050, and wheelchair accessibility incident for $174,671. Recent losses include Hurricane Helene damage totaling approximately $90,479.57 and various claims related to city employee operations causing collateral damage. The report indicates active claims management with multiple adjusters assigned and varying claim statuses, providing the basis for the City's insurance procurement for the upcoming fiscal year.
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Data
| Member Loss Report - PL | ||||||||||||||||||||||||||||||||||
| Run Date: 07/15/2026 | ||||||||||||||||||||||||||||||||||
| Claim Number | Loss Date | Reported | Coverage | Claimant | Adjuster | Status | Description | Fund Year | Activity This Period - Indemnity Payments | Activity This Period - Indemnity Reserves | Activity This Period - Indemnity Recoveries | Activity This Period - Indemnity Incurred | Activity This Period - Expense Payments | Activity This Period - Expense Reserves | Activity This Period - Expense Recoveries | Activity This Period - Expense Incurred | Activity This Period - Payments Subtotal | Activity This Period - Reserves Subtotal | Activity This Period - Recoveries Subtotal | Activity This Period - Incurred Subtotal | Total As of Date - Indemnity Payments | Total As of Date - Indemnity Reserves | Total As of Date - Indemnity Recoveries | Total As of Date - Indemnity Incurred | Total As of Date - Expense Payments | Total As of Date - Expense Reserves | Total As of Date - Expense Recoveries | Total As of Date - Expense Incurred | Total As of Date - Payments Subtotal | Total As of Date - Reserves Subtotal | Total As of Date - Recoveries Subtotal | Total As of Date - Incurred Subtotal | ||
| VA2021099962 | 1/12/21 | 1/13/21 | APD | Sonllaliz Trujillo | C | Damaged windshield | 2020 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $158.27 | $0.00 | $0.00 | $158.27 | $0.00 | $0.00 | $0.00 | $0.00 | $158.27 | $0.00 | $0.00 | $158.27 | 0218 | 2020 | |
| VA2021100110 | 1/28/21 | 1/29/21 | AL | Victoria Roberson | Melissa Correll | C | IV and OV were involved in an accident | 2020 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $123,808.59 | $0.00 | $0.00 | $123,808.59 | $34,282.94 | $0.00 | $0.00 | $34,282.94 | $158,091.53 | $0.00 | $0.00 | $158,091.53 | 0218 | 2020 |
| GC2021101254 | 3/7/21 | 5/27/21 | GL | Jacob Barratt Minor | Gladys Alicea | C | Citizen was standing in line waiting to enter the Strawberry Festival with his mother and sister when suddenly a vehicle drove through the crowd | 2020 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2020 |
| GC2021100747 | 3/14/21 | 4/7/21 | GL | Renada Walker | Mirinda Hunter | C | While walking in the park claimant allegedly stepped in a hole causing her to sustain bodily injuries | 2020 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $7,500.00 | $0.00 | $0.00 | $7,500.00 | $0.00 | $0.00 | $0.00 | $0.00 | $7,500.00 | $0.00 | $0.00 | $7,500.00 | 0218 | 2020 |
| GC2022104640 | 3/18/21 | 5/11/22 | GL | Ariela Jeon | William Morgan | C | Tripped over poorly maintained rubber tiles and mulch | 2020 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $35,000.00 | $0.00 | $0.00 | $35,000.00 | $8,534.38 | $0.00 | $0.00 | $8,534.38 | $43,534.38 | $0.00 | $0.00 | $43,534.38 | 0218 | 2020 |
| VA2021100678 | 3/25/21 | 3/29/21 | APD | Carson Seavey Iii | Crystal Garcia | C | CLAIMANT ALLEGES MEMBER RAN STOP SIGN CAUSING BOTH VEHICLES TO COLLIDE | 2020 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $27,640.29 | $0.00 | $512.25 | $27,128.04 | $245.60 | $0.00 | $0.00 | $245.60 | $27,885.89 | $0.00 | $512.25 | $27,373.64 | 0218 | 2020 |
| GC2021100731 | 3/30/21 | 4/5/21 | GL | Antesia Kelly | William Morgan | C | Claimant reported a tree fell on her fence | 2020 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2020 |
| GC2021100827 | 4/9/21 | 4/14/21 | GL | Helen Herbert | Melissa Correll | C | Claimant alleges that she was looking at the hamburger food truck not paying attention to the steps and fell | 2020 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $105,000.00 | $0.00 | $0.00 | $105,000.00 | $12,287.68 | $0.00 | $549.34 | $11,738.34 | $117,287.68 | $0.00 | $549.34 | $116,738.34 | 0218 | 2020 |
| GC2021100960 | 4/21/21 | 4/27/21 | GL | Gloria Felton | William Morgan | C | Tree fell on floating kayak dock while claimant was fishing from it The tree punctured a 3 inch hole in the dock and caused damage to claimant s fishing rods reels folding chair and plastic bucket | 2020 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $95,000.00 | $0.00 | $0.00 | $95,000.00 | $72,652.75 | $0.00 | $0.00 | $72,652.75 | $167,652.75 | $0.00 | $0.00 | $167,652.75 | 0218 | 2020 |
| VA2021100999 | 4/28/21 | 4/30/21 | APD | Sean Dietrich | William Morgan | C | Per claimant While approaching the entrance of my neighborhood to exit onto to the main road a city yard waste pickup vehicle Green Cove Springs was ahead of mine It was also waiting to turn and exit Another city vehicle was parked off of the road behind me to my left The operator of the second parked vehicle was aware the one in front of mine was about to begin reversing instead of exiting and began shouting to indicate to its driver that I was behind him The driver did not receive the alert an | 2020 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $5,251.00 | $0.00 | $319.25 | $4,931.75 | $390.00 | $0.00 | $0.00 | $390.00 | $5,641.00 | $0.00 | $319.25 | $5,321.75 | 0218 | 2020 |
| GC2021101760 | 6/1/21 | 7/15/21 | GL | Sylvia Howard | Shafanta Jones | C | Passenger and driver on bus owned by Clay County school was in an accident | 2020 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2020 |
| VA2021101627 | 6/9/21 | 7/2/21 | AL | James Mason | Vasia Collier | C | While attempting to make a left turn IV was struck in the right rear wheel by OV OV allegedly left the scene of the accident | 2020 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $40,000.00 | $0.00 | $0.00 | $40,000.00 | $0.00 | $0.00 | $0.00 | $0.00 | $40,000.00 | $0.00 | $0.00 | $40,000.00 | 0218 | 2020 |
| GC2021101446 | 6/11/21 | 6/16/21 | GL | Jeremy Martin | Vasia Collier | C | A City owned tree had limbs fall onto a citizens vehicle | 2020 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2020 |
| GC2021101679 | 6/25/21 | 7/8/21 | GL | Candice Joest | William Morgan | C | Claimant tripped and fell on sidewalk | 2020 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $45,000.00 | $0.00 | $0.00 | $45,000.00 | $22,164.96 | $0.00 | $0.00 | $22,164.96 | $67,164.96 | $0.00 | $0.00 | $67,164.96 | 0218 | 2020 |
| VA2021102102 | 7/8/21 | 8/17/21 | APD | Governors Pointe | Shafanta Jones | C | Employee Nathan Nettles was operating City vehicle 701 and the step of the truck caught the entry gate of the community | 2020 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $8,265.00 | $0.00 | $0.00 | $8,265.00 | $0.00 | $0.00 | $0.00 | $0.00 | $8,265.00 | $0.00 | $0.00 | $8,265.00 | 0218 | 2020 |
| GC2021102299 | 8/28/21 | 9/3/21 | GL | Darryl Forbes | Vasia Collier | C | Power surge took out control panel on oven May 27th and August 28th | 2020 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2020 |
| GC2021102840 | 9/11/21 | 11/1/21 | GL | Sherry Conner | George Guffey | C | Trip and fall on uneven sidewalk | 2020 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $10,000.00 | $0.00 | $0.00 | $10,000.00 | $0.00 | $0.00 | $0.00 | $0.00 | $10,000.00 | $0.00 | $0.00 | $10,000.00 | 0218 | 2020 |
| GC2021102933 | 10/16/21 | 11/12/21 | GL | Co Patrick Fields Gcs Real Estate Partnership | Mirinda Hunter | C | Alleged that City performed some maintenance repairs to an electrical pole outside the office When the service was reconnected apparently the polarity connection was reversed This resulted in damage to the HVAC equipment | 2021 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $10,256.00 | $0.00 | $0.00 | $10,256.00 | $0.00 | $0.00 | $0.00 | $0.00 | $10,256.00 | $0.00 | $0.00 | $10,256.00 | 0218 | 2021 |
| VA2021103259 | 10/25/21 | 12/15/21 | APD | Tammy Perry | Mirinda Hunter | C | Member backed vehicle up and hit his mailbox | 2021 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $695.91 | $0.00 | $0.00 | $695.91 | $105.00 | $0.00 | $0.00 | $105.00 | $800.91 | $0.00 | $0.00 | $800.91 | 0218 | 2021 |
| VA2022103738 | 11/2/21 | 2/9/22 | APD | Crystal Garcia | C | Windshield | 2021 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $369.97 | $0.00 | $0.00 | $369.97 | $0.00 | $0.00 | $0.00 | $0.00 | $369.97 | $0.00 | $0.00 | $369.97 | 0218 | 2021 | |
| GC2026292685 | 11/14/21 | 2/12/26 | POL | Passion Pollard | Tori Maxwell | O | Claimant alleges unlawful entry into their residence unlawful detention and arrest and the use of excessive force by police officers | 2021 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $25,000.00 | $0.00 | $25,000.00 | $6,676.50 | $70,323.50 | $0.00 | $77,000.00 | $6,676.50 | $95,323.50 | $0.00 | $102,000.00 | 0218 | 2021 |
| VA2022103655 | 11/30/21 | 2/2/22 | APD | Vasia Collier | C | windshield | 2021 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $329.97 | $0.00 | $0.00 | $329.97 | $0.00 | $0.00 | $0.00 | $0.00 | $329.97 | $0.00 | $0.00 | $329.97 | 0218 | 2021 | |
| GC2022103860 | 12/3/21 | 2/18/22 | RPP | Forest Scott | C | Please see the attached E mail Service Requests and Costs for damage to a Power Pole which occurred on 12 03 2021 from a vehicle accident The loss location is listed as US 17 and CR 209 Near 3106 US 17 N Location 109 | 2021 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $1,839.06 | $0.00 | $0.00 | $1,839.06 | $1,839.06 | $0.00 | $0.00 | $1,839.06 | 0218 | 2021 | |
| GC2022103861 | 12/5/21 | 2/18/22 | RPP | Forest Scott | C | Please see the attached E mail Service Requests and Costs for damage to a Power Pole which occurred on 12 05 2021 at 6 30 PM from a vehicle accident The loss location is listed as 616 Houston Street Green Cove Springs Florida 32043 | 2021 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $70.00 | $0.00 | $0.00 | $70.00 | $70.00 | $0.00 | $0.00 | $70.00 | 0218 | 2021 | |
| VA2022103740 | 1/2/22 | 2/9/22 | APD | Mirinda Hunter | C | Windshield | 2021 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $102.97 | $0.00 | $0.00 | $102.97 | $0.00 | $0.00 | $0.00 | $0.00 | $102.97 | $0.00 | $0.00 | $102.97 | 0218 | 2021 | |
| GC2022104572 | 1/19/22 | 5/4/22 | GL | Kenneth Kohmen | Mirinda Hunter | C | When the pole fell over the power lines snapped and came down striking the citizen on the head and knocking him to the ground | 2021 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2021 |
| GC2022103863 | 1/21/22 | 2/18/22 | RPP | Forest Scott | C | Please see the attached E mail Service Requests and Costs for damage to a Switch Cabinet which occurred on 01 21 2022 at 3616 Magnolia Point Boulevard Green Cove Springs Florida 32043 | 2021 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $3,599.04 | $0.00 | $0.00 | $3,599.04 | $3,599.04 | $0.00 | $0.00 | $3,599.04 | 0218 | 2021 | |
| VA2022104571 | 2/2/22 | 5/4/22 | APD | Sharon Walden | Jazmine Harrell | C | IV and OV began to back out of the parking space at the same time and collided | 2021 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $1,312.57 | $0.00 | $0.00 | $1,312.57 | $0.00 | $0.00 | $0.00 | $0.00 | $1,312.57 | $0.00 | $0.00 | $1,312.57 | 0218 | 2021 |
| VA2022103894 | 2/4/22 | 2/23/22 | APD | Mirinda Hunter | C | Windshield | 2021 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $529.97 | $0.00 | $0.00 | $529.97 | $0.00 | $0.00 | $0.00 | $0.00 | $529.97 | $0.00 | $0.00 | $529.97 | 0218 | 2021 | |
| VA2022103897 | 2/17/22 | 2/23/22 | APD | Crystal Garcia | C | Damaged windshield | 2021 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $127.96 | $0.00 | $0.00 | $127.96 | $0.00 | $0.00 | $0.00 | $0.00 | $127.96 | $0.00 | $0.00 | $127.96 | 0218 | 2021 | |
| GC2022103962 | 2/28/22 | 3/1/22 | RPP | Forest Scott | C | Per the attached Web Loss Notice there was vandalism damage to two restroom buildings at near the Spring Park This was more damage than just a small repair The police case number is 2022 000331 Per Member Contact in Public Works via phone call with Synergy LH the damage was to two different buildings the Pool Building Restrooms Asset 093005 and the Restroom Pavilion Building Asset 100007 The damages to asset 093005 include broken sink spigots burn markings on hand drier toilet paper clogging the | 2021 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $10,474.98 | $0.00 | $0.00 | $10,474.98 | $10,474.98 | $0.00 | $0.00 | $10,474.98 | 0218 | 2021 | |
| GC2022103963 | 2/28/22 | 3/1/22 | RPP | Forest Scott | C | Per the attached Web Loss Notice there was vandalism damage to two restroom buildings at near the Spring Park This was more damage than just a small repair The police case number is 2022 000331 Per Member Contact in Public Works via phone call with Synergy LH the damage was to two different buildings the Pool Building Restrooms Asset 093005 and the Restroom Pavilion Building Asset 100007 The damages to asset 093005 include broken sink spigots burn markings on hand drier toilet paper clogging the | 2021 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $15,748.10 | $0.00 | $0.00 | $15,748.10 | $15,748.10 | $0.00 | $0.00 | $15,748.10 | 0218 | 2021 | |
| VA2022104447 | 3/17/22 | 4/21/22 | APD | Crystal Garcia | C | Repair for damaged windshield | 2021 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $102.97 | $0.00 | $0.00 | $102.97 | $0.00 | $0.00 | $0.00 | $0.00 | $102.97 | $0.00 | $0.00 | $102.97 | 0218 | 2021 | |
| VA2022104441 | 4/6/22 | 4/21/22 | APD | Jazmine Harrell | C | cracked windshield | 2021 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $629.15 | $0.00 | $0.00 | $629.15 | $0.00 | $0.00 | $0.00 | $0.00 | $629.15 | $0.00 | $0.00 | $629.15 | 0218 | 2021 | |
| VA2022104448 | 4/19/22 | 4/21/22 | APD | Mirinda Hunter | C | Employee was removing signs from recently removed channel poles He lost his footing with channel in his hands which caused channel to impale the AC condenser of IV | 2021 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $135.00 | $0.00 | $0.00 | $135.00 | $135.00 | $0.00 | $0.00 | $135.00 | 0218 | 2021 | |
| GC2022104431 | 4/19/22 | 4/20/22 | GL | Jerol Stepp | Mirinda Hunter | C | While employee was checking a meter outside the meter caught fire and the sparks from the fire caused damage to a truck that was parked nearby | 2021 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2021 |
| GC2022104482 | 4/26/22 | 4/26/22 | GL | Patty Brown | Crystal Garcia | C | AT T struck a water service | 2021 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2021 |
| GC2023112180 | 5/1/22 | 7/17/23 | GL | Bridgette Adams | Melissa Correll | C | OV hit OV | 2021 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $430.50 | $0.00 | $0.00 | $430.50 | $430.50 | $0.00 | $0.00 | $430.50 | 0218 | 2021 |
| GC2022105153 | 6/2/22 | 7/6/22 | GL | Lahryn Davis | Erica Cassalia | C | auto accident | 2021 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2021 |
| GC2022105789 | 6/30/22 | 9/7/22 | GL | Michael Haskell | Erica Cassalia | C | Claimant was allegedly struck by a vehicle at intersection | 2021 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2021 |
| GC2022105220 | 7/8/22 | 7/12/22 | GL | Maggie Anderson | Jazmine Harrell | C | Claimant alleges flooding in home due to a weather event | 2021 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2021 |
| VA2022105612 | 8/18/22 | 8/18/22 | APD | Clay County Fire Rescue | Jazmine Harrell | C | While exiting the Cul de Sac IV grazed the fire truck causing minor damage | 2021 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2021 |
| GC2022109602 | 8/20/22 | 12/9/22 | GL | Vivianna Allen Minor | Melissa Correll | C | Claimant allegedly fell off the ladder of bunk bed in a cabin | 2021 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2021 |
| VA2022108221 | 8/30/22 | 10/20/22 | APD | Jazmine Harrell | C | Member alleges a rock hit his windshield | 2021 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $1,263.10 | $0.00 | $0.00 | $1,263.10 | $0.00 | $0.00 | $0.00 | $0.00 | $1,263.10 | $0.00 | $0.00 | $1,263.10 | 0218 | 2021 | |
| GC2022108495 | 10/25/22 | 11/9/22 | GL | Donna Snelling | Jazmine Harrell | C | When guideline was hooked up it pulled the weather head up and caused shingles on claimants roof to pull up and caused cracks in the ceiling | 2022 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $3,517.73 | $0.00 | $0.00 | $3,517.73 | $2,270.40 | $0.00 | $0.00 | $2,270.40 | $5,788.13 | $0.00 | $0.00 | $5,788.13 | 0218 | 2022 |
| GC2022109334 | 11/10/22 | 11/16/22 | GL | Grace Torsanko | Jazmine Harrell | C | Alleged that tree fell on claimant s fence | 2022 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $1,719.54 | $0.00 | $0.00 | $1,719.54 | $1,949.87 | $0.00 | $0.00 | $1,949.87 | $3,669.41 | $0.00 | $0.00 | $3,669.41 | 0218 | 2022 |
| VA2023110141 | 12/1/22 | 1/26/23 | APD | Jazmine Harrell | C | Auto glass repair to IV | 2022 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $432.02 | $0.00 | $0.00 | $432.02 | $0.00 | $0.00 | $0.00 | $0.00 | $432.02 | $0.00 | $0.00 | $432.02 | 0218 | 2022 | |
| VA2023110992 | 12/7/22 | 4/7/23 | APD | Lakeshia Dunbar | Jazmine Harrell | C | intersection accident | 2022 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2022 |
| GC2022109647 | 12/11/22 | 12/13/22 | GL | Debra Crawford | Ann Alvarez | C | The citizen stated that she was walking across the pier with her fishing pole and tackle box and stepped in a hole that is located on the city pier under the left side of the pavilion where she fell down on her right knee | 2022 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2022 |
| GC2023110306 | 1/3/23 | 2/9/23 | GL | Kaden Bohlmann | Jazmine Harrell | C | Claimant alleges low hanging wire caused damage to rental truck | 2022 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2022 |
| GC2023110633 | 3/6/23 | 3/8/23 | GL | Lisa Hickok | Jazmine Harrell | C | While mowing mower picked up a heavy metallic object and launched it across the street The object entered the window of claimant s home and ricocheted off an interior wall into another interior wall and came to rest on the floor | 2022 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $6,827.12 | $0.00 | $0.00 | $6,827.12 | $2,119.48 | $0.00 | $0.00 | $2,119.48 | $8,946.60 | $0.00 | $0.00 | $8,946.60 | 0218 | 2022 |
| GC2023110650 | 3/6/23 | 3/9/23 | GL | Lisa Hickok | Jazmine Harrell | C | Blade from the lawn mower kicked up a metal pipe and the blade propelled the pipe through the window of claimant s home | 2022 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2022 |
| GC2023110641 | 3/8/23 | 3/8/23 | GL | Robert Patterson | Jazmine Harrell | C | While City employee was weedeating a rock hit the passenger side of claimant s vehicle shattering the window | 2022 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $228.12 | $0.00 | $0.00 | $228.12 | $0.00 | $0.00 | $0.00 | $0.00 | $228.12 | $0.00 | $0.00 | $228.12 | 0218 | 2022 |
| VA2023110933 | 3/22/23 | 4/3/23 | APD | Jennifer Valenzuela | Jazmine Harrell | C | IV was parked and unoccupied in a parking spot when the front bumper was damaged | 2022 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $110.00 | $0.00 | $0.00 | $110.00 | $110.00 | $0.00 | $0.00 | $110.00 | 0218 | 2022 |
| GC2023111495 | 4/24/23 | 5/19/23 | GL | Myla Barker Minor | Jazmine Harrell | C | IV ran over claimant s backpack and damaged their phone | 2022 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $500.00 | $0.00 | $0.00 | $500.00 | $0.00 | $0.00 | $0.00 | $0.00 | $500.00 | $0.00 | $0.00 | $500.00 | 0218 | 2022 |
| GC2023111279 | 4/26/23 | 5/2/23 | GL | Bill Carlson | Jazmine Harrell | C | Claimant alleges his hybrid hot water heaters electrical control panel has lost power | 2022 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2022 |
| GC2023111239 | 4/27/23 | 4/28/23 | GL | Jazmine Harrell | C | Claimant allegedly hit the curb with his enclosed utility trailer | 2022 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2022 | |
| GC2023111507 | 5/16/23 | 5/22/23 | GL | Lloyd Haight | Jazmine Harrell | C | Claimant alleges that house is not getting proper voltage | 2022 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $2,500.00 | $0.00 | $0.00 | $2,500.00 | $1,763.63 | $0.00 | $0.00 | $1,763.63 | $4,263.63 | $0.00 | $0.00 | $4,263.63 | 0218 | 2022 |
| GC2023111708 | 6/5/23 | 6/7/23 | EO | Jeannette Golden | Melissa Correll | C | claimaint claims age and race descrimination | 2022 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $18,000.00 | $0.00 | $0.00 | $18,000.00 | $5,855.61 | $0.00 | $0.00 | $5,855.61 | $23,855.61 | $0.00 | $0.00 | $23,855.61 | 0218 | 2022 |
| VA2023112206 | 6/8/23 | 7/19/23 | APD | Jazmine Harrell | C | windshield damage | 2022 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $1,230.92 | $0.00 | $0.00 | $1,230.92 | $0.00 | $0.00 | $0.00 | $0.00 | $1,230.92 | $0.00 | $0.00 | $1,230.92 | 0218 | 2022 | |
| GC2023111849 | 6/10/23 | 6/20/23 | GL | Steven Tran | Jazmine Harrell | C | Claimant alleges sewer back up due to a utility pole being installed over the sewage pipe which blocked the pipe | 2022 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $625.00 | $0.00 | $0.00 | $625.00 | $0.00 | $0.00 | $0.00 | $0.00 | $625.00 | $0.00 | $0.00 | $625.00 | 0218 | 2022 |
| VA2023111893 | 6/20/23 | 6/23/23 | APD | Jazmine Harrell | C | OV crashed into IV while trying to make a right turn from the left lane | 2022 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2022 | |
| GC2023111946 | 6/27/23 | 6/28/23 | GL | Courtney Harris | Jazmine Harrell | C | mowers cause windshield damaged | 2022 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $335.34 | $0.00 | $0.00 | $335.34 | $0.00 | $0.00 | $0.00 | $0.00 | $335.34 | $0.00 | $0.00 | $335.34 | 0218 | 2022 |
| GC2023112120 | 7/10/23 | 7/12/23 | GL | Bettie Tune | Jazmine Harrell | C | Claimant alleges Smoke was coming from bedroom and kitchen vents They turned the breaker off and then contacted City of Green Cove Springs Electric Department who came and went up the pole on the outside of the house They had discovered that a neutral was burned up on the pole | 2022 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $591.03 | $0.00 | $0.00 | $591.03 | $1,684.85 | $0.00 | $0.00 | $1,684.85 | $2,275.88 | $0.00 | $0.00 | $2,275.88 | 0218 | 2022 |
| GC2023112345 | 7/18/23 | 7/31/23 | GL | Marguerite Martin | Jazmine Harrell | C | After repairing house water meter claimant alleges damages due to dirt coming out of water lines | 2022 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2022 |
| GC2023112384 | 7/27/23 | 8/2/23 | GL | Christina Slack | Tori Maxwell | O | Claimant alleges slip and fall outside of salon | 2022 | $0.00 | $0.00 | $0.00 | $0.00 | $120.00 | -$120.00 | -$120.00 | $120.00 | $120.00 | -$120.00 | -$120.00 | $120.00 | $125,000.00 | $0.00 | $0.00 | $125,000.00 | $38,764.01 | $17,285.99 | $0.00 | $56,050.00 | $163,764.01 | $17,285.99 | $0.00 | $181,050.00 | 0218 | 2022 |
| VA2023112580 | 8/7/23 | 8/18/23 | APD | James Cogan | Jazmine Harrell | C | windshield damage | 2022 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $527.16 | $0.00 | $0.00 | $527.16 | $0.00 | $0.00 | $0.00 | $0.00 | $527.16 | $0.00 | $0.00 | $527.16 | 0218 | 2022 |
| GC2023112547 | 8/7/23 | 8/16/23 | GL | Brandon Leino | Jazmine Harrell | C | Claimant alleges they were driving where city workers were edging and the edger hit a rock that busted their passenger window of vehicle | 2022 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $357.39 | $0.00 | $0.00 | $357.39 | $0.00 | $0.00 | $0.00 | $0.00 | $357.39 | $0.00 | $0.00 | $357.39 | 0218 | 2022 |
| VA2023112651 | 8/22/23 | 8/23/23 | APD | Erin Vineyard | Jazmine Harrell | C | Officer was off duty in personal vehicle pulling out of lot and struck parked IV | 2022 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $1,560.97 | $0.00 | $0.00 | $1,560.97 | $110.00 | $0.00 | $0.00 | $110.00 | $1,670.97 | $0.00 | $0.00 | $1,670.97 | 0218 | 2022 |
| VA2023112988 | 9/6/23 | 9/7/23 | APD | Roger White | Jazmine Harrell | C | IV was rear ended by OV | 2022 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $1,539.05 | $0.00 | $0.00 | $1,539.05 | $110.00 | $0.00 | $0.00 | $110.00 | $1,649.05 | $0.00 | $0.00 | $1,649.05 | 0218 | 2022 |
| GC2023113172 | 9/16/23 | 9/20/23 | GL | Cody Brown | Jazmine Harrell | C | pothole damage | 2022 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2022 |
| VA2023113495 | 10/7/23 | 10/10/23 | AL | Rita Gonzales | Ann Alvarez | C | IV was instructed to start moving again which caused claimant to lose balance and fall backwards through a banner during the parade | 2023 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2023 |
| GC2023113747 | 10/24/23 | 11/1/23 | GL | Frederick Snell | Jazmine Harrell | C | Claimant allegedly was driving down the road and his trailer struck a bump in the street that was uneven and it caused the trailer leg to bed backwards | 2023 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $848.15 | $0.00 | $0.00 | $848.15 | $300.00 | $0.00 | $0.00 | $300.00 | $1,148.15 | $0.00 | $0.00 | $1,148.15 | 0218 | 2023 |
| GC2023113997 | 11/25/23 | 11/28/23 | GL | Pamela Johnson | Jazmine Harrell | C | The Echo started staticing and the lights were flashing off and on Claimant s mom went into the garage and the electrical panel started smoking and part of it had melted They were able to shut it off Called and reported to the City of Green Cove Springs Police Department who sent out Lonnie Barr of the City of Green Cove Springs Electric Dept came out to check on the incident Mr Barr checked the meter and the transformer | 2023 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $3,980.11 | $0.00 | $0.00 | $3,980.11 | $2,222.28 | $0.00 | $0.00 | $2,222.28 | $6,202.39 | $0.00 | $0.00 | $6,202.39 | 0218 | 2023 |
| VA2024115045 | 12/2/23 | 3/7/24 | APD | Kristi Chandler | Nitzamarie Escalera Flores | C | Claimant was allegedly involved in a pedestrian automobile accident | 2023 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2023 |
| GC2024115178 | 12/22/23 | 3/20/24 | GL | Caysie Hunter | Tori Maxwell | O | Claimant allegedly tried to cross the crosswalk when wheels of wheelchair got stuck in sand and wheelchair flipped over | 2023 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $100,000.00 | $0.00 | $100,000.00 | $11,638.73 | $63,032.27 | $0.00 | $74,671.00 | $11,638.73 | $163,032.27 | $0.00 | $174,671.00 | 0218 | 2023 |
| VA2024114614 | 1/25/24 | 2/1/24 | APD | Christine Eulenfeld | Jazmine Harrell | C | OV hit IV | 2023 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2023 |
| VA2024114665 | 2/1/24 | 2/6/24 | APD | Jazmine Harrell | C | the gate arm came down and damaged IV | 2023 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2023 | |
| GC2024115113 | 2/6/24 | 3/14/24 | GL | Gregory Horwath | Jazmine Harrell | C | Claimant alleges that a tree on his rental property fell on a electrical line and pole and knocked out power in the home | 2023 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2023 |
| VA2024114787 | 2/15/24 | 2/16/24 | APD | Patricia Burke | C | windshield damage | 2023 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $689.06 | $0.00 | $0.00 | $689.06 | $0.00 | $0.00 | $0.00 | $0.00 | $689.06 | $0.00 | $0.00 | $689.06 | 0218 | 2023 | |
| GC2024114835 | 2/20/24 | 2/21/24 | GL | Doxa Chruch | Jazmine Harrell | C | Member was allegedly mowing the church when a rock flew up and busted out 2 window panes | 2023 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $405.12 | $0.00 | $0.00 | $405.12 | $610.50 | $0.00 | $0.00 | $610.50 | $1,015.62 | $0.00 | $0.00 | $1,015.62 | 0218 | 2023 |
| GC2024278830 | 3/17/24 | 7/15/24 | GL | Aleta Davis | Mirinda Hunter | C | claimant tripped on uneven concrete | 2023 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2023 |
| VA2024115196 | 3/20/24 | 3/21/24 | AL | Jazmine Harrell | C | IV was asked to move truck forward and in doing so struck fire hydrant | 2023 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2023 | |
| GC2024277719 | 5/22/24 | 5/22/24 | GL | Kadisha Davis | Jazmine Harrell | C | claimant was passing by city worker as they were edging the sidewalk and a rock hit their windshield | 2023 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $619.90 | $0.00 | $0.00 | $619.90 | $0.00 | $0.00 | $0.00 | $0.00 | $619.90 | $0.00 | $0.00 | $619.90 | 0218 | 2023 |
| GC2024278265 | 6/2/24 | 6/17/24 | RPP | Ann Trevino | C | Per the attached Member E mail Loss Notice Original Proposal and Florida Highway Patrol Police Report Case FHP24ON0277523 a vehicle accident damage the Police Department Bulletin Sign on State Road 16 on 06 02 2024 | 2023 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $17,230.90 | $0.00 | $0.00 | $17,230.90 | $17,230.90 | $0.00 | $0.00 | $17,230.90 | 0218 | 2023 | |
| GC2024278266 | 6/5/24 | 6/17/24 | RPP | Levi Holmstrom | C | Per the attached Member E mail Loss Notice Memorandum Photos Police Report 2024 000820 Quote and Order a vehicle damaged a Fire Hydrant on the corner of Highland Avenue and North Street on 06 05 2024 | 2023 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $85.00 | $0.00 | $0.00 | $85.00 | $85.00 | $0.00 | $0.00 | $85.00 | 0218 | 2023 | |
| VA2024278579 | 6/27/24 | 7/1/24 | APD | Patricia Burke | C | Windshield damage vin 5423 | 2023 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $425.00 | $0.00 | $0.00 | $425.00 | $0.00 | $0.00 | $0.00 | $0.00 | $425.00 | $0.00 | $0.00 | $425.00 | 0218 | 2023 | |
| VA2024278645 | 7/2/24 | 7/3/24 | APD | Patricia Burke | C | IV was backing out and hit metal gate | 2023 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $1,187.15 | $0.00 | $0.00 | $1,187.15 | $488.78 | $0.00 | $0.00 | $488.78 | $1,675.93 | $0.00 | $0.00 | $1,675.93 | 0218 | 2023 | |
| GC2024279233 | 7/23/24 | 7/31/24 | GL | Jason Walters | Jazmine Harrell | C | Member electric department allegedly was working on electricity and during a power surge claimants pool motor was damaged | 2023 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $636.48 | $0.00 | $0.00 | $636.48 | $0.00 | $0.00 | $0.00 | $0.00 | $636.48 | $0.00 | $0.00 | $636.48 | 0218 | 2023 |
| GC2024279045 | 7/23/24 | 7/23/24 | GL | Marie Reider | Jazmine Harrell | C | claimant claims the electricity was going on and off affecting their AC to stop working | 2023 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $553.10 | $0.00 | $0.00 | $553.10 | $0.00 | $0.00 | $0.00 | $0.00 | $553.10 | $0.00 | $0.00 | $553.10 | 0218 | 2023 |
| GC2024279745 | 8/15/24 | 8/19/24 | RPP | Levi Holmstrom | C | Per the attached Member E mail Loss Notice Photos and Excel lists of Labor and Material Costs a vehicle accident damaged a City owned Utility Pole on 08 15 2024 in the morning Per additional Member Contact via phone call with Synergy LH another party s Dump Truck hit the Member s Utility Pole at 503 Sunset Avenue Police Case Number is 2024001147 Synergy LH used 8 00 AM as the time of loss for input purposes only | 2023 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $85.00 | $0.00 | $0.00 | $85.00 | $85.00 | $0.00 | $0.00 | $85.00 | 0218 | 2023 | |
| GC2024279839 | 8/21/24 | 8/21/24 | GL | Joleen Abadia | Jazmine Harrell | C | Weed eater allegedly hit back windshield of claimant s vehicle with a rock | 2023 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $942.50 | $0.00 | $0.00 | $942.50 | $0.00 | $0.00 | $0.00 | $0.00 | $942.50 | $0.00 | $0.00 | $942.50 | 0218 | 2023 |
| GC2024280531 | 9/19/24 | 9/23/24 | GL | Van Royal | Jazmine Harrell | C | employees were conducting right of way maintenance and somehow damaged the claimant s glass door | 2023 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $550.00 | $0.00 | $0.00 | $550.00 | $0.00 | $0.00 | $0.00 | $0.00 | $550.00 | $0.00 | $0.00 | $550.00 | 0218 | 2023 |
| GC2024280606 | 9/20/24 | 9/26/24 | GL | Amanda Gelegan | Jazmine Harrell | C | claimant alledgely hit a pothole and blew out their tire | 2023 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2023 |
| GC2025284060 | 9/26/24 | 1/6/25 | RPP | Forest Scott | C | Per the attached Member E mail and Phone Calls Hurricane Helene damaged the Merry Go Round at Spring Park Location 100 on 09 26 2024 Per Member this asset is different than the multi play structure | 2023 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $85.00 | $0.00 | $0.00 | $85.00 | $85.00 | $0.00 | $0.00 | $85.00 | 0218 | 2023 | |
| GC2024280808 | 9/26/24 | 9/30/24 | RPP | Forest Scott | C | Per Member Contact Hurricane Helene damaged the following assets 100010 Small Multi play Structure Spring Park Playground Metal Tree fell on playground damaging playground equipment Area has been barricaded to reduce use and potential injury 163001 Pier Railing of Pier was damaged by boat that came loose of its mooring Area has been barricaded to reduce use and potential injury | 2023 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $59,254.17 | $0.00 | $0.00 | $59,254.17 | $59,254.17 | $0.00 | $0.00 | $59,254.17 | 0218 | 2023 | |
| GC2024280807 | 9/26/24 | 9/30/24 | RPP | Forest Scott | C | Per Member Contact Hurricane Helene damaged the following assets 100010 Small Multi play Structure Spring Park Playground Metal Tree fell on playground damaging playground equipment Area has been barricaded to reduce use and potential injury 163001 Pier Railing of Pier was damaged by boat that came loose of its mooring Area has been barricaded to reduce use and potential injury | 2023 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $31,225.40 | $0.00 | $0.00 | $31,225.40 | $31,225.40 | $0.00 | $0.00 | $31,225.40 | 0218 | 2023 | |
| GC2025285788 | 9/26/24 | 3/26/25 | POL | Melina Hodges | Tori Maxwell | O | Claimant intends to sue for the deprivation of due process of law illegal search seizure false arrest imprisonment | 2023 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $15,000.00 | $0.00 | $15,000.00 | $3,682.00 | $51,318.00 | $0.00 | $55,000.00 | $3,682.00 | $66,318.00 | $0.00 | $70,000.00 | 0218 | 2023 |
| GC2024281859 | 10/21/24 | 10/22/24 | GL | Kathryn Wills | Nitzamarie Escalera Flores | C | Kathryn Wills was visiting the City Hall in Green Cove Springs FL today and fell down the stairs in the City Hall Building | 2024 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2024 |
| GC2024283520 | 12/7/24 | 12/10/24 | GL | Thomas Evans | Jazmine Harrell | C | Claimant s wheel was damaged hitting a curb when traffic was detoured for a parade | 2024 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2024 |
| GC2024283709 | 12/12/24 | 12/16/24 | GL | Stacey Whitehead | Jazmine Harrell | C | Claimants front bumper and undercarriage was damaged from a rod sticking out approximately 4 inches from the top of a parking block | 2024 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $1,958.22 | $0.00 | $0.00 | $1,958.22 | $110.00 | $0.00 | $0.00 | $110.00 | $2,068.22 | $0.00 | $0.00 | $2,068.22 | 0218 | 2024 |
| VA2024283699 | 12/12/24 | 12/16/24 | APD | Patricia Burke | C | IV front bumper went over the parking block when reversing it pulled the bumper off and caused damage | 2024 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2024 | |
| VA2025284443 | 1/21/25 | 1/24/25 | APD | Patricia Burke | C | Windshield crack Vin 0153 | 2024 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $655.00 | $0.00 | $0.00 | $655.00 | $0.00 | $0.00 | $0.00 | $0.00 | $655.00 | $0.00 | $0.00 | $655.00 | 0218 | 2024 | |
| VA2025285017 | 2/18/25 | 2/20/25 | AL | Avery Baker | Jazmine Harrell | C | OV ran a stop sign and hit IV causing a low impact crash | 2024 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2024 |
| VA2025285593 | 3/13/25 | 3/19/25 | APD | Jovon McBean Knight | C | Cracked Windshield | 2024 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $796.43 | $0.00 | $0.00 | $796.43 | $0.00 | $0.00 | $0.00 | $0.00 | $796.43 | $0.00 | $0.00 | $796.43 | 0218 | 2024 | |
| GC2025288838 | 3/19/25 | 8/15/25 | POL | Anthony Marroletti, Jr. | Tori Maxwell | O | Claimant alleges false arrest and detention | 2024 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $2,500.00 | $0.00 | $2,500.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $2,500.00 | $0.00 | $2,500.00 | 0218 | 2024 |
| VA2025285923 | 3/31/25 | 4/1/25 | APD | Jazmine Harrell | C | IV went to pass a kid on a bike in his lane after he passed the kid and was a safe distance infront of the kid he got back into his lane at that point is when he hit the mailbox | 2024 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2024 | |
| GC2025286288 | 4/15/25 | 4/18/25 | GL | Adfsan Dzelilovic | Jazmine Harrell | C | City employee was weed eating when they unknowingly hit a rock that allegedly hit and shattered claimant s window on their vehicle | 2024 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $2,259.35 | $0.00 | $0.00 | $2,259.35 | $110.00 | $0.00 | $0.00 | $110.00 | $2,369.35 | $0.00 | $0.00 | $2,369.35 | 0218 | 2024 |
| GC2025287739 | 6/20/25 | 6/25/25 | GL | Jim Davis | Jazmine Harrell | C | Claimant alleges air conditioner s voltage was damaged because of the power outage | 2024 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2024 |
| GC2025287981 | 6/20/25 | 7/8/25 | GL | Bunmi Bamigbetan | Jazmine Harrell | C | FPL had problems delivering power to the city s electric In result the issue allegedly caused damage to claimant s refrigerator and A C unit | 2024 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2024 |
| GC2025288056 | 7/9/25 | 7/10/25 | GL | Amanda Shelton | Jazmine Harrell | C | Claimant alleges damage to vehicle window from member weed eating and a rock was ejected and struck window | 2024 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2024 |
| GC2026291841 | 8/1/25 | 1/6/26 | GL | Joseph Pearson | Mirinda Hunter | C | Claimant was riding their motorcycle over a metal grate in the road a grate that is owned and operated for the city when their tire allegedly became wedged in a large gap in the grate causing claimant to crash and throw them off motorcycle | 2024 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2024 |
| GC2025289170 | 8/27/25 | 8/29/25 | GL | Genesis Williams | Jazmine Harrell | C | Member was weed eating on 17 north when a rock flew out of the weed eater and broke the passenger window of claimants truck | 2024 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2024 |
| GC2025289248 | 9/2/25 | 9/3/25 | GL | Karl Yeakel | Jazmine Harrell | C | Transformer leaking oil on the property has destroyed grass trees etc | 2024 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $604.10 | $0.00 | $0.00 | $604.10 | $604.10 | $0.00 | $0.00 | $604.10 | 0218 | 2024 |
| GC2025289680 | 9/22/25 | 9/23/25 | RPP | Levi Holmstrom | C | Per the attached Email Loss Notice and Incident Report a worker was picking up debris while operating the Gator vehicle The operator hit a grassy slick spot while close to a pond The Gator vehicle and the operator entered the pond The vehicle was described as being submerged up to the roof | 2024 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $11,044.39 | $0.00 | $0.00 | $11,044.39 | $11,044.39 | $0.00 | $0.00 | $11,044.39 | 0218 | 2024 | |
| GC2025289755 | 9/24/25 | 9/26/25 | GL | Spring Park Coffee | Jazmine Harrell | C | City employee was weed eating in front of the coffee shop when a small rock allegedly flew from the weed eater and hit the window | 2024 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $207.00 | $0.00 | $0.00 | $207.00 | $207.00 | $0.00 | $0.00 | $207.00 | 0218 | 2024 |
| GC2025290323 | 10/21/25 | 10/28/25 | GL | John Drouet | Jazmine Harrell | C | City s electric department was doing work in claimant s neighborhood which resulted in a power outage for about two minutes Claimant alleges once the power was restored their monitors and computer were not functioning | 2025 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2025 |
| GC2025290437 | 10/26/25 | 10/30/25 | GL | Lauren Petersen | Jazmine Harrell | C | Claimant alleges blockage on city s side caused sewer backup in their home | 2025 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $4,332.13 | $0.00 | $0.00 | $4,332.13 | $744.20 | $0.00 | $0.00 | $744.20 | $5,076.33 | $0.00 | $0.00 | $5,076.33 | 0218 | 2025 |
| GC2026291970 | 11/12/25 | 1/12/26 | RPP | Levi Holmstrom | C | Per the attached Email Loss Notice Photographs and Quote a tree fell on and damaged the fixed generator at Lift Station 26 The damage was discovered on 11 12 2025 Per the Member follow up e mail wind may have been the cause for the tree to fall but the tree was rotten unhealthy inside but not visible from the outside Synergy LH used 12 00 PM as the time of loss for input purposes only | 2025 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $3,680.00 | $0.00 | $0.00 | $3,680.00 | $3,680.00 | $0.00 | $0.00 | $3,680.00 | 0218 | 2025 | |
| GC2026292855 | 12/6/25 | 2/20/26 | GL | Shannon Roach | Mirinda Hunter | O | Claimants were in an auto accident that was caused by all the stop signs within the intersection being allegedly covered with black trash bags resulting in claimants sustaining injuries in relation to PD claim GC2026292938 | 2025 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $25,000.00 | $0.00 | $25,000.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $25,000.00 | $0.00 | $25,000.00 | 0218 | 2025 |
| GC2026292998 | 12/6/25 | 2/27/26 | GL | Herbert Bentley | Mirinda Hunter | C | Claimants were in an auto accident that was allegedly caused by all stop signs at the intersection being covered with black trash bags resulting in the claimant sustaining injuries in relation to PD claim GC2026292938 | 2025 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2025 |
| GC2026293215 | 12/6/25 | 3/10/26 | GL | Herbert Bentley | Mirinda Hunter | C | Claimants were in an auto accident that was caused by all the stop signs within the intersection being allegedly covered with black trash bags resulting in claimant sustaining injuries in relation to claim GC2026292938 | 2025 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2025 |
| GC2026292938 | 12/6/25 | 2/25/26 | GL | Alma Bentley Kendall | Jazmine Harrell | O | Claimants were in an auto accident that was caused by all the stop signs within the intersection being allegedly covered with black trash bags | 2025 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $9,661.64 | $38.36 | $1,262.25 | $8,437.75 | $160.00 | $0.00 | $0.00 | $160.00 | $9,821.64 | $38.36 | $1,262.25 | $8,597.75 | 0218 | 2025 |
| VA2026292076 | 12/31/25 | 1/15/26 | APD | Cassandra Fitzgerald | Jazmine Harrell | C | IV made a traffic stop with OV When driver of IV exited patrol vehicle they proceeded on foot to complete the stop with OV when they didn t put IV in park Therefore IV continued to roll forward and make impact with OV | 2025 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $3,564.27 | $0.00 | $0.00 | $3,564.27 | $556.56 | $0.00 | $0.00 | $556.56 | $4,120.83 | $0.00 | $0.00 | $4,120.83 | 0218 | 2025 |
| VA2026292568 | 1/12/26 | 2/5/26 | AL | Kelly Dortch | Mirinda Hunter | C | Claimant was slowing in traffic when they were allegedly rearended by Clay County School Board which then shoved claimant into the trailer in front of them | 2025 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2025 |
| GC2026292338 | 1/17/26 | 1/27/26 | GL | United Methodist Church | Jazmine Harrell | C | Claimant was moving an object and hit the hot water heater which started leaking water Then claimant proceeded to call a plumber because they could not find the cutoff switch The second plumber recommended that they contact the city who did come out City then had to cut open a sidewalk to locate the cutoff switch | 2025 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2025 |
| GC2026293781 | 3/26/26 | 4/2/26 | GL | Octavia Flowers | Jazmine Harrell | C | Claimant alleges sewage water entered their home causing damage | 2025 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $610.63 | $0.00 | $0.00 | $610.63 | $610.63 | $0.00 | $0.00 | $610.63 | 0218 | 2025 |
| GC2026294919 | 4/16/26 | 5/21/26 | RPP | Levi Holmstrom | O | Per the attached Member Email Loss Notice Police Report Police Business Card and City Cost Receipt a Vehicle Damaged a Utility Pole on 04 16 2026 in the City of Green Cove Springs Vehicle 1 passed Vehicle 2 while Vehicle 2 was turning left into the parking lot of the Church located at 310 South Oakridge Avenue Green Cove Springs Florida 32043 Vehicle 2 was traveling southbound and Vehicle 1 was traveling southbound behind Vehicle 2 Vehicle 1 sideswiped Vehicle 2 while Vehicle 1 was turning After | 2025 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $85.00 | $3,000.00 | $0.00 | $3,085.00 | $85.00 | $3,000.00 | $0.00 | $3,085.00 | 0218 | 2025 | |
| VA2026294419 | 4/24/26 | 4/28/26 | APD | Patricia Burke | C | APD Claim IV cracked windshield Vin 6598 8847 7346 1771 | 2025 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $340.00 | $0.00 | $0.00 | $340.00 | $0.00 | $0.00 | $0.00 | $0.00 | $340.00 | $0.00 | $0.00 | $340.00 | 0218 | 2025 | |
| GC2026295137 | 5/19/26 | 6/2/26 | GL | K. B. | Mirinda Hunter | C | BI Claim Claimant minor was allegedly told to place a metal clipboard between their legs when the clipboard broke causing claimant to sustain injuries | 2025 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | 0218 | 2025 |
| GC2026295738 | 6/5/26 | 6/25/26 | GL | Christie Exendine | Mirinda Hunter | O | BI Claimant alleges that rubber was loose on ladder stairs due to improper maintenance and caused their fall resulting in injuries | 2025 | $0.00 | $10,500.00 | $10,500.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $10,500.00 | $10,500.00 | $0.00 | $0.00 | $10,500.00 | $0.00 | $10,500.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $10,500.00 | $0.00 | $10,500.00 | 0218 | 2025 |
| VA2026295761 | 6/16/26 | 6/26/26 | AL | Aaron Indemnity | Jazmine Harrell | O | PD IV backed into OV | 2025 | $0.00 | $7,000.00 | $7,000.00 | $0.00 | $0.00 | $1,000.00 | $1,000.00 | $0.00 | $0.00 | $8,000.00 | $8,000.00 | $0.00 | $0.00 | $7,000.00 | $0.00 | $7,000.00 | $0.00 | $1,000.00 | $0.00 | $1,000.00 | $0.00 | $8,000.00 | $0.00 | $8,000.00 | 0218 | 2025 |
| $0.00 | $17,500.00 | $17,500.00 | $0.00 | $120.00 | $880.00 | $880.00 | $120.00 | $120.00 | $18,380.00 | $18,380.00 | $120.00 | $942,574.86 | $215,038.36 | $15,723.86 | $1,141,889.36 | $608,642.11 | $211,767.23 | $574.34 | $819,835.00 | $1,551,216.97 | $426,805.59 | $16,298.20 | $1,961,724.36 |
Info
| Client Name: | FLC |
| Report Name: | FMIT Member Loss Report - PL |
| Description: | FMIT Member Loss Report - PL |
| Filter: | (FMIT Number is less than 9,000.00 and LOB does not contain "Workers Compensation" and Claim Number is not empty) and Member Number (Member) is equal to "0218" |
| Group By: | Member Number then Policy Year |
| Sort By: | Date of Injury |
| Options: | As Of Date is 06/30/2026 |
| Run Date: | 7/15/2026 |
Sheet3
File details come from the government source that posted it. Updated .