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rr rr �r r r r rr r r rr r r �r r r r r r r <br /> Policy Number(s)- 691-13382, 81T4863A, 881-62336, 9158P303 TR'A'VELER'S J� <br /> � • - . . r : Irl . is � <br /> Policy Number:69L13382 <br /> CLARKE MURRAY 2210 AD CFQ5433 04119/2007 04/20/2007 05/0912007 C <br /> INCIDENT ONLY-DRIVER TRAVELING WB DOWN ISLE(PARKING LOT)WHEN THE B Inc: $0.00 $0.00 $0.00 $0.00 <br /> Pd: $0.00 $0.00 $0.00 $0.00 <br /> O/S: $0.00 $0.00 $0.00 $0.00 <br /> CLUZ MARIA D 028 AS c6U8355 11107/2006 1111312005 09122!2008 C <br /> MR.MAJOR WAS SOUTHBOUND ON FAIRVIEW AND WENT TO CHANGE LANES AND CLIP Inc: $1,475.00 $1,160.00 $0.00 $315.00 <br /> Pd: $1,474.50 $1,159.50 $0.00 $315.00 <br /> O/S: $0.00 $0.00 $0.00 $0.00 <br /> CRUMBLE MARY 028 AS CFQ7482 07/11/2007 07/13=07 08/26/2009 C <br /> CLAIMANT CLAIMS SHE WAS ATTEMPTING TO BOARD THE DOWNTOWN TROLLEY WHEN Inc: $0.00 $0.00 $0.00 $0.00 <br /> Pd: $0.00 $0.00 $0.00 $0.00 <br /> O/S: $0.00 $0.00 $0.00 $0.00 <br /> DEAR CERESA 155 AS CFQ4784 03/22/2007 03/2712007 05/25/2007 C <br /> OUR OPER WAS STOPPED AT RR CROSSING ON N.OAKLAND AVE WHEN CAR HIT OUR Inc: $0.00 $0.00 $0.00 $0.00 <br /> Pd: $0.00 $0.00 $0.00 $0.00 <br /> O/S: $0.00 $0.00 $0.00 $0.00 <br /> FORQUREAN PATRICIA 155 AS CF04293 03/03/2007 03/08/2007 06/18/2007 C <br /> VIRGINIA WAS GETTING READING TO MERGE ONTO RT 51 N FROM WALMART NORTH. Inc: $1,278.00 $1,252.00 $0.00 $26.00 <br /> Pd: $1,277.54 $1,252.00 $0.00 $25.54 <br /> O/S: $0.00 $0.00 $0.00 $0.00 <br /> FRYER C05TELLA 220 AD CAS1827 04/26/2007 0510112007 05130/2007 C <br /> IV WAS GOING TO LOSS LOCATION TO PICK UP A WHEELCHAIR PASSENGER,OVER Inc: $546.00 $546.00 $0.00 $0.00 <br /> Pd: $545.51 $545.51 $0.00 $0.00 <br /> O/S: $0.00 $0.00 $0.00 $0.00 <br /> HIETTER AMANDA A 077 AS CFQ0523 10/10/2006 10/1112006 12106/2007 C <br /> IV TURNED INTO PEDESTRIAN VEH MIRROR CREATED BLIND SPOT Inc: $10,000.00 $10,000.00 $0.00 $0.00 <br /> Pd: $10,000.00 $10,000.00 $0.00 $0.00 <br /> O/S: $0.00 $0.00 $0.00 $0.00 <br /> HOLUNOEN SHEILA A 028 AS CFQ8625 0813112007 09/0512007 09/01/2010 C <br /> IV WAS N/B ON WATER ST. IN FAR RIGHT TURN LANE WHEN OV CAME ACROSS WATER ST. IN FRONT OF IV. IV Inc: $3,405.00 $3,000.00 $0.00 $405.00 <br /> APPLIED BRAKES BUT OV KEPT COMING OUTAND IV HIT OV'S REAR RIGHT BUMPER WITH WRIGHT FRONT BUMPER. Pd: $3,405.00 $3,000.00 $0.00 $405.00 <br /> O/S: $0.00 $0.00 $0.00 $0.00 <br /> HOWELL DAISY 155 AS CF04133 02/28/2007 03/0112007 02/15/2008 C <br /> CLAIMANT STATES BUS TOOK OFF BEFORE SHE WAS ABLE TO SIT DOWN,CAUSING Inc: $5,425.00 $5,200.00 $0.00 $225.00 <br /> Pd: $5,425.00 $5,200.00 $0.00 $225.00 <br /> O/S: $0.00 $0.00 $0.00 $0.00 <br /> Losses as of:08/27/2011 Run Date:08/29/2011 Page 2 <br />