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Policy Number(s): 691-13382, 81T4863A, 881-62336, 9158P303 TRAVELERS) <br /> Detaill Loss Re <br /> 08/2912006 08/29/2011 <br /> port Losses From:Claimant Adj Off FP Claim Number Accident Date Notice Date Close Date O/C Total la m edica xpense <br /> Policy Number:691-13382 <br /> JONES MELVIN 077 AS CFQ2810 01112/2007 01112/2007 02/13/2008 C <br /> INS SB ON WEBSTER,CLMNT WAS EB. INS STATES SHE HAD STOPPED AT CANTRE Inc: $8,467.00 $8,467.00 $0.00 $0.00 <br /> Pd: $8,467.02 $8,467.02 $0.00 $0.00 <br /> O/S: $0.00 $0.00 $0.00 $0.00 <br /> JOYNER FLOYD 220 AD CBV9885 04/03/2007 04/0512007 04/0512007 G <br /> BUS WAS E/B ON WELLINGTON WAY WHEN CAR WENT TO TURN FROM A PARKING LOT 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 /> KELLY JAMES E 155 LR CFQ4790 03/19/2007 03/2712007 06/2212007 C <br /> INCIDENT AT INSD TRANSIT CENTER WHERE A PASSENGER WAS ASSAULTED BY ANO Inc: $1,435.00 $0.00 $0.00 $1,435.00 <br /> Pd: $1,435.20 $0.00 $0.00 $1,435.20 <br /> O/S: $0.00 $0.00 $0.00 $0.00 <br /> KOPHAZY KEN 077 AB GFQ5473 0419412007 04/2312007 03115/2008 C <br /> INS WAS TURNING FROM 16TH ST.ONTO BUENA VISTA AND TURNED TO SHARP,CL Inc: $3,124.00 $2,250.00 $0.00 $874.00 <br /> Pd: $3,123.80 $2,250.00 $0.00 $873.80 <br /> O/S: $0.00 $0.00 $0.00 $0.00 <br /> LITTLE SEANNA 155 AS CF01327 11/09/2006 11/10!2006 82/01/2007 c <br /> CLAIMANT FELL WHEN STEPPED OFF BUS AND BROKE ANKLE 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 /> LOFTON CHRIS D 155 AS CFQ7295 07103/2007 0710312007 07/17/2007 C <br /> INS STOPPED AT INTERSECTION OF PRAIRIE&RT.36 EB.WHEN INS GOT GREEN 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 /> MCCULLOUGH BRENDA K 028 AS CFQ4546 03/15/2007 0311712007 0812012008 C <br /> LAVONE MADE A HARD SUDDEN STOP TO AVOID HITTING ANOTHER VEHICLE.3 PAS Inc: $24,869.00 $24,869.00 $0.00 $0.00 <br /> Pd: $24,869.18 $24,869.18 $0.00 $0.00 <br /> O/S: $0.00 $0.00 $0.00 $0.00 <br /> MILFORD RICK 077 AS CFQ9343 0518542007 1011112007 05/07/2008 G <br /> INSURED HIT BRAKES TO AVOID ACCIDENT AND CLAIMANT FLEW TO FRONT OF BUS Inc: $2,200.00 $2,200.00 $0.00 $0.00 <br /> Pd: $2,200.00 $2,200.00 $0.00 $0.00 <br /> O/S: $0.00 $0.00 $0.00 $0.00 <br /> NEATHERY ROSE 155 LR CFQ2690 0110312007 01/0812007 03/02/2007 c <br /> CLAIMANT STEPPED OFF CURB @ TRANSIT CETNER&FELL HITTING HER HEAD&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 /> Losses as of:08/27/2011 Run Date:08/29/2011 Page 3 <br />