R2011-153 ACCEPTING BID AND AUTHORIZING CONTRACT WITH TRAVERLERS COMPANIES, INC.

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Policy Number(s): 691-13382, 81T4863A, 88L62336, 9158P303 TRAVELFRS J� Policy Number:69L13382 SWANSON IMOGENE 220 AD CAS0633 04/1412007 04/1612007 06130/2007 C ED WAS TURNING FROM 16TH ST ONTO BUENA VISTA AND TURNED TO SHARP CLIPP Inc: $5,634.00 $5,634.00 $0.00 $0.00 Pd: $5,633.78 $5,633.78 $0.00 $0.00 0/S: $0.00 $0.00 $0.00 $0.00 SYKES LINDA 155 AS CFQ8326 08/18/2007 08/2112007 08/11/2007 C WHEN CLAIMANT EXITED TROLLEY SLIPPED DOWN STEPS HURTING RIGHT KNEE Inc: $0.00 $0.00 $0.00 $0.00 Pd: $0.00 $0.00 $0.00 $0.00 O/S: $0.00 $0.00 $0.00 $0.00 TAYLOR THERESA L 077 AB CBV6055 02/14/2007 02116/2007 02/04/20008 C LILLIE STATES SHE WAS SB ON MEADOWLARK WHEN A CAR STOPPED ABURTLY IN F Inc: $2,503.00 $2,448.00 $0.00 $55.00 Pd: $2,502.73 $2,447.73 $0.00 $55.00 O/S: $0.00 $0.00 $0.00 $0.00 WALKER ROCHELLE 155 AB CFQ5442 0411912007 04/20/2007 05/0312007 c 'INCIDENT ONLY"INS TRAVELING WB ISLE(PARKING LOT)WHEN THE BLAZER PU Inc: $0.00 $0.00 $0.00 $0.00 Pd: $0.00 $0.00 $0.00 $0.00 O/S: $0.00 $0.00 $0.00 $0.00 WHITE KEVIN 155 AB CF01567 11/03/2006 11/20/2006 12111/2006 C CHEROKEE AND BUS SB ON RT 48,CHEROKEE WENT TO CHANGE LANES FROM THE I Inc: $0.00 $0.00 $0.00 $0.00 Pd: $0.00 $0.00 $0.00 $0.00 O/S: $0.00 $0.00 $0.00 $0.00 Subtotals for Policy Number:69LI3382 Total Claim Count:41 Inc: $75,497.00 $72,136.00 $0.00 $3,361.00 Pd: $75,494.88 $72,134.80 $0.00 $3,360.08 O/S: $2.12 $1.20 $0.00 $0.00 Policy Number:81T4863A 028 AB CES4830 02/17/2010 02117/2010 Inc: $0.00 $0.00 $0.00 $0.00 Pd: $0.00 $0.00 $0.00 $0.00 O/S: $0.00 $0.00 $0.00 $0.00 /FRITO LAY SALES 028 AD EKZ2847 05121/2010 05/25/2010 07/15/2010 c ALICE WAS TRAVELING NORTH ON MONROE AND SHE CAME UP TO A FRITO TRUCK P Inc: $0.00 $0.00 $0.00 $0.00 Pd: $0.00 $0.00 $0.00 $0.00 O/S: $0.00 $0.00 $0.00 $0.00 Losses as of:08/27/2011 Run Date:08/29/2011 Page 5