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Policy Number(s): 691-13382, 81T4863A, 881-62336, 9158P303 TRAVELERS) <br /> ;Detail Loss Report Losses From: 08/29/2006 To 08/29/2011 <br /> Claimant Adj Off FP Claim Number .- Date Notice Date Close D. • Total -• <br /> Policy Number:81T4863A <br /> FERENC JESSICA 028 AS EGV4235 11/03/2009 11/0412009 07/26/2011 C <br /> LADY EXTIED THE BUS WITH TWO CHILDREN AND WENT TO GET THIRD CHILD AND DRIVER CLOSED THE DOOR Inc: $23,347.00 $23,000.00 $0.00 $347.00 <br /> ON HER ARM. Pd: $23,346.75 $23,000.00 $0.00 $346.75 <br /> O/S: $0.00 $0.00 $0.00 $0.00 <br /> GREEN ALONZO 028 AS CES4632 01127/2010 0112812010 03/1912010 C <br /> ROSEMARY MILLER WAS STOPPED ON PRAIRIE AT THE CORNER OF 19TH.LETTING 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 /> HAMMONDS DENNIS 028 AS CES5957 06125/2010 07/01/2010 09/28/2010 C <br /> OUR OPERATOR STATES WHILE 2-PASSENGERS EXITED THE BUS THEN THE BELL WAS RUNG AND A THIRD Inc: $0.00 $0.00 $0.00 $0.00 <br /> PASSENGER DECIDED TO EXIT THE BUS AT THE LAST MINUTE.JASON STATES THE DOOR BARELY TOUCHED HIM Pd: $0.00 $0.00 $0.00 $0.00 <br /> IF IT DID TOUCH HIM.MALE STATED'YOU ALMOST GOT M O/S: $0.00 $0.00 $0.00 $0.00 <br /> HAWS MARILYN F 028 AD EGV1787 1011612009 10119/2009 1012112009 C <br /> JOYCE WENT TO EXIT CUB FOODS OUT ONTO PERSHING RD.THEN SHE REMEMBERED Inc: $2,006.00 $2,006.00 $0.00 $0.00 <br /> Pd: $2,005.89 $2,005.89 $0.00 $0.00 <br /> O/S: $0.00 $0.00 $0.00 $0.00 <br /> HIGH WILLIAM 028 AS CES5448 04/1312010 04123/2010 04/30/2010 C `:' <br /> OV#1 STRUCK OV#2&OV$2 STRUCK OV#3&OV$3 WENT INTO IV ,IV IS 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 /> HOPKINS CELESTE 028 AS CES5636 05/1112010 05118/2090 05128/2010 C <br /> MS.HOPKINS WAS ON THE CITY BUS AND SHE COMPLAINED TO ME THAT SOMEONE 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 /> JONES MERLE 028 AD EGV8320 12/05/2009 1210712009 12/24/2009 C <br /> BYRON WENT TO TURN ONTO W.WILLIAM ST.OFF OF N.MAIN ST.AND WHEN HEInc: $659.00 $659.00 $0.00 $0.00 ~ <br /> Pd: $659.32 $659.32 $0.00 $0.00 <br /> O/S: $0.00 $0.00 $0.00 $0.00 <br /> LAW BEVERLY 028 AS CES5873 06/21/2010 06/2112010 0612012010 c <br /> BEVERLY WAS EAST BOUND ON WOOD ST.GETTING READY TO TURN RIGHT ONTO S. 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 /> LOCKHART MARION 028 AS CES4378 12/17/2009 01/0412010 04/13/2010 C <br /> OPERATOR LAVONE BOLYARD STATES ON HER INCIDENT REPORT:SHE STOPPED AT Inc: $900.00 $900.00 $0.00 $0.00 <br /> Pd: $900.00 $900.00 $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 7 <br />