HomeMy WebLinkAboutBeus Correspondence from Travelers - Claim Acknowledgment Claim Acknowledgment
CLAIM# LOSS DESIG. ADJ.OFFICE FIELD OFFICE NAME REPORTING STATE
F4X2354 � LR 028
CLAIM HANDLER PHONE NUMBER SUPERVISOR
ANDREW LEGERE 1 (630) 961-8677 RSV
ACCOUNT INFORMATION
PARENT COMPANY NAME IC'ITY
COUNTNAME
CITY OF TWIN FALLS OF TWIN FALLS
RISK LOCATION ADDRESS MAILING ADDRESS
321 2ND AVE E
ID 83301 TWIN FALLS ID 83301
LOCATION CODE
POLICY PROFILE
POLICY FORM POLICY NUMBER EFFECTIVE DATE
ZLP C 1 10/01/2024
LOSS ACCIDENT INFORMATION
DATE OF ACCIDENT CALLER NAME ACCIDENT LOCATION
01/24/2025
TIME OF ACCIDENT CALLER PHONE NUMBER/EXT
245 HARRISON STREET,
DATE REPORTED CALLER TYPE TWIN FALLS ID 83301
01/24/2025 1
DESCRIPTION OF ACCIDENT
MCGHEE AND THEIR DAUGHTER. A NEIGHBORING PROPERTY ALSO HAD SOME MINIMAL BACKUP
DUE TO THE BLOCKAGE . WILLCONTACTED A PLUMBER WHO CAME OUT AND FOUND A BLOCKAGE IN
THE CITY' S SEWER LINE .
P0016 8/2022
CLAIM # F4X2354
LIABILITY ACCIDENT INFORMATION
TYPE OF GL NOTICE
SUBSTANCE OR OBJECT CLAIMANT FELL ON
HOW OBJECT GOT THERE
HOW PRODUCT WAS BEING USED AT THE TIME OF THE ACCIDENT
MANUFACTURER NAME
MAKE/MOD EL/SIZE/STYLE
DAMAGE
WHERE&WHEN PURCHASED
WHERE CAN PRODUCT BE SEEN
CLAIMANT INFORMATION
NAME CLAIMANT NO. TYPE
RACHEL SCHEELE 245 HARRISON STTWIN FALLSID83301 �01
DESCRIPTION
ATTORNEY
TOTAL CLAIMANTS: 1
P0016 8/2022