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3 OAKVIEW AVENUE 2-19-23 CLAIM 3 INDEPENDENT RECEIVED CLAIMS SERVICE, INC. FEB 27 2023 Service - Integrity • Experience CITY OFSALEM Notice of Casualty Loss to Building BOARD OF HEALTH Under Massachusetts General Laws, Chapter 139, Section 3B February 21, 2023 Salem, MA Building Inspector 1 Salem Green Salem, MA 01970 MA Board of Health 9 North Street Salem, MA 01970 Salem, MA Fire Department 48 Lafayette Street Salem,MA 01970 INSURED: Kimberly Maddocks ADDRESS: 3 Oak View Ave, Salem,MA 01970-4315 LOCATION OF LOSS: 3 Oak View Ave, Salem,MA 01970-4315,US COMPANY: MAPFRE Insurance POLICY#: 4633518193 CLAIM#: 23-93390 DATE OF LOSS: 02/19/2023 TYPE OF LOSS: Other Dear Sir or Madam: Independent Claims Service is the insurance adjusting firm hired by the above referenced client to handle the captioned loss on behalf of their insured. A claim has been made involving loss, damage, or destruction of the above-captioned property which may either exceed $1,000.00 or cause Massachusetts General Laws, Chapter 143, Section 6 to be applicable. If notice under Massachusetts General Laws, Chapter 139, Section 3B is appropriate, please bring it to our attention, and include a reference of the captioned insured: Location, policy number, and/or date of loss. Sincerely, INDEPENDENT CLAIMS SERVICE,INC. 22 Water Street • Westborough, MA 01 581 • 508.366.8535 • FAX 508.366.0917 • www.icsclaims.com