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5 BERRYWOOD LANE 3-21-23 CLAIM RECEIVED APR 13 2023 �, Safety Insurance CITY OF SALEM AUTO•HOME•BUSINESS BOARD OF HEALTH April 6, 2023 Building Commissioner or Inspector of Buildings Fire Department or Arson Squad Board of Health or Board of Selectmen City Hall SALEM, MA 01970 RE: Claim Number: LHMA0215A2 Insured(s): KEITH FRASER Property Address: 5 BERRYWOOD LANE, SALEM, MA 01970 Policy Number: HMA0210002 Date of Loss: 3/21/2023 Notice of Loss Under M.G.L. c. 139 FA 3113 This communication shall serve as written notice pursuant to M.G.L. c. 139, § 3B that [Safety Insurance Company] ("Safety") has received a claim involving loss, damage or destruction to a building or other structure at the above-reference address which may either: (1) meet or exceed $1,000; or (2) cause the condition or the building or other structure to render M.G.L. c. 143 § 6 applicable. In accordance with M.G.L. c. 139, § 313, if the city or town intends to initiate proceedings designed to perfect a lien under Section 3B, M.G.L. c. 143, §9 or M.G.L. c. 111, § 127B, please notify Safety of the same by certified mail. Kindly forward such notice to my attention, at the address indicated above, and include with such notice a reference to the above-described insured, property address, policy number and claim number. If you have any questions regarding this notice, please feel free to contact me directly by email at johncronin@safetyinsurance.com or by phone at 617-951-0600 extension 3025. Sincerely, John Cronin Property Claims Adjuster Visit us at www.safetyinsurance.com/claims for Frequently Asked Claims Questions Safety Insurance P.O.Box 55098 Boston,MA 02205-5098 800-951-2100 We'll help you manage life's stormsO O'10_C139 1 33