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17 DANIELS ST UNIT 1-CLAIM Progressive Home, by Homesite PROGREWIT Underwritten By: Homesite Insurance Company Of The Midwest Tel: 1-866-960-8609 Fax: 1-866-935-2858 6000 American Parkway Madison,WI 53783-0001 88259002 NN RP 1720230817 NNNNNNNN W04MI W18 Claim Number: 01-006-567838 BUILDING COMMISIONER Date Of Loss: 07/25/2023 98 WASHINGTON ST Policy Number: 37511807 SALEM, MA 01970-3506 Policyholder. Lisa Leblanc 'I"II�'ll��l"III'I'11111�11�III�II�III�III1�1111�111111111�I11� August 16, 2023 ATTENTION: Building Commissioner or Inspector of Buildings Fire Department or Arson Squad, Board of Health or Board of Selectmen C/O City or Town Hall NOTICE PURSUANT TO MASS. GEN. LAWS, CHAPTER 139, SECTION 318 Our Insured: LISA LEBLANC Property Address: 17 Daniels St# 1, UNIT 1 Salem, MA, 01970-5214 Policy Number: 37511807 Claim Number: 01-006-567838 Date of Loss 07/25/2023 This correspondence shall serve as notice that, pursuant to Massachusetts General Laws Chapter 139, Section 38, a claim has been made involving loss, damage or destruction to a building or other structure which may either exceed$1,000 or cause Massachusetts General Laws, Chapter 143, Section 6 to be applicable. If any notice pursuant to Massachusetts General Laws Chapter 139, Section 313 is appropriate, please direct such notice to my attention and kindly, pursuant to the information provided above, include the insured's name, address, policy number, claim number and date of loss. If you contact us via email, please use claimdocuments@afics.com and be sure to reference the claim number in the subject line of your email. Please contact me with any questions. Sincerely, S'�f* d~ Sterling Hepburn Claim Adjuster II AFICS on behalf of Homesite Insurance Company of the Midwest Steding.Hepbum @afics.com Phone: 1-608-722-2844 1 Fax: 1-866-935-2858 Mail: 6000 American Parkway, Madison, WI 53783-0001 Page 1 of 1 MEWtMI PP,)99�,)MYMW WiDS Y1J IpIB e0•SeRln)ePtlMed39w�Mq&