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13 SPRING STREET UNIT 2- CLAIM 7-14-24 Admikk Safety Insurance 7/ AUTO• HOME•BUSINESS July 17, 2024 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: LHMA0420E1 Insured(s): ROBERT LAROSA Property Address: 13 SPRING ST UNIT 2, SALEM, MA 01970 Policy Number: HMA0616055 Date of Loss: 7/14/2024 Notice of Loss Under M.G.L. c. 139, § 313 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, § 3B, 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 LfsaMonettegaafetyrnsurance.com or by phone at 800-951-2100 extension 3420. Sincerely, Lisa Monette Property Claims Field 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 storms® O10_C13B 1 x 31