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1 RICE STREET 9-22-24 CLAIM S' INDEPENDENT RECEIVED CLAIMS SERVICE, INC. SEP 262024 Service - Integrity Experience CITY OFSALEM Notice of Casualty Loss to Building BOARD OF HEALTH Under Massachusetts General Laws, Chapter 139, Section 3B September 23, 2024 Salem,MA Building Inspector 1 Salem Green Salem,MA 01970 Salem, MA Board of Health 9 North Street Salem, MA 01970 Salem,MA Fire Department 48 Lafayette Street Salem,MA 01970 INSURED: Micaela Dechaves ADDRESS: 1 Rice St, Salem, MA 01970 LOCATION OF LOSS: 1 Rice St, Salem,MA 01970 COMPANY: Vermont Mutual Insurance POLICY#: HP00147224 CLAIM#: 24-97515 DATE OF LOSS: 09/22/2024 TYPE OF LOSS: Water 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 01581 • 508.366.8535 • FAX 508.366.0917 • www.icsclaims.com