9 HILLSIDE AVENUE 7-25-25 CLAIM K]S INDEPENDENT
CLAIMS SERVICE, INC.
Service • Integrity • Experience
Notice of Casualty Loss to Building
Under Massachusetts General Laws, Chapter 139, Section 3B
August 2, 2025
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: Harvinderpal&Manjit Singh
ADDRESS: 16458 SE 166th Terrace,Renton,WA 98058
LOCATION OF LOSS: 9 Hillside Avenue, Salem,MA 01970
COMPANY: Vermont Mutual Insurance
POLICY#: DP00046833
CLAIM#: 25-99415
DATE OF LOSS: 07/25/2025
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 01 581 • 508.366.8535 • FAX 508.366.091 7 • www.icsclaims.com