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107 MASON STREET, UNIT 2, 5-23-25 CLAIM rS INDEPENDENT RECEIVED CLAIMS SERVICE, INC . JUN 03 2025 Service Integrity Experience CITY OFSALEM BOARD OF HEALTH Notice of Casualty Loss to Building Under Massachusetts General Laws, Chapter 139, Section 3B May 29,2025 Salem,MA Building Inspector 1 Salem Green Salem,MA 01970 Salem, TMA Board of Health 9 North Street Salem,MA 01970 Salem,MA Fire Department 48 Lafayette Street Salem,MA 01970 INSURED: Ramon Hidalgo ADDRESS: 107 Mason St Unit 2, Salem,MA 01970 LOCATION OF LOSS: 107 Mason St, Salem,MA 01970 COMPANY: Vermont Mutual Insurance POLICY#: HP00218119 CLAIM#: 25-99052 DATE OF LOSS: 05/23/2025 TYPE OF LOSS: Wind 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 9 FAX 508.366.091 7 • www.icsclaims.com