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21 ECLIPSE LN UNIT 178D_ NOTICE OF LOSS 7-3-25 W Safety Insurances 7, AUTO • HOME • BUSINESS July 7, 2025 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: LHMA05C1A4 _ - Insured(s): ROBERT DADDARIO Property Address: 21 ECLIPSE LN # 178D, SALEM, MA 01970 Policy Number: HMA0622521 Date of Loss: 7/3/2025 Notice of Loss Under M.G.L. c. 139, § 3B 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 sergioalvarez-@safetyinsurarce.com or by phone at 617-951-0600 extension 1249: Sincerely, Sergio Alvarez Property Claims Adjuster Visit us at w .safetyinsurance.00m/claims for Frequently Asked Claims Questions Safety Insurance P.O.Box 55098 Boston,MA 02205-5098 800-951-2100 Well help you manage life's storms® 0 () a * Q oio ci3s �'P '.-lE 35