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107 Federal Street, Unit 3 5-27-21 claim Phone: 978-632-2660 Fax: 978-632-2662 RECEIVED JAMES A. TRUDEAU Adjustment Service Inc. .JUN 0 3 2021 P. O. Box 7 F SALEM Gardner, MA 01440 CITY OF HEALTH BOARD O claimsQvtrudeauad".com TH Notice of Casualty Loss of Buildin Under Massachusetts General Laws, Chapter 139, Section 3B June 1,2021 Building inspector 93 Washington Street Salem,MA 01970 oard ofXgtoealth93 Washn Street Salem,MA 01970 Fire Department Dept. of Records 48 Lafayette Street Salem,MA 01970 Insured: 107 Federal Street Condo Trust Loss Location: 107 Federal Street, Unit 3,Salem,MA 01970 Insurance Company: The Concord Group Ins.Companies Policy No.: 20018243 Date of Loss: May 27, 2021 File Number: 21-19131 Claim Number: 0030018675 Type of Loss: Water Damage Claim has been made involving loss, damage, or destruction of the above captioned property, which may either exceed$1,000.00 or cause "Mass. Gen. Laws, Chapter 143, Section 6" to be applicable. If any notice under"Mass. Gen. Laws Cha ter 139 Section 3B" is appropriate, please direct it to the writer and include a reference to the captioned insured,location,policy number, date of loss, and file or claim number. Claim has been made involving loss, damage or destruction of the above-captioned property, which may exceed $5000. If any notice under Massachusetts General Laws, Chapter 175 Section 97A is appropriate, please direct it to the attention of this writer and include a reference to the above-captioned insured, location,policy number,date of loss and claim number. On this date, I cause copies of this notice to be sent to the person(s) named above at the address indicated by first class mail. Sincerely, Joshua M. Trudeau Claims Adjuster