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20 CENTRAL STREET - CLAIM NOTICE Samuel F. McCormack Co. Inc. Insurance Adjusters and Appraisers Samuel F.Nkoum we Ca,dnc. ADJUSTERS AND APPRAISERS September 13, 2021 Salem City Hall Building Inspector 93 Washington Street Salem. MA 01970 RE ASSURED: Brian K Best LOSS LOCATION: 20 Central St, Salem, MA 01970 POLICY NO: HO17098510 TYPE OF LOSS: Water DATE OF LOSS: 09/10/2021 OUR FILE NO: 21-02754 To Whom It May Concern: 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 any notice under Massachusetts General Laws, Chapter 139, Section 313 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 or file number. Thank you for your anticipated cooperation. Very truly yours, Edward Bennett Adjuster efb@mccormackadjuster.com cc: Board of Health Fire Department SKEP 15'*11:318 S E P 42 Holbrook Avenue,Braintree,MA 021841-800-972-5399(781)843-1222 Fax(781)849-8191 125 Waterhouse Road,Bourne,MA 02532(508)403-2600 Fax(508)403-2602 www.mccormackadjuster.com