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Home My WebLink AboutInsurance Letter - Correspondence - 8 WALKER ROAD 2 8/12/2025 Progressive Home, by Homesite i Underwritten By: Homesite Insurance Company Of The Midwest Tel: 1-866-960-8609 Fax: 1-866-935-2858 6000 American Parkway Madison,WI 53783-0001 Claim Number: 01-009-163363 000382FC6500MO1052241502 Q03A 001 Date Of Loss: 08/11/2025 Policy Number: 43174478 NORTH ANDOVER TOWN HALL Policyholder: Jessica Salois } 120 MAIN ST NORTH ANDOVER, MA 01845-2420 August 12, 2025 ATTENTION: Building Commissioner or Inspector of Buildings Fire Department or Arson Squad, Board of Health or Board of Selectmen C/O City or Town Hall NOTICE PURSUANT TO MASS. GEN. LAWS, CHAPTER 139, SECTION 3B Our Insured: JESSICA SALOIS Property Address: 8 Walker Rd Apt 2 North Andover, MA, 01845-1920 Policy Number: 43174478 CD Claim Number: 01-009-163363 N Date of Loss 08/11/2025 co M O O This correspondence shall serve as notice that, pursuant to Massachusetts General Laws Chapter 139, Section 0 3B, a claim has been made involving loss, damage or destruction to a building or other structure which may either exceed $1,000 or cause Massachusetts General Laws, Chapter,143, Section 6 to be applicable. 0 0 If any notice pursuant to Massachusetts General Laws Chapter 139, Section 3B is appropriate, please direct such notice to my attention and kindly, pursuant to the information provided above, include the insured's name, address, policy number, claim number and date of loss. If you contact us via email, please use claimdocuments@afics.com and be sure to reference the claim number in the subject line of your email. Please contact me with any questions. Sincerely, S' trod Samantha Ford Claims TPA Property Independent Adjuster AFICS on behalf of Homesite Insurance Company of the Midwest Samantha.Ford@afics.com Phone: 1-608-722-2632 1 Fax: 1-866-935-2858 Mail: 6000 American Parkway, Madison, WI 53783-0001 Page 1 of 1