CLAIM ID: 2304SK039 TYPE OF LOSS: Fire

DETAILED SPREADSHEET CLAIM DATE: Apr 1, 2023 CAT Code:

REPORT DATE: May 15, 2023
INSURED: Osman Ahmed Syed

ITEM ITEM DATA TAG RECEIPT REPLACEMENT PURCHASE PRICE AGE REPLACEMENT VALUE DEPRECIATION ACTUAL CASH VALUE
ROOM BOX LOCATION PHOTO DESCRIPTION BRAND DISPOSITION CONDITION QTY PHOTO MODEL # SERIAL # PHOTO RETAILER SOURCE NOTES
EACH TOTAL Y M EACH TOTAL CATEGORY % AMOUNT EACH TOTAL

Assorted Lace, Elastic

Unit 5 Band 5pc Loss listed 1

Electric Shavers And

Unit 5 Loss listed 1
Cord 3pc

Unit 5 Bike Accessories 2 Pc Loss listed 1

Assorted Cords, Head

Unit 5 Phone Rubber Loss listed 1 0 0
Attachments 11pc

Assorted Medication,
Unit 5 Kleenex, Ziploc Baggies 4 Loss listed 1
Pc

Unit 5 Assorted Paper Art Loss listed 1

Assorted Paper Products

Unit 5 Loss listed 1 0 0
7pc

Unit 5 Misc Items 11pc Loss listed 1

Unit 5 Assorted Clips 7pc Loss listed 1 0 0

Assorted Ribbons, And

Unit 5 Loss listed 1
Lanyards 7pc

Unit 5 Assorted Bracelets 6pc Loss listed 1

4- Tennis Balls, 1- Key

Unit 5 Loss listed 1
Chain

Assorted Art Supplies

Unit 5 7pc Loss listed 1 0 0

Shampoo, Conditioner,
Unit 5 Loss listed 5 0 0
Lotion, Assorted Soaps

Air Freshener, Bucket

Unit 5 Loss listed 2 0 0
13.5/12.5 In

Dish Soap, Bubbles,

Unit 5 Loss listed 3 0 0
Glasses Cleaner

Assorted Hygiene
Unit 5 Loss listed 8 0 0
Products

Unit 5 Assorted Cleaning Items Loss listed 4 0 0

Powered by Encircle Insured Initials ________ Page 1 of 14

 CLAIM ID: 2304SK039 TYPE OF LOSS: Fire
DETAILED SPREADSHEET CLAIM DATE: Apr 1, 2023 CAT Code:
REPORT DATE: May 15, 2023
INSURED: Osman Ahmed Syed

ITEM ITEM DATA TAG RECEIPT REPLACEMENT PURCHASE PRICE AGE REPLACEMENT VALUE DEPRECIATION ACTUAL CASH VALUE
ROOM BOX LOCATION PHOTO DESCRIPTION BRAND DISPOSITION CONDITION QTY PHOTO MODEL # SERIAL # PHOTO RETAILER SOURCE NOTES
EACH TOTAL Y M EACH TOTAL CATEGORY % AMOUNT EACH TOTAL

Mug, Bathroom Caddy

Unit 5 6.5/5/3.5 In, Soap Tray, Loss listed 4 0 0
Garbage Bin 8/9.5 In

Laundry Soap, Toilet

Unit 5 Loss listed 4 0 0
Bowl Cleaner

Unit 5 Mop Pail 15.5/10/10 In Loss listed 1 0 0

Recycling Bin 7/12.5/16

Unit 5 Loss listed 1 0 0
In

Unit 5 Assorted Power Cords Loss listed 4 0 0

Unit 5 Gloves 9pc, Razors Loss listed 13 0 0

Unit 5 Empty Boxes Loss listed 2 0 0

Waterpik With Box And

Unit 5 Loss listed 4 0 0
Cord, Epilator Head

Assorted House Items

Unit 5 Loss listed 14 0 0
From Closet

Floor Savers, Lint Roller

Unit 5 Loss listed 3 0 0
Refill, Can Cozy

Kleenex, Quips, Lens

Unit 5 Loss listed 4 0 0
Cleaner

Thread And Travel Sew

Unit 5 Loss listed 5 0 0
Kits

Unit 5 Assorted Office Items Loss listed 15 0 0

Unit 5 Lotion And Sunscreen Loss listed 2 0 0

Assorted Makeup And

Unit 5 Accessories And Tray Loss listed 18 0 0
5/9/1 In

Unit 5 Assorted Medications Loss listed 16 0 0

Unit 5 Assorted Medications Loss listed 3 0 0

Unit 5 Adhesive Loss listed 1 0 0

Powered by Encircle Insured Initials ________ Page 2 of 14

 CLAIM ID: 2304SK039 TYPE OF LOSS: Fire
DETAILED SPREADSHEET CLAIM DATE: Apr 1, 2023 CAT Code:
REPORT DATE: May 15, 2023
INSURED: Osman Ahmed Syed

ITEM ITEM DATA TAG RECEIPT REPLACEMENT PURCHASE PRICE AGE REPLACEMENT VALUE DEPRECIATION ACTUAL CASH VALUE
ROOM BOX LOCATION PHOTO DESCRIPTION BRAND DISPOSITION CONDITION QTY PHOTO MODEL # SERIAL # PHOTO RETAILER SOURCE NOTES
EACH TOTAL Y M EACH TOTAL CATEGORY % AMOUNT EACH TOTAL

Unit 5 Assorted Medications Loss listed 14 0 0

Assorted Medical
Unit 5 Loss listed 4 0 0
Supplies

Assorted Hair
Unit 5 Loss listed 1 0 0
Accessories

Assorted Medical
Unit 5 Loss listed 16 0 0
Supplies

Unit 5 Misc Items From Closet Loss listed 15 0 0

Assorted Candy And

Unit 5 Loss listed 21 0 0
Container 7.5/7.5/2.5 In

Unit 5 Assorted Bags. Loss listed 2 0 0

CAT 1200A Professional

Unit 5 TT5 Loss listed 1 PPSCT2 0 0
Power Station

Unit 5 TT5 Black Document folder Loss listed 1 0 0

Unit 5 TT5 Kleenex Loss listed 1

Unit 5 TT5 Paint Brush Loss listed 1

Unit 5 TT5 Candy Loss listed 1

4-wheels Large Luggage

Storage Bag, Maroon, Secure Loss listed 1
Room Brand

Storage 2-wheels Large Luggage Loss listed 1

Room Bag, Beelite Brand

Storage 2-wheels Carry-on Loss listed 1

Room Luggage, VIP Brand

Storage 4-wheel Large Luggage, Loss listed 1

Room Wagon R Brand

Storage Noma Bagless Canister Loss listed 1

Room Vacuum

Storage Picture Note

Empty Box Of Chair, JYSK Loss listed 2
Room

Powered by Encircle Insured Initials ________ Page 3 of 14

 CLAIM ID: 2304SK039 TYPE OF LOSS: Fire
DETAILED SPREADSHEET CLAIM DATE: Apr 1, 2023 CAT Code:
REPORT DATE: May 15, 2023
INSURED: Osman Ahmed Syed

ITEM ITEM DATA TAG RECEIPT REPLACEMENT PURCHASE PRICE AGE REPLACEMENT VALUE DEPRECIATION ACTUAL CASH VALUE
ROOM BOX LOCATION PHOTO DESCRIPTION BRAND DISPOSITION CONDITION QTY PHOTO MODEL # SERIAL # PHOTO RETAILER SOURCE NOTES
EACH TOTAL Y M EACH TOTAL CATEGORY % AMOUNT EACH TOTAL

Storage 20lbs Whole Wheat

Room Flour Loss listed 1

Storage 10lbs Gold Bismati Rice Loss listed 1

Room

Storage Conair Hair Dryer Loss listed 1

Room

Storage Black+Decker Steam Iron Loss listed 1

Room

Storage 200mL Kirkland Juice Loss listed 24

Room

Storage Marveo Avengers Puzzle;

Loss listed 1
Room Tumbling Tower, 48 Pcs

Storage Boxes Of 3-ply Kleenex Loss listed 11

Room

Storage Dove Bar Soap Loss listed 20

Room

Storage 170mL Colgate; 4- pcs Loss listed 1

Room Oral B Toothbrushes

Storage Box Of Quality Street Loss listed 1

Room Caramels

Storage Vacuum Seal Bags Loss listed 14

Room

Plastic Bags For

Storage
Bedsheet (1) And Loss listed 1
Room Pillowcases (6)

Storage Assorted
Room Candies/Chocolates Loss listed 1

Storage Hand And Foot Warmers Loss listed 1

Room

2- 375g Vaseline Jelly; 1-

Storage 1.18L Dove Shampoo; 1- Loss listed 1
Room 600mL Vaseline Lotion;
3- 591mL Body Wash

Storage Hair Colors Loss listed 1

Room

Storage Recyclable 4L Jugs, Loss listed 1

Room Bottles, and Styrofoams

Storage Empty Boxes Loss listed 1

Room

Powered by Encircle Insured Initials ________ Page 4 of 14

 CLAIM ID: 2304SK039 TYPE OF LOSS: Fire
DETAILED SPREADSHEET CLAIM DATE: Apr 1, 2023 CAT Code:
REPORT DATE: May 15, 2023
INSURED: Osman Ahmed Syed

ITEM ITEM DATA TAG RECEIPT REPLACEMENT PURCHASE PRICE AGE REPLACEMENT VALUE DEPRECIATION ACTUAL CASH VALUE
ROOM BOX LOCATION PHOTO DESCRIPTION BRAND DISPOSITION CONDITION QTY PHOTO MODEL # SERIAL # PHOTO RETAILER SOURCE NOTES
EACH TOTAL Y M EACH TOTAL CATEGORY % AMOUNT EACH TOTAL

Storage
Room Men's Belt Loss listed 1

Storage Brooms Loss listed 2

Room

Storage Baseball Bat Loss listed 1

Room

236mL Wood Glue,

Storage 150mL White Glue, Twist Loss listed 3
Room Green Apple

Storage Philips Shaver Loss listed 1

Room Accessories

Storage
Paper Towel Loss listed 1
Room

2- Boxes Of 4 Vitakin D3,

Storage 5- Sachets Emergen-C, 5- Loss listed 1
Room Sachets Cinnamon
Orange Tea

Storage 3- XLarge Plastic Bags, 5- Loss listed 8

Room Shopping Bags

Storage Beach Ball Loss listed 1

Room

Storage Spray Mop Loss listed 1

Room

Storage 4- pcs AAA Panasonic Loss listed 1

Room Battery, 5- Rolls Thread

Storage Armani Eyeglasses Case;

Loss listed 1
Room Mirror

Storage
Room Water Flossers Loss listed 1

Storage 50mL Mont Blanc Ink Loss listed 1

Room

Storage Broom And Dustpan Loss listed 1

Room

Storage 16x24in Door Mat Loss listed 2

Room

Storage Assorted paper clips Loss listed 20

Room

Storage Keychains Loss listed 2

Room

Powered by Encircle Insured Initials ________ Page 5 of 14

 CLAIM ID: 2304SK039 TYPE OF LOSS: Fire
DETAILED SPREADSHEET CLAIM DATE: Apr 1, 2023 CAT Code:
REPORT DATE: May 15, 2023
INSURED: Osman Ahmed Syed

ITEM ITEM DATA TAG RECEIPT REPLACEMENT PURCHASE PRICE AGE REPLACEMENT VALUE DEPRECIATION ACTUAL CASH VALUE
ROOM BOX LOCATION PHOTO DESCRIPTION BRAND DISPOSITION CONDITION QTY PHOTO MODEL # SERIAL # PHOTO RETAILER SOURCE NOTES
EACH TOTAL Y M EACH TOTAL CATEGORY % AMOUNT EACH TOTAL

Storage Assorted Screws, door

Room hinges Loss listed 1

Storage Empty Boxes Loss listed 1

Room

Bathroom Shower curtain Loss listed 1

Bathroom Toilet Brush Loss listed 1

Plastic Bucket, Empty

Bathroom Loss listed 1
Bottle

Over The Door Steelcraft

Bedroom 1 Loss listed 1
Hook Rack

Sealy Queen size

Bedroom 1 Loss listed 1
Mattress

Ottoman with storage

Bedroom 1 Loss listed 1
14"x14"x14"

Bedroom 1 Queen Size Pillows Loss listed 2

Bedroom 1 Tablecloth 50”x68” Loss listed 1

Large Giordano and Polo

Bedroom 1 Loss listed 2
Royal Luggages

Assorted medicine
Bedroom 1 Loss listed 1
Products

Plastic Basket
Bedroom 1 13”x2.5”x5” Loss listed 1

3-envelopes, 1-pencil, 1-
Bedroom 1 Loss listed 1
stylus, 1-stationery clip

1-napkins, 1-paper
handkerchiefs, 1-
Bedroom 1 Loss listed 1
washcloth, 2-condoms,
1-feminine sanitary pads

1-Flick Basketball,1-
Empty Box 1- 1- Paint
Bedroom 1 Loss listed 1
Brush, 1- Gift Bag, 3- Gift
Tags

Nestle Dark Mint Thins

Bedroom 1 Loss listed 1
300g

Bedroom 1 Empty Boxes Loss listed 2

Powered by Encircle Insured Initials ________ Page 6 of 14

 CLAIM ID: 2304SK039 TYPE OF LOSS: Fire
DETAILED SPREADSHEET CLAIM DATE: Apr 1, 2023 CAT Code:
REPORT DATE: May 15, 2023
INSURED: Osman Ahmed Syed

ITEM ITEM DATA TAG RECEIPT REPLACEMENT PURCHASE PRICE AGE REPLACEMENT VALUE DEPRECIATION ACTUAL CASH VALUE
ROOM BOX LOCATION PHOTO DESCRIPTION BRAND DISPOSITION CONDITION QTY PHOTO MODEL # SERIAL # PHOTO RETAILER SOURCE NOTES
EACH TOTAL Y M EACH TOTAL CATEGORY % AMOUNT EACH TOTAL

2 Sets Of Twin Size

Bedroom 2 Mattress And Bedframes Loss listed 2

Queen Size Memo

Bedroom 2 Loss listed 2
Pillows

Bedroom 2 Body Pillow Loss listed 1

Twin Size Mattress

Bedroom 2 Loss listed 2
Protectors

Bedroom 2 Stuffed Toys Loss listed 2

6x4 Outdoor Woven

Bedroom 2 Loss listed 1
Rug/Mat

Bedroom 2 Plastic Hangers Loss listed 32

Assorted Toys And

Bedroom 2 Loss listed 1
School Supplies

Bedroom 2 Kids' Belts Loss listed 2

Bedroom 2 Belt For A Kid's Dress Loss listed 1

Kitchen Table
Kitchen Loss listed 1
71"×35.5"×29.5"

Kitchen Chairs
Kitchen Loss listed 4
17"×18"×38"

Plastic Table Cloth

Kitchen 75"×55" Loss listed 1

Panasonic Inverter
Kitchen Loss listed 1 TYPE S333
Microwave

Cutting Boards And Pot

Kitchen Loss listed 1
Holders

Kitchen Dish Rack Loss listed 1

Kitchen Toastmaster Toaster Toastmaster Loss listed 1 TM-26TSC

Kitchen Bag Water Bottles Loss listed 2

Powered by Encircle Insured Initials ________ Page 7 of 14

 CLAIM ID: 2304SK039 TYPE OF LOSS: Fire
DETAILED SPREADSHEET CLAIM DATE: Apr 1, 2023 CAT Code:
REPORT DATE: May 15, 2023
INSURED: Osman Ahmed Syed

ITEM ITEM DATA TAG RECEIPT REPLACEMENT PURCHASE PRICE AGE REPLACEMENT VALUE DEPRECIATION ACTUAL CASH VALUE
ROOM BOX LOCATION PHOTO DESCRIPTION BRAND DISPOSITION CONDITION QTY PHOTO MODEL # SERIAL # PHOTO RETAILER SOURCE NOTES
EACH TOTAL Y M EACH TOTAL CATEGORY % AMOUNT EACH TOTAL

Kitchen Cup Storage Rack Loss listed 1

Cutlery Organizer Plastic

Baskets, Microwave
Kitchen Loss listed 1
Cover & Paper Towel
Holder

Kitchen 1/4 Dates Loss listed 1

Kitchen Assorted Condiments Loss listed 1

Kitchen Walnuts Loss listed 1

Coffee And Assorted

Kitchen Loss listed 1
Spices

Assorted Cooking
Kitchen Loss listed 1
Igredients

Assorted Cooking
Kitchen Loss listed 1
Ingredients

Kitchen Spice Mixes Loss listed 7

Kitchen 800g Cream Of Wheat Loss listed 3

Kitchen Cooking Ingredients Loss listed 1

Unknown
Kitchen Spices/Cooking Loss listed 1
Ingredients

Assorted Cookies And

Kitchen Bars Loss listed 1

Kitchen Assorted Pastas Loss listed 1

Kitchen Assorted Bags Of Rice Loss listed 1

Vegetable Flavor
Kitchen Loss listed 10
Noodles

Kitchen Popcorn Loss listed 1

Kitchen Spice Mixes Loss listed 4

Powered by Encircle Insured Initials ________ Page 8 of 14

 CLAIM ID: 2304SK039 TYPE OF LOSS: Fire
DETAILED SPREADSHEET CLAIM DATE: Apr 1, 2023 CAT Code:
REPORT DATE: May 15, 2023
INSURED: Osman Ahmed Syed

ITEM ITEM DATA TAG RECEIPT REPLACEMENT PURCHASE PRICE AGE REPLACEMENT VALUE DEPRECIATION ACTUAL CASH VALUE
ROOM BOX LOCATION PHOTO DESCRIPTION BRAND DISPOSITION CONDITION QTY PHOTO MODEL # SERIAL # PHOTO RETAILER SOURCE NOTES
EACH TOTAL Y M EACH TOTAL CATEGORY % AMOUNT EACH TOTAL

Kitchen Papad Loss listed 3

Kitchen Chow Mein Noodles Loss listed 3

Betty Crocker Foil

Kitchen Loss listed 2
Containers And Lids

Kitchen Kirkland Almonds 1.36kg Loss listed 1

Kirkland Signature
Kitchen Loss listed 1
Mayonnaise (Empty)

3- 100' Alcan; 1- 164ft

Kitchen Loss listed 1
Cling Wrap

Kitchen Granola Loss listed 1

Kitchen 1- Paper Towel, 1- Wipes Loss listed 1

Kitchen Chia seeds In A Jar Loss listed 1

1L Gallo Virgin Coconut

Kitchen Loss listed 1
Oil

Kitchen 1.25kg Nestle Mini Bars Loss listed 1

Kitchen Foam Cups Loss listed 1

Kitchen Сardamom seeds Loss listed 1

500g Horlicks, 500g

Kitchen Dabur Chyawanprakash, Loss listed 1
66g Hajmola

Roasted Chickpea In
Kitchen Loss listed 1
Plastic Container

5mL Vitamin D, 5mL

Kitchen Loss listed 2
Ddrops

French’s Mustard 830g,

Apple Cider Vinegar
Kitchen Loss listed 1
500mL, Kraft BBQ Sauce
455mL

999 Kesar Yellow &

Kitchen Loss listed 1
Orange Red

Powered by Encircle Insured Initials ________ Page 9 of 14

 CLAIM ID: 2304SK039 TYPE OF LOSS: Fire
DETAILED SPREADSHEET CLAIM DATE: Apr 1, 2023 CAT Code:
REPORT DATE: May 15, 2023
INSURED: Osman Ahmed Syed

ITEM ITEM DATA TAG RECEIPT REPLACEMENT PURCHASE PRICE AGE REPLACEMENT VALUE DEPRECIATION ACTUAL CASH VALUE
ROOM BOX LOCATION PHOTO DESCRIPTION BRAND DISPOSITION CONDITION QTY PHOTO MODEL # SERIAL # PHOTO RETAILER SOURCE NOTES
EACH TOTAL Y M EACH TOTAL CATEGORY % AMOUNT EACH TOTAL

Haldiram’s Boondi Indian

Snacks 350g, Great Value
Kitchen Ice Cream Cups 79g, Pot Loss listed 1
Of Gold Dark Chocolate
Collection 248g

Kitchen 200g Imli Candy Loss listed 1

Kitchen Cleaning Supplies Loss listed 3

Kitchen Hot kitchen stand Loss listed 1

Kitchen PRESSURE COOKER part Loss listed 1

Kitchen Chicken Broth Loss listed 1

Parachute coconut oil

Kitchen Loss listed 1
500mL

Kitchen Water filter pitcher Loss listed 1

Spoons And Stainless

Kitchen Loss listed 1
Steel Scrub

Kitchen Bag Of pulse candy Loss listed 1

Kitchen 10mL Cooking Oil Loss listed 1

Kitchen Bottle Brush Loss listed 1

Hershey’s Cocoa 100%

Kitchen Cacao 226g Loss listed 1

Tim Hortons Hot

Kitchen Loss listed 1
Chocolate 1.5 Kg

10kg & 1.81kg Flour;

Kitchen Loss listed 3
2.58kg Quaker Oats

Kitchen 3.6kg Popcorn Loss listed 1

Kitchen Assorted Spices Loss listed 1

1lb Quinoa, 4lb Pigeon

Kitchen Loss listed 1
Peas, Chick Peas

Powered by Encircle Insured Initials ________ Page 10 of 14

 CLAIM ID: 2304SK039 TYPE OF LOSS: Fire
DETAILED SPREADSHEET CLAIM DATE: Apr 1, 2023 CAT Code:
REPORT DATE: May 15, 2023
INSURED: Osman Ahmed Syed

ITEM ITEM DATA TAG RECEIPT REPLACEMENT PURCHASE PRICE AGE REPLACEMENT VALUE DEPRECIATION ACTUAL CASH VALUE
ROOM BOX LOCATION PHOTO DESCRIPTION BRAND DISPOSITION CONDITION QTY PHOTO MODEL # SERIAL # PHOTO RETAILER SOURCE NOTES
EACH TOTAL Y M EACH TOTAL CATEGORY % AMOUNT EACH TOTAL

2lb Premium Tea, Wagh

Kitchen Bakri Loss listed 1

285g Organic Fish N Fry

Kitchen Loss listed 1
Coating Mix

Kitchen 2kg Sugar Loss listed 1

Kitchen 1kg Salt Loss listed 1

Kitchen Assorted Asian Food Loss listed 1

Unknown Spice In A Tin

Kitchen Loss listed 1
Can

Shoe Horn And Back

Kitchen Loss listed 1
Scratcher

Kitchen 2x38in Area Rug Loss listed 1

Kitchen TT5 Thermos 500 mL Loss listed 1 0 0

Kitchen TT5 Thermos 750 mL Loss listed 1 0 0

Kitchen TT5 Black Vegetable Peeler Loss listed 1 0 0

Living Room Throw Pillows Loss listed 4

3 Seater Couch
Living Room 81"×36"×32" Loss listed 1

Living Room Love Seat 60"×36"×31" Loss listed 1

Living Room Rug 71"x24" Loss listed 1

Living Room Slices of cheese Loss listed 7

Great value whole kernel

Living Room Loss listed 1
corn750g

Living Room Ice Loss listed 2

Powered by Encircle Insured Initials ________ Page 11 of 14

 CLAIM ID: 2304SK039 TYPE OF LOSS: Fire
DETAILED SPREADSHEET CLAIM DATE: Apr 1, 2023 CAT Code:
REPORT DATE: May 15, 2023
INSURED: Osman Ahmed Syed

ITEM ITEM DATA TAG RECEIPT REPLACEMENT PURCHASE PRICE AGE REPLACEMENT VALUE DEPRECIATION ACTUAL CASH VALUE
ROOM BOX LOCATION PHOTO DESCRIPTION BRAND DISPOSITION CONDITION QTY PHOTO MODEL # SERIAL # PHOTO RETAILER SOURCE NOTES
EACH TOTAL Y M EACH TOTAL CATEGORY % AMOUNT EACH TOTAL

Living Room Prescription for medicine Loss listed 1

Cracker Barrel Mozza

Living Room Loss listed 1
Cheddar 320g

Living Room Switz Sambosa Leaves Loss listed 1

Living Room Empty containers Loss listed 3

Living Room Hala minced beef (3 PCs) Loss listed 3

Living Room Chicken 3 Pieces Loss listed 1

Living Room Empty Containers Loss listed 3

Shana Original Paratha

Living Room Loss listed 1
400g

Great Value Neapolitan

Living Room Loss listed 1
Ice Milk 4L

Living Room 11 Eggs Loss listed 11

2- Bush’s Black Bean

Fiesta 398 mL, 2- Great
Value Dark Red Kidney
Living Room Loss listed 1
Beans 540 mL, 1- Heinz
Beans Red Kidney 398
mL

Saskatoon Berry Jam 950

Living Room Loss listed 1
mL

Kirkland Sunsweet Pitted

Living Room Prunes 1.6 kg Loss listed 1

Kirkland Spanish Olives

Living Room Loss listed 1
1L

No Name Soya Sauce

Living Room Loss listed 1
450 mL

Dairyland Homogenized
Living Room Loss listed 1
Milk 4L

Unknown leaves, cheese,

Living Room Loss listed 1
candy

Happy Village Smyrna

Living Room Loss listed 1
Figs 1.13 kg

Powered by Encircle Insured Initials ________ Page 12 of 14

 CLAIM ID: 2304SK039 TYPE OF LOSS: Fire
DETAILED SPREADSHEET CLAIM DATE: Apr 1, 2023 CAT Code:
REPORT DATE: May 15, 2023
INSURED: Osman Ahmed Syed

ITEM ITEM DATA TAG RECEIPT REPLACEMENT PURCHASE PRICE AGE REPLACEMENT VALUE DEPRECIATION ACTUAL CASH VALUE
ROOM BOX LOCATION PHOTO DESCRIPTION BRAND DISPOSITION CONDITION QTY PHOTO MODEL # SERIAL # PHOTO RETAILER SOURCE NOTES
EACH TOTAL Y M EACH TOTAL CATEGORY % AMOUNT EACH TOTAL

Dairyland Whipped
Living Room Cream 225g Loss listed 1

Living Room Coca-Cola 2L Loss listed 1

Hershey’s Chipits Milk

Living Room Chocolate Baking Pieces Loss listed 1
270g

Living Room Dill Loss listed 1

Supra vit vitamin C

Living Room Loss listed 1
1000mg 80g

Knorr 2 Chicken
Living Room Flavoured Bouillon Loss listed 1
Cubes 20g

Living Room Kraft BBQ Sauce 455mL Loss listed 1

Living Room Rice In Glass Container Loss listed 1

Big Marble Farms

Living Room Loss listed 1
Seedless Cucumber

Living Room Heinz Mayonnaise 4L Loss listed 1

1- Kraft Crunchy Peanut

Butter 1kg , 2-
Living Room Loss listed 3
Compliments Smooth
Peanut Butter

Living Room Saskatoon Berry 360mL Loss listed 1

Living Room 1- Apple, 3kg Potatoes Loss listed 1

Unknown Food In
Living Room Loss listed 1
Container

Philadelphia Whipped
Living Room Loss listed 1
Original 227g

Unknown Food In Plastic

Living Room Loss listed 1
Bowl

Living Room 2- Pieces Chocolate Loss listed 1

Living Room Becel Margarine 427g Loss listed 2

Powered by Encircle Insured Initials ________ Page 13 of 14

 CLAIM ID: 2304SK039 TYPE OF LOSS: Fire
DETAILED SPREADSHEET CLAIM DATE: Apr 1, 2023 CAT Code:
REPORT DATE: May 15, 2023
INSURED: Osman Ahmed Syed

ITEM ITEM DATA TAG RECEIPT REPLACEMENT PURCHASE PRICE AGE REPLACEMENT VALUE DEPRECIATION ACTUAL CASH VALUE
ROOM BOX LOCATION PHOTO DESCRIPTION BRAND DISPOSITION CONDITION QTY PHOTO MODEL # SERIAL # PHOTO RETAILER SOURCE NOTES
EACH TOTAL Y M EACH TOTAL CATEGORY % AMOUNT EACH TOTAL

Astro Original Natural

Living Room Yogourt 750g Loss listed 2

Green Giant Whole

Kernel Corn 341mL,
Living Room Loss listed 2
Compliments Tomato
Sauce 213 mL

1-Atlantic Salmon , 2-
Living Room Flaked Light Tuna 2- Loss listed 1
Unknown canned fish

Great Value Pasta

Living Room Sauce , Sweetened Loss listed 1
Condensed Milk

Living Room Chilli pepper Loss listed 1

Living Room Unknown Food Loss listed 1

Living Room Carrot Loss listed 1

Knorr 2 Chicken
Living Room Flavoured Broth Cubes Loss listed 1
20g

Heinz Tomato Ketchup

Living Room Loss listed 2
1.25 L

Living Room Empty Boxes Loss listed 3

extension cable, 2-USB

Living Room Loss listed 1
cables

Living Room Craft Loss listed 1

Tablecloth 54”x 23”,

Living Room lighter Loss listed 2

Samsung 65” QLED With Sam QN65Q6BAF 0D1Y3CUT9

Living Room SM5 Loss listed 1
Feet And Cord XZC 03388W

6'7" x 9'6" Area Rug, Picture Note

Living Room Loss listed 1
CA09779

ESPORTS 1- Mattress Protector W/

**LOSS SG12 Loss listed 1
Previous Broken Zipper
LISTED**

ESPORTS
**LOSS SG12 1- Brown Travel Pillow Loss listed 1
LISTED**

Total: $0.00

Powered by Encircle Insured Initials ________ Page 14 of 14