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 BRAND DISPOSITION CONDITION QTY MODEL # SERIAL # RETAILER NOTES
PHOTO DESCRIPTION PHOTO PHOTO SOURCE EACH TOTAL Y M EACH TOTAL CATEGORY % AMOUNT EACH TOTAL

Unit 5 TT1 Assorted Utensils Cleaned 1 0 0

Baking sheets, dishes,

Unit 5 TT2 pot, grater,bowls Cleaned 1 0 0

Pot, Frying Pans, baking

Unit 5 TT3 form, lids Cleaned 1 0 0

Plastic Containers, Lids ,

Unit 5 TT4 Plates, Plastic Bowls Cleaned 1 0 0

Personal Documents,
Puzzle , Driver’s
Unit 5 TT6 Handbook, Fast Wireless Cleaned 1 0 0
Charger

Children's crafts, primary

Unit 5 TT6 Cleaned 1 0 0
documents

Personal Paperwork And

Files, Watches, Passport,
Unit 5 SM1 Boxed Pen, Glasses, Cleaned 1 0 0
Check books

Tools, Electronics,
Assorted Cords,
Unit 5 SM2 Remotes, Books, Plastic Cleaned 1 0 0
Baskets

Crafts, Card Games,

Assorted Personal Items,
Unit 5 SM3 Candles, Pen And Cleaned 1 0 0
Pencils, Money

Unit 5 TT7 Assorted Art Supplies Cleaned 1 0 0

Unit 5 TT7 Art Supplies, Scissors Cleaned 1 0 0

Craft Kit, Board Games,

Unit 5 SM4 Basket Balls, Soccer Ball Cleaned 1

Unit 5 Side Tables Cleaned 2

Digital Photo Frame,

Noma Led, Scales,
Unit 5 TT8 Assorted Cords, Cleaned 1 0 0
Electronics, Watches ,
Keys, Jewelries

Unit 5 Side Table Cleaned 1

Unit 5 Drying Rack Cleaned 1

Unit 5 Children’s Craft Cleaned 1 0 0

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 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 BRAND DISPOSITION CONDITION QTY MODEL # SERIAL # RETAILER NOTES
PHOTO DESCRIPTION PHOTO PHOTO SOURCE EACH TOTAL Y M EACH TOTAL CATEGORY % AMOUNT EACH TOTAL

Unit 5 Sleigh For Kids Cleaned 1

Full Size Wooden Bed

Unit 5 Frame Cleaned 1

Unit 5 TV Stand Cleaned 1 0 0

Unit 5 Tires Cleaned 4

ESPORTA SG1 3- Comforters/double Cleaned 3

ESPORTA SG1 1- Purse,1- King Sheet Cleaned 2

1- Jacket,1- Quilted
ESPORTA SG2 Vest,1- Rug Cleaned 3

2- Coats W/ Hoods,5-
ESPORTA SG2 Sweatshirts Cleaned 7

ESPORTA SG2 4- Dresses Cleaned 4

ESPORTA SG2 4- Negligee,2- Pj Pcs Cleaned 5

ESPORTA SG2 7- Blouses,8- Pants Cleaned 15

ESPORTA SG2 3- Sweatpants,4- Pants Cleaned 7

3- Thick Fleece Blankets/

ESPORTA SG3 King Cleaned 3

ESPORTA SG3 1- Umbrella Cleaned 1

3- Jackets,1- Down Cost

ESPORTA SG4 W/ Hood Cleaned 3

2- Down
ESPORTA SG4 Coats,1-w/hood,2- Black Cleaned 5
Down Coats W/ Hoods 1-
Fur Trim

4- Sheets/king,4- Pillow
ESPORTA SG5 Case Cleaned 8

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 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 BRAND DISPOSITION CONDITION QTY MODEL # SERIAL # RETAILER NOTES
PHOTO DESCRIPTION PHOTO PHOTO SOURCE EACH TOTAL Y M EACH TOTAL CATEGORY % AMOUNT EACH TOTAL

ESPORTA SG5 3- Tavel Pillows Cleaned 3

ESPORTA SG5 5-Sweatshirts, 2- Dresses Cleaned 7

ESPORTA SG5 3- Pants,2- Sweatpants Cleaned 5

ESPORTA SG5 4- Sweaters, 13- T- Shirts Cleaned 17

ESPORTA SG6 6- Bags Cleaned 6

2- Neck Warmers,4-
ESPORTA SG6 Hats,1- Hood,4- Cleaned 14
Belelaclavas,3- Earmuffs,

3- Toques,6- Pr Gloves,2-
ESPORTA SG6 Caps Cleaned 11

2- Leather Jackets,2-
ESPORTA SG6 Jackets Cleaned 4

ESPORTA SG6 2- Coats W/ Hoods Cleaned 4

1- Polo Shirt,2- Dress

ESPORTA SG6 Shirts Cleaned 3

2- Towels,3- Hand
ESPORTA SG6 Towels,3- Face Cloth,1- Cleaned 11
Rug,1- Apron,1- Tie

ESPORTA SG7 14- Dresses Cleaned 14

ESPORTA SG7 19- Long Scarves Cleaned 19

ESPORTA SG7 2- Tank Tops Cleaned 2

12- Pr Underwear, 28- Pr

ESPORTA SG8 Socks, 8- Bras Cleaned 48

ESPORTA SG8 4- Single Socks,3- Single Cleaned 7

Gloves

1- Pr Mitts,1- Small Cloth

Purse,2- Battery
ESPORTA SG8 Operated Winter Cleaned 7
Gloves,3- Pr Winter
Gloves/ 1- Leather

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 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 BRAND DISPOSITION CONDITION QTY MODEL # SERIAL # RETAILER NOTES
PHOTO DESCRIPTION PHOTO PHOTO SOURCE EACH TOTAL Y M EACH TOTAL CATEGORY % AMOUNT EACH TOTAL

ESPORTA SG9 2- Pr Winter Boots Cleaned 2

ESPORTA SG9 2- Pr Leather Boots Cleaned 2

3-Pr Sandals,1- Pr Flip

ESPORTA SG9 flops Cleaned 4

ESPORTA SG9 5- Pr Shoes,1 Sandals Cleaned 6

ESPORTA SG9 7- Pr Runners Cleaned 7

4- Pr Shoes/1-pr Steel
ESPORTA SG9 Cleaned 4
Toe

ESPORTA SG10 2- Luggage Cleaned 2 0 0

3- Laptop Bags ( Inside

ESPORTA SG10 Luggage ) Cleaned 3

2- Large Insulated Skip

ESPORTA SG11 The Dishes Coolers Cleaned 2

Bedroom 1 Wood Chair Cleaned 1

Bedroom 1 Black Ikea Table Cleaned 1

Bedroom 1 Office Chair Cleaned 1

Kitchen AH1 Coffee Cups And Glasses Cleaned 1

Assorted Dishes And

Kitchen AH2 Cutlery Cleaned 1

Kitchen AH2 Apple Slicer Cleaned 1

Kitchen AH1 Glasses Cleaned 1

Kitchen AH2 Glass Bowl & Containers Cleaned 1

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 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 BRAND DISPOSITION CONDITION QTY MODEL # SERIAL # RETAILER NOTES
PHOTO DESCRIPTION PHOTO PHOTO SOURCE EACH TOTAL Y M EACH TOTAL CATEGORY % AMOUNT EACH TOTAL

Kitchen Chair Cleaned 1

Assorted Water Bottles

Kitchen AH5 And Thermos Cleaned 1

Kitchen AH5 Blender Cups Cleaned 1

Kitchen AH5 Lids Cleaned 1

Kitchen AH5 Handy Chopper Cleaned 1

Living Room AH3 Table Lamp Cleaned 1

Living Room AH4 Table Lamp Cleaned 1

Living Room Coffee Table Cleaned 1

Total: $0.00

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