39
Insured or Claimant Name Pol: # street address Date of Loss: town, MA zip Type of Loss: CONTENTS LIST Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C 1 1 toaster oven black and decker store 5yr 109 2 1 stereo sanyo gift 6yr 125 3 1 antique bureau gift/fam 100+ 600 4 2 antique wooden chairs fam/store 100+ 750 5 1 clothes drying rack Ames 12yr 20 6 1 stroller evenflo gift 6yr 170 7 1 lamp shade store 15yr 27 8 2 bed sheets store 6mon 60 9 1 curtain wilson's 5yr 65 10 1 woven basket store 4yr 35 11 1 saw Millers falls tools Father's 50yr 65 12 1 plant water bucket Auburchons 5yr 10 13 1 dust pan w/brush Auburchons 2yr 5 14 1 lrg grill lighter Auburchons new 7 15 1 lrg woven basket gift 4yr 65 16 1 laundry basket store 2yr 10 17 10 towels store 1-2yr 110 18 1 bra store 1yr 40 19 2 panties store 1yr 30 20 4 sweatshirts A&E 1-2yr 140 21 1 hat store 1yr 15 22 1 pillowcase store 1yr 10 23 3 pairs of sweatpants store 1-2yr 60 24 1 dress Target new 25 25 1 child's shirt Target new 10 26 2 pairs of socks Target new 12 27 25 pairs of socks various 1-2yr 100 28 1 bed sheet store 1yr 30 29 8 various female shirts store 1-2yr 240 30 2 pairs of pajama bottoms store 1-2yr 30 31 4 nightgowns various 1-2yr 120 32 2 dish cloths store 1yr 7 33 1 winter sweat band gift 2yr 30 Date Office# 1-413-253-3664 FAX # 1-413-256-8910 Brian D. Birmingham, Public Adjuster P.O. Box 2192 145 University Drive Amherst, MA 01004-2192 The above information is true to the best of my knowledge. _____________________________________________ Signed / Dated Page 1 of 39

Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

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Page 1: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Insured or ClaimantName Pol: # street address Date of Loss:town, MA zip Type of Loss:

CONTENTS LIST

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

1 1 toaster oven black and decker store 5yr 109

2 1 stereo sanyo gift 6yr 125

3 1 antique bureau gift/fam 100+ 600

4 2 antique wooden chairs fam/store 100+ 750

5 1 clothes drying rack Ames 12yr 20

6 1 stroller evenflo gift 6yr 170

7 1 lamp shade store 15yr 27

8 2 bed sheets store 6mon 60

9 1 curtain wilson's 5yr 65

10 1 woven basket store 4yr 35

11 1 saw Millers falls tools Father's 50yr 65

12 1 plant water bucket Auburchons 5yr 10

13 1 dust pan w/brush Auburchons 2yr 5

14 1 lrg grill lighter Auburchons new 7

15 1 lrg woven basket gift 4yr 65

16 1 laundry basket store 2yr 10

17 10 towels store 1-2yr 110

18 1 bra store 1yr 40

19 2 panties store 1yr 30

20 4 sweatshirts A&E 1-2yr 140

21 1 hat store 1yr 15

22 1 pillowcase store 1yr 10

23 3 pairs of sweatpants store 1-2yr 60

24 1 dress Target new 25

25 1 child's shirt Target new 10

26 2 pairs of socks Target new 12

27 25 pairs of socks various 1-2yr 100

28 1 bed sheet store 1yr 30

29 8 various female shirts store 1-2yr 240

30 2 pairs of pajama bottoms store 1-2yr 30

31 4 nightgowns various 1-2yr 120

32 2 dish cloths store 1yr 7

33 1 winter sweat band gift 2yr 30

Date

Office# 1-413-253-3664 FAX # 1-413-256-8910

Brian D. Birmingham, Public AdjusterP.O. Box 2192

145 University DriveAmherst, MA 01004-2192

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 1 of 39

Page 2: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

34 3 pillowcase store 1yr 30

35 2 porcelain head collectable dolls gift 100+ 370

36 3 child's toys store 1-2yr 50

37 1 box cutter Auburchons 2yr 5

38 1 turkey baster store 3yr 10

39 1 mouse trap Auburchons 1yr 5

40 1 wire plant stand Judy's antiques 100yr 35

41 2 tins gift 10yr 40

42 1 magnifying glass staples 30yr 20

43 1 metal wall shelf gift 25yr 100

44 1 tube of armor all kmart new 7

45 2 jugs gift 50yr 150

46 1 bottle gift 75yr 60

47 16 cabinet knobs part of bureau 100yr 48

48 1 air purifier norelco store 50yr 110

49 1 metal sink w/ cabinet gift 50yr 1,100

50 1 whirlpool washin machine LSQ9030PQ1 Manny's new 450

51 1 metal cabinet w/house 50yr 500

52 1 Painting (Tom Sawyer) w/frame gift 45yr 165

53 1 Whirlpool Dryer Manny's new 350

54 1 wooden cabinet part of kitchen w/house 40yr 350

55 2 tubs of laundry detergent store new 20

56 1 Original Nintendo store 17yr 50

57 2 nintendo games store 17yr 40

58 2 controllers store 17yr 40

59 4 collectible coke bottles gift 50+yr 12

60 1 teddy bear gift 1yr 15

61 1 lunch bag store 2yr 12

62 1 pair of gloves 'the claw' store 5yr 40

63 2 hand exercisers store 7yr 30

64 2 pairs of isatoner gloves store 1-2yr 30

65 1 wooden toy potty chairs gift 60yr 75

66 6 L shaped hangers wood new 9

67 2 boxes of flower seeds Walmart new 24

68 1 turf builder store new 20

69 1 doll store 1-2yr 30

70 9 Eyeshadow (make-up) gift new 72

71 2 rolls of tape staples new 6

72 1 gal. of antifreeze staples new 6

73 1 empty photo album staples new 10

74 5 pairs of skis rossignal cleaned and serviced 600

75 3 pairs of ski boots ski team replace 4yr 625

76 4 pairs of ski poles cleaned and serviced 200

77 1 refrigerator Kenmore 1068656310 grandmother's 13yr 650

78 21 various curtians various 2-6yr 1,625

79 2 decorative plates gift 10yr 80

80 1 plate gift 12yr 30

81 2 martini glasses gift 2yr 20

82 1 flower mister store 4yr 10

83 3 mugs store 10yr 15

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 2 of 39

Page 3: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

84 4 bowls gift 1-5yr 300

85 4 jars candy jars Walmart 5yr 16

86 1 jar candle yankee candle new 22

87 1 butter dish white & blue store 1-5yr 8

88 5 beer glasses gift old 25

89 1 pepper shaker store 5yr 10

90 2 glass jars store 5yr 10

91 7 various glasses gift 1-10yr 14

92 3 sm decorative plates willow-glen gift 15-20yr 30

93 1 shot glasses gift 20yr 12

94 3 sm wine glasses aunt's 75yr 60

95 1 decorative pepper shaker local craft 10yr 12

96 1 lrg down comforter home shopping 2days old new 225

97 64 country living magazines 234

98 3 country home magazines 20

99 1 full plate set w/serving serves 8 gift 75yrs 1,200

100 dishes and coffee cups (teal) included in above

101 2 grey goose martini glasses gift 6months 20

102 2 candle stick holders crystal aunt's/fam 75yr 30

103 1 sm coffee mug set grandmother's 100yr 80

104 2 lrg dec. wine glasses Thorns 2yr 60

105 8 cabinet knobs cabinet 20yr 56

106 4 wine glasses store 10yr 48

107 1 pair of earrings gift 10yr 45

108 1 light up ceramic x-mas tree family 60yr 100

109 1 jar family 75yr 25

110 1 metal star form mall hollow 40yr 90

111 1 checker board deerfied antiques 100yr 300

112 1 china serving dish gift 50yr 120

113 1 porcelain salt & pepper shakers aunt's/fam 100yr 75

114 1 salad dressing jar 2yr 3

115 2 brandy glasses family 10yr 20

116 5 iced tea glasses grandmother 100yr 120

117 2 onion soup bowls grandmother 100yr 25

118 3 mugs gift 25yr 60

119 2 dessert dishes part of Tea set stated above

120 3 saucers part of Tea set stated above

121 1 coffee cup aunt 20yr 10

122 3 glasses store 10yr 12

123 2 saki glasses grandmother 75yr 70

124 1 creamer aunt 75yr 45

125 2 bowls grandmother 100yr 60

126 1 candle jar aunt 75yr 65

127 1 Flour jar set grandmother 100yr 115

128 6 wine glasses store 10yr 90

129 4 candle holders family 75yr 25

130 1 ceramic jar aunt 75yr 125

131 1 8 shot shooter store 3-5yrs 5

132 1 champange flute aunt 25yr 80

133 5 glasses crystal grandmother 20yr 100

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 3 of 39

Page 4: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

134 4 beer glasses gift 15yr 20

135 1 wooden shoe insert gift 100yr 35

136 5 bowls part of set

137 2 plates part of set

138 3 glass baking dishes aunt 75-100yr 100

139 1 ceramic jar gift 30yr 60

140 1 mini teapot gift 75yr 105

141 2 ceramic light fixtures elec grandmother 75yr 150

142 2 bowls grandmother 30yr 80

143 1 metal bowl store 1-5yr 5

144 1 photo w/frame store 20yr 30

145 3 serving plates store 15yr 75

146 1 mini lamp aunt antique 30

147 1 blueberry pie dish w/ cover gift 20yr 45

148 1 stainless steel strainer Thorns 50yr 35

149 1 cow bell from farm family 75yr 85

150 3 sm jars store 100 15

151 2 dec wooden houses gift 10 20

152 1 Antique Salve container gift 50+ 10

153 3 salt & pepper shakers store 100+ 25

154 5 bowls store 40 100

155 2 ash trays store 5-10yr 10

156 6 plates store 20yr 48

157 2 creamers store 20yr 24

158 1 gravy dish store 20yr 10

159 1 napkin holder store 5yr 3

160 3 candy dishes store 10yr 21

161 1 margherita glass store 5yr 8

162 1 lrg creamer store 20yr 15

163 11 lrg plates store 20yr 110

164 7 small plates store 20yr 42

165 1 dec salt shaker w/hat plate store 20yr 22

166 1 dec rooster store 5-10yr 13

167 1 coffee cup store 10yr 5

168 1 sugar bowl store 5-10yr 6

169 1 antique square table gift 100+ 600

170 1 antique 4 drawer dresser family 200+ 950

171 4 painting w/frames 4seasons Andy Pine gift at 75 ea 300

172 30 various necklaces various 1-15 600

173 5 watches various 5-15 200

174 1 key store 2-5yr 5

175 14 bracelets various 1-15yr 140

176 25 pairs of earrings various 1-20 500

177 7 rings various 5-15 210

178 1 back massager health store 2 45

179 3 cd's store 1-10yr 60

180 7 old dec. tins store 50-75yrs 84

181 1 baseball store 1yr 10

182 1 wax potporri tart yankee candle store 5yr 20

183 1 wax potporri tart stand yankee candle store 5yr 25

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 4 of 39

Page 5: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

184 1 plastic shovel store 2 2

185 1 playstaiton remote circuit city 5-10yr 40

186 1 ceramic pourer grandmother store 100 105

187 2 bottles of cleaner store 1 16

188 1 bottle of taning oil store 1 7

189 1 qrt. Of motor oil store 1 4

190 1 Greist new 50+ 20

191 1 glass square terrariam store 5 65

192 2 serving dishes store 20 28

193 24 kitchen utensils store 5-30 225

194 42 pcs. Cutlery (forks/knives/spoons store 5-30 220

195 1 antique spice rack family 100+ 250

196 1 antique bowl family 100+ 150

197 1 antique tool box family 100yrs 150

198 1 antique coner cabinet handmade dad's 50yr 400

199 1 serving dishes store 20 50

200 1 antique tall thin book shelf family 100+yrs 200

201 1 green dinner set w/ cups store 50 225

202 2 candy dishes store 5-10 12

203 1 wall hanging spice display by Casey handmade 14yr 100

204 1 trash basket store 2-5 5

205 1 serving dish store 10 9

206 1 wooden bowl shakerbox store 15-20 100

207 1 tape player for handicapped U.S. Government catolouge 30+ 100

208 1 painting w/frame lithograph gift 65yr 225

209 1 dutch oven store 10+ 57

210 1 10" saute pan store 5-10 25

211 1 casserole dish store 1-5yr 23

212 1 3qrt sauce pan store 2-5 18

213 850 photos store 1-40+ 850

214 350 papers store 2-5 200

215 7 greeting cards store 1 28

216 1 home air compressor black & decker store 25yr 50

217 2 rakes store 3-5 75

218 1 snow shovel store 1-3 35

219 1 pitch fork store 1-10 40

220 1 milk carton store 1 3

221 1 leather hand bag prada store 1-5 400

222 1 rug store 5-10 65

223 3 plastic industrial trash barrels store clean 1-3 15

224 2 extention cords store clean 1-5 10

225 1 antique beverage frementor apple press gift 200yr Steve W.

226 1 antique clock seai-chi gift 100yr Steve W.

227 1 antique clock eagle frog&eagle aunt lou 100+ 1,500

228 1 antique hand basket aunt lou 100 150

229 1 antique mini chest farm 75 300

230 1 antique short black chair grandmother 75 370

231 1 antique coner cabinet farm 100 400

232 1 antique mirror grandmother 100 275

233 1 antique long box farm 100+ 700

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 5 of 39

Page 6: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

234 1 antique hand basket grandmother 200 200

235 1 antique tapered box kelly bros-ashfield grandmother 150+ 600

236 1 pair of gloves store 1-5 10

237 2 sm paintings W/frame deerfield store 25 300

238 2 photos w/ frame store 100+ Steve W.

239 1 7 photo frame store 1-10 45

240 1 vacuum cleaner Eureka super broom store 3-5 65

241 1 vacuum cleaner Hoover deluxe store 3-5 160

242 3 floor maps store 10+ 25

243 19 photos w/ frame store 1-20 480

244 1 3pc. Ashtray set (China) store 50+ 600

245 1 china oil lantern store 50+ included

246 4 china creamers store 50+ included

247 2 china sugar bowls store 50+ included

248 2 china cups store 50+ included

249 2 china mini serving dishes store 50+ included

250 2 china bowls store 50+ included

251 1 hose store 1-5 25

252 1 3 drawer chest antique store 100+ 350

253 2 outdoor lantern light fixtures store 1-5 210

254 2 flash lights store 1-5 24

255 2 brooms store 1 20

256 100 antique bricks gift 100+ 250

257 1 miracle grow sprayer store 50+ 3

258 1 dec metal bowl store 50 13

259 2 figurines store 5-10 20

260 15 metal tins store 1-15 225

261 1 sm dec. antique mirror gift 100 35

262 1 cookie jar store 15

263 3 antique tins store 45

264 4 antique glass jars store 100+ 1,200

265 1 sugar dish store 11

266 1 creamer set family 100+ 125

267 1 mini doll house sugar bowl store 35

268 3 sm heart decorations store 15

269 1 plate stand store 8

270 2 antique lamps farm 100+ 275

271 1 trash can store 16

272 1 tea pot store 12

273 1 creamer store 10

274 6 metal wall candle holders iron + brass store 300

275 6 metal shelf brakets store 240

276 1 glass photo frame store 20

277 3 jars store 100

278 1 teapot store 115

279 3 marble candle sticks store 100 6

280 3 ceramic pots w/lids aunt lou 100 450

281 1 ceramic pot aunt lou 100 150

282 1 ceramic bowl aunt lou 100 600

283 3 ceramic bowls aunt lou 100 500

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 6 of 39

Page 7: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

284 1 ceramic tea pitcher aunt lou 100 29

285 1 metal pot w/cover store 22

286 1 jar store 9

287 1 martini glass store 8

288 3 glass mugs store 21

289 4 decorative mugs store 60

290 2 cookie jars store 120

291 7 mini wine glasses store 84

292 6 flute glasses store 150

293 5 various glasses store 75

294 2 antique paintings dotty halls 100-200 650

295 1 antique tin pri mos mother 100 65

296 1 antique lamp oil gift 100+ Steve W.

297 4 decorative plates store 100

298 1 plate stand store 9

299 1 mini tea set store 75

300 2 vases store 24

301 6 porcelain jugs store 90

302 2 lrg. Marbles store 10

303 10 glass jars store 30

304 1 ash tray store 5

305 4 ceramic jars store 36

306 8 antique figurines 1960 Holt. Howard grandmother 46 160

307 2 tall thin vases store 14

308 3 sm dec dishes store 32

309 1 antique lamp oil/electric store 75+ 300

310 1 antique bowl gift 100+ 145

311 3 antique pots farm 100+ 90

312 5 antique jars farm 100+ 200

313 11 antique jugs farm 100+ 550

314 2 antique pitchers farm 100+ 100

315 1 wooden tool storage cabinet northampton antique 100+ 850

316 3 vacuum hoses various used 300

317 1 sprinkler store clean new 5

318 1 garden hose store clean new 5

319 1 garden hose reel store clean new 11

320 1 rake store 1-3 15

321 2 shovels store 5-10 30

322 1 plunger store 5 11

323 1 plant waterer store 1-3 12

324 1 paint roller store 1-3 3

325 1 wheeled barrel store 1-3 70

326 16 linear feet 1X8 wood store

327 1 weed wacker store 1-10 135

328 1 weed eater store 1-10 25

329 2 pedistal planters store 1-10 50

330 9 large planters store 1-10 63

331 34 planters store 1-10 170

332 24 biodegradable planters store 1-10 96

333 6 clay planters store 1-10 132

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 7 of 39

Page 8: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

334 2 wall hanging basket planters store 1-10 30

335 1 plant waterer store 1-5 10

336 6 sets of fake flowers store 30

337 1 fake flower stand store 20

338 4 gas cans store 1-5 20

339 2 childrens chairs store 60

340 1 crib mattress store 180

341 6 curtian rods store 60

342 1 milk carton store 5

343 5 plant hangers store 10

344 2 outdoor light fixtures store 150

345 1 table pedistal w/ house 100 125

346 5 jane magazines store 25

347 5 woman's day magazines store 25

348 12 national geographic magazines store 96

349 21 rolls of wall paper store new 525

350 1 decorative wooden birdcage store 10

351 1 decorative child's cabinet store 10-20 60

352 1 picnic table store 350

353 1 oval mirror 4.5'x2' store 300

354 1 outdoor floor stool store 30

355 1 Bike 21 speed mongoose casey's clean/repair 1-5 450

356 1 antique rocking chair store 50 300

357 1 antique hand held tool basket store 150

358 4 folding metal chairs store 5-10 40

359 2 wire baskets egg basket store 50+ 20

360 4 door curtain rods store 40

361 1 set of dried flowers store 15

362 1 car battery store used 60

363 1 cabinet 2 door store 200

364 1 sm end table wood store 200

365 1 antiquue magazine rack store 60

366 1 antique 3 tier wall shelf store 120

367 1 lrg clothes drying rack ames 12yr 20

368 1 antique padded chair store 400

369 1 antique 2 tier end table family 100+ Steve W.

370 2 antique ladder back chairs family 100+ Steve W.

371 1 antique ladder back chair family 100+ Steve W.

372 1 child's playhouse today's kids store 1-3 450

373 1 plastic table little tykes store 1-3 50

374 1 halloween cape store 1-5 5

375 11 furnace filters store new 25

376 2 folding chairs store used 20

377 1 broom store used 10

378 1 mop store used 10

379 1 folding table (6ft) store 30

380 37 stuffed toys store 111

381 2 lrg. Stuffed animals store 16

382 2 curtians store 10

383 1 cooler store 25

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 8 of 39

Page 9: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

384 4 insert panels store 8

385 12 filters store new 30

386 1 skiing jacket store 1-5 230

387 1 snow pants store 1-5 150

388 1 lunch bag store 5

389 1 sand box store 120

390 1 children's table store 20

391 1 lunch bag store 5

392 1 pair of leather gloves store 20

393 1 pot store 10

394 1 antique ladder back chair family 100 Steve W.

395 1 antique vanity chest family 100+ 200

396 1 green metal plant stand store 60

397 37 hangers store 37

398 1 freezer Sears 106.262180 Sears 15 515

399 1 doll house little tykes store 140

400 4 beach chairs store 60

401 1 child's beach chair store 15

402 2 folding chairs store 20

403 1 lamp shade store 7

404 1 lrg cooler store 25

405 1 winter jacket columbia store 150

406 1 set of car floor mats store 25

407 56 children's shirts various store 4-10 1,120

408 38 children's pants various store 4-10 1,140

409 9 girls skirts store 270

410 3 children's hats store 24

411 5 childrens coats store 500

412 6 children's sweaters store 300

413 1 bed sheet store 30

414 1 fireplace tool stand store 40

415 1 painting w/frame store 80

416 2 square buckets store 16

417 5 pairs of women's shoes store 1-10 300

418 2 pairs of children's boots store 4-10 100

419 1 carry cooler store 4-10 10

420 1 pair of children's shoes store 4-10 40

421 1 leather dress store 1-5 200

422 1 pair of slippers store 3 20

423 7 pairs of children's pants store 4-10 210

424 7 children's shirts store 4-10 140

425 4 girl's tanktops store 4-10 40

426 1 pair of girls sandles store 4-10 30

427 1 small planter store 5

428 1 pair of children's boots store 4-10 50

429 1 pair of cowboy boots gift 1-5 150

430 1 queen size bed frame aunt 75+ 500

431 2 folding chairs store 20

432 1 6 way wall plug adapter store 5

433 2 dust masks store 2

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 9 of 39

Page 10: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

434 4 pairs of shoe laces store 2

435 1 hose snap adapter store 2

436 1 mini paint roller store 3

437 1 light bulb store 1

438 1 3 prong outlet adapter store 2

439 1 grinding wheel store 29

440 1 roll of thread wire store 5

441 1 baby spoon gift 4-10 15

442 2 spoons store 2

443 1 glass cutter store 15

444 1 ruler store 2

445 1 unasselembled coat rack store 45

446 1 vacuum cleaner Euro pro hepa shark store new 109

447 1 hand tool cart store 50

448 1 paint pan store 3

449 1 screwdriver store 10

450 2 brushes store 6

451 1 paint can opener store 2

452 1 dish bucket store 2

453 1 ruler store 2

454 1 bag of sos pads store 3

455 1 wire brush store 6

456 1 weed wacker replacement spool store new 23

457 1 showerhead store 35

458 1 jigsaw blade set store 20

459 1 box of lawn seed store 20

460 2 glass bottles store 30

461 1 glass jug store 20

462 1 tire cleaner store new 6

463 1 floor wash store new 4

464 1 raid store new 4

465 2 containers of lighter fluid store new 6

466 1 guitar letter holder store 40

467 1 power drill black & decker store 60

468 1 tub of polishing compound store used 8

469 4 rolls of masking tape store new 4

470 2 electric hand sanders Skill/craftsman store 240

471 1 manual hand sander store 10

472 1 lamp store 8

473 1 bag of curtian hooks store 4

474 1 box of ound head plugs store 15

475 1 box of tacs store 4

476 3 bags of wall anchors store 3

477 3 glass door handles store 45

478 1 cement trowel store 30

479 1 wall sander store 10

480 1 15 fl chain store 1-5 25

481 1 leather camera case store 50

482 2 bags of steel wool store 4

483 1 wire brush store 2

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 10 of 39

Page 11: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

484 1 bathroom toothbrush holder store 4

485 1 bathroom soap holder store 4

486 2 mini blinds store 24

487 1 2ft florescent lights store 15

488 1 tackle box store 30

489 1 sm wooden box store 10

490 1 ice scraper store 3

491 1 power supply (6plug) store 5

492 1 glass vase store 10

493 1 plastic takle box store 25

494 1 metal teapot planter store 15

495 2 pillows store 30

496 1 baby changing station gift 120

497 1 hankerchief store 6

498 1 sundress store 30

499 1 pilliow store 15

500 3 hand towels store 9

501 1 baby bib gift 4

502 1 thong underwear Victoria's Secert store 10

503 2 soft cover book aunt 24

504 1 pair of flip flops store 20

505 1 wicker basket store 8

506 15 bottles of hair care products store new 225

507 1 antique table family 240

508 1 set of dec fruit store 30

509 1 lrg tarp store 45

510 1 lrg net store 30

511 1 tool box store 25

512 2 light fixtures store 30

513 5 sets of transparent curtains store 100

514 1 window fan store 40

515 8 antique vent covers store 100+ 480

516 27 chair spindles store 162

517 1 sled store 10

518 1 american flag store 1-5 10

519 1 vacuum head w/ hose (part of item # 446) included

520 2 extention cords store 1-3 8

521 1 wicker ring chair store 30

522 2 pairs of girls shoes store 4-10 40

523 1 smoke detectors store 8

524 1 candlestick light adapters store 4

525 1 wood glue store new 12

526 1 night light store 1-5 5

527 3 rolls of electical tape store new 6

528 1 paint edger store 7

529 3 light socket plug adapters store 9

530 1 paint tray store 5

531 1 cast iron sink store 15-30 750

532 1 plunger store 5

533 4 4" flourescent lights store 60

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 11 of 39

Page 12: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

534 1 flourescent light fixture store 30

535 1 flute w/case store 200

536 2 family drawn pictures store 40

537 1 antique ironing board store 40

538 2 antique light fixtures store 120

539 1 instate magazine store 7

540 1 rollerblades store 4-10 45

541 1 antique hatbox store 100+ 60

542 25 drawer handles store 125

543 1 antique oil lantern P&A royal store 50+ 60

544 3 glass liquor bottles store 60

545 2 licence plates store 50

546 1 baby metal dish store 5

547 1 extention cords store 1-3 10

548 1 light fixture store 15

549 1 Jigsaw black & decker store 3-5 150

550 1 sanding block store 8

551 1 smoke detectors store 10

552 1 photo frame store 10

553 1 paint roller store 3

554 1 fondue set gift 1-10 25

555 1 bell store 10

556 1 antique fondue set family 50+ 50

557 1 tube of caulk store new 6

558 1 6 piece wine glass set gift 5-10 30

559 5 glasses store 10

560 7 tea cups store 35

561 2 salt & pepper shakers store 12

562 3 white glass coffe cups store 15

563 1 antique electric drill dynomyte model A family 75 300

564 1 antique tea pot store 160

565 1 antique lamp store 120

566 1 antique x-mas tree stand family 260

567 1 child's block set family 30-50 25

568 1 antique semi circle table family 200

569 1 antique dec cabinet door family 160

570 5 wicker baskets store 50

571 2 fake flowers store 10

572 4 curtain rods store 40

573 3 rolls of sheet rock tape store new 21

574 1 candlestick holder store 5

575 1 12ft of copper tube insulation store new 25

576 2 coffee cups store 10

577 1 caller id store 3-5 30

578 1 rocking horse x-mas light store 20

579 1 print w/frame store 10

580 1 soft cover book store 12

581 1 wall sander store 20

582 1 baby scale store 5-10 60

583 2 glass goblets store 90

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 12 of 39

Page 13: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

584 2 ceramic candlestick holders store 15

585 1 miracle grow store used 10

586 16 glass bottles store 500

587 1 paint stripper store 10

588 1 tung oil ??? store used

589 1 bag of steel wool store 5

590 1 candle holder store 2

591 1 wall paper primer store 4

592 1 bondo store new 4

593 1 wooden sword store 6

594 1 ceramic pot store 15

595 1 flashlight store 1-3 10

596 1 insceticide store 5

597 1 telephone store 1-3 45

598 1 lighter fluid store new 5

599 2 bags of charcoal store new 22

600 1 car jack store 1-5 45

601 1 dishpan store 10

602 1 tube of caulking store used 6

603 2 screwdrivers store 20

604 2 wrenches store 30

605 1 beltsander craftsman store 120

606 1 lightcover store 40

607 1 knee pads store 4-10 20

608 1 electric drill master mechanic store 1-5 160

609 1 collenetics store

610 1 dictionary webster's unabridged store 35

611 6 stuffed animals store 1-10 30

612 20 jewelry boxes store 1-30yrs 400

613 1 pair of sneakers Nike store 4-10 120

614 1 Air conditioner Sears mod.106.87206090 store 3-5 270

615 1 wind chime store 15

616 2 tubes of caulking store new 12

617 3 gallons of paint store new 60

618 2 cans of paint store new 30

619 1 can of raid store new 8

620 1 gallon of anti freeze store new 12

621 1 gallon of paint thinner store new 20

622 2 metal lawn ornaments store new 16

623 5 cans of paint store new 75

624 2 cans of stain store new 30

625 1 gallon of paint store new 20

626 9 cans of linseed oil store new

627 1 pillar candle holder store 5

628 2 rolls of tape store new 4

629 9 plates store 18

630 1 Child's toy Hurcules store 2-5 10

631 8 drawer handles store 45

632 1 funnel store used 2

633 1 plastic serving dish store 2

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 13 of 39

Page 14: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

634 1 level store 5

635 1 takle box store 20

636 2 boxes of nails store 6

637 1 gallon of joint compound store used 35

638 1 set of black dishes store 60

639 1 drawer organizer store 5

640 65 forks/knives/spoons store 5-30 65

641 1 can of wood primer store new 8

642 2 scrub pads store 1

643 1 hand mixer store 5-10 10

644 1 stained glass window decoration store 10

645 5 cans of paint store new 75

646 6 wall plugs & covers store 30

647 1 burner bowl store 15

648 3 paint rollers store new 6

649 2 adult's hats store 1-5 30

650 9 spatulas store 20

651 1 roll of painters tape store used 8

652 4 paint brushes store new 8

653 1 glass box w/ pedistal stand store 45

654 2 plant saucers store 4

655 1 pair of mittens store 1-5 15

656 1 bag of clothes pins store used 5

657 1 hammer store 1-5 20

658 1 hair dryer ion shine 1875 store 1-5 35

659 1 roll of duct tape store used 5

660 1 wall clock regulator store 2-5 50

661 1 pony head on a stick aunt 50+ 25

662 9 antique hardcover books various aunt 75-100 360

663 1 pair of sandles store 1yr 20

664 1 cordless phone store 1-5 60

665 1 candle holder store 5

666 2 calculators store 1-5 16

667 3 necklaces various store 1-5yr 30

668 10 stuffed toys store 1-10yr 120

669 1 belt chain store 25

670 1 jar candle yankee candle store used 10

671 1 lrg necklace bead kit store 2-5 25

672 1 2006 calander store new 10

673 1 santa claus decoration store 5

674 1 wooden egg store 4

675 1 lamp store 15

676 4 phone books phone company 1-4 40

677 4 interior design books various store 80

678 5 interior design magazines various store 50

679 7 interior design brochures various store 70

680 2 female wallets store 30

681 2 student organizers store 30

682 1 drawing by Payton store 60

683 1 pillow ball decoration store 15

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 14 of 39

Page 15: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

684 1 botannical air topper store 10

685 1 marble table top store 160

686 1 octagon end table store 60

687 1 square kitchen table family 400

688 1 animated mirror pictures store 60

689 75 music cd's various store 1-5 1,125

690 1 blue nantucket candleholders store 24

691 1 dec. x-mas candleholder store 10

692 1 bowls store 5

693 5 tea saucers store 15

694 3 dec pics store 24

695 1 antique lamp store 50+ 60

696 1 long stem rose vase store 10

697 2 pumpkins store 5-10 8

698 2 sets of watercooler store 30

699 3 candle sticks store new 6

700 1 1 step corn removers Dr Scholl's store used 16

701 1 sm photo album family 8

702 6 photos family

703 1 3-D camera Nishika N8000 store 300

704 1 bag of tea lights store 2

705 1 bartender's manual store 5-10 40

706 1 tin store 10

707 1 poem book store 15

708 1 set of stenciles store 6

709 1 rope plant hanger store 10

710 1 pumpkin candle w/ holder store 8

711 1 Radar Dectector Uniden 1RD6499SWS store 1-5 30

712 1 pack of floral picks store 5

713 1 index card box store 2

714 1 glue gun store 1-5 20

715 2 bags of glue sticks store new 20

716 1 sewing pin cushion store 4

717 1 bag of coin rolls store used 5

718 1 bag of incense store used 4

719 1 kitchen hutch store 10-20 250

720 1 shag-vac 6gal. Genie 1.1 hp store 1-5 40

721 2 metal pots store 40

722 1 metal tea kettle store 20

723 1 wooden dec rooster store 5

724 1 seasoning grinder store 5

725 2 wall decorations store 10

726 1 stove kenmore store 4-10 500

727 3 pairs of kids shoes store 4-10 60

728 5 cans of juciy juice store new 15

729 1 wooden pot/bucket store 10

730 1 calendar store used 10

731 2 jars of spagetti sauce Ragu store new 6

732 60 eye shadow/liner make-up store new 480

733 1 sm dec rocking chair store 25

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 15 of 39

Page 16: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

734 1 eye glass case store 10

735 1 x-mas ornament store 5

736 1 wire betty boop basket store 20

737 1 rectangular antique coffee table family 200

738 3 antique ladder back chair family 100+ Steve W

739 2 glass bowls store 10

740 1 kettle cooker store 3-5 75

741 1 lrg kettle cooker corningware SCO200 store 3-5 140

742 1 ice/wine bucket store 15

743 2 glass pie dishes store 14

744 1 pasta strainer store 5

745 2 wooden salad bowls store 10

746 1 plastic serving tray store 5

747 1 metal serving tray store 10

748 3 hot plate pads store 15

749 1 dish towels store 5

750 1 cake pan store 8

751 1 ceramic pie plate store 8

752 1 metal bowl store 5

753 1 metal pie plate store 5

754 1 book stand store 45

755 1 plastic bowl store 5

756 2 glass scrapers store used 8

757 1 paint tray store 5

758 3 paint brushes store used 6

759 1 putty spatulas store 3

760 1 paint roller store 5

761 3 dec doll hat boxes store 30

762 1 glass vase store 10

763 1 ceramic dish store 5

764 1 cast iron pot Wagner Ware Sydney store 5-10 25

765 1 paint thinner store 10

766 1 string of dec garlic cloves store 2 5

767 1 gal of paint store new 20

768 9 sm cans of stain store new 45

769 1 Showtime rotisserie set set it and forget it store 1-5 60

770 2 crock pots store 5-10 80

771 1 bag of plastic cups store new 3

772 20 various cookbooks various store 10-30 300

773 28 cooking magazines various store 140

774 7 books various store 1-10 70

775 5 tickets to basketball game Shelbourne police vs patriots new 45

776 3 pairs of gloves (2pr leather) store 1-3 60

777 1 brand new shirt New York company store 1-3 40

778 1 womens long pants New York company store 1-3 50

779 4 various candy bars store new 2

780 2 lunch boxes store 1-5 16

781 1 bag of chips store new 3

782 1 star wall candle holder store 4

783 1 children's activity pad 53845sh4 store 1-5 40

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 16 of 39

Page 17: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

784 2 tins store 30

785 1 leather personal organizer store 15

786 1 halloween wall hanging store 5

787 1 calendar store 2 10

788 58 various spices store new 106

789 72 cans of food store new 144

790 2 plastic spice racks store 1-5 40

791 102 boxes/bags of food store new 204

792 56 jars of food store new 102

793 80 healthcare products (creams,pills,ect) store used/new 800

794 1 antique hair dryer GE store 30-50 250

795 1 pr of hot plate gloves store 25

796 75 boxes of food store new 225

797 1 thermos store 15

798 1 qt of motor oil store new 5

799 3 bags of vegtables store new 15

800 4 bags of stuffing store new 16

801 1 bottle of bubbles store new 10

802 2 cans of spray lubricant Auto store new 16

803 1 can of pudding store new 2

804 1 bag of cotton balls store new 1

805 20 bottles of nail polish store used/new 100

806 1 alumminum turkey pan store 20

807 1 gal of paint store new 20

808 1 sm cooler store 3-5 10

809 1 gal of vinegar store used 6

810 1 bag of bird seed store new 10

811 1 glass vase store 5

812 40 various cookbooks store 1-50+ 100

813 3 tubes of caulking store new 9

814 5 flashlights store 1-5 50

815 1 blade sharpening stone store 6

816 1 tape measure store 7

817 11 screwdrivers store 55

818 5 spatulas store 10

819 1 window razor store 3

820 1 lint roller store 5

821 1 level store 5

822 2 tool belt holsters store 8

823 4 wrenches store 60

824 2 rulers store 4

825 1 mini photo frame store 4

826 2 gardening clippers store 2-5 30

827 1 35mm camera Kodak KB10 store 120

828 5 light bulbs store 3

829 1 plastic belt store 5

830 1 candlestick holder store 5

831 1 box of wall mounts store 3

832 1 plate hanger store 3

833 1 mouse trap store 15

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 17 of 39

Page 18: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

834 2 paintbrushes store used 6

835 1 hairbrush store 10

836 1 wire brush store 10

837 2 rolls of tape store new 6

838 1 extention cords store 1-5 10

839 1 jar of nails store 1-10 6

840 1 sm heart wreath dec store 12

841 1 licence plate store 25

842 1 pr of sunglasses store 30

843 1 elec hair trimmer w/bag store 1-5 40

844 1 shampoo kit store 1-5 25

845 1 flower notebook store 5

846 15 magazines various 10-Jan 55

847 1 road atlas store 12

848 1 agenda w/calculator store 2 15

849 3 cd's various store 1-5 45

850 1 air cast store 12

851 2 maps store 1-3 20

852 1 woman's purse bag store 30

853 1 dictionary store 45

854 1 hair dresser fanny pack store 45

855 1 Leather haircare kit store 120

856 1 Harmonica blue harp family 30+ 200

857 1 hair trimmer w/kit store 45

858 1 hair dresser's robe store 20

859 1 soft cover book store 10

860 1 coin purse store 6

861 1 Academic Achievement award From Clinton earned 200

862 1 thick ash tray store 8

863 1 adding machine family 25

864 1 box of invitations store 4

865 1 door stop store 2

866 1 Antique Scrabble family 30 60

867 1 clear plastic coin purse store 6

868 1 botannical jar topper store 10

869 2 licence plates store 1-5 50

870 10 various nail care products store used/new 50

871 1 bag of various clay store 60

872 1 roll of 35 mm film store used 8

873 1 wooden box store 10

874 1 box of old nails family 30+ 20

875 1 slate welcome sign store 40

876 15 hair cutting magazines various store 1-10 120

877 1 antique sewing machine kenmore store 50+ 600

878 74 metal eating utensiles store 5-10 148

879 33 plastic eating utensiles store 1-5 33

880 58 metal kitchen utensiles store 5-10 116

881 9 plastic kitchen utensiles store 1-5 18

882 6 wooden kitchen utensiles store 5-10 12

883 1 ceramic kitchen utensile store 1-5 2

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 18 of 39

Page 19: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

884 1 menora store 14

885 1 presto pressure cooker manual store 3-5 3

886 3 daily planners store 2 30

887 1 dictionary store 45

888 1 can opener store 8

889 2 pr of glasses store 30

890 1 plastic butcher knife store 2

891 1 box of sewing needles store 4

892 2 cassette tapes various store 5-10 16

893 1 kids day planner store 5

894 100 popsicle sticks store new 3

895 1 metal heart tin store 10

896 1 picture frame store 8

897 1 ring candle holder store 2

898 3 antique spoons family 50+ 30

899 1 antique fork family 50+ 10

900 1 photo w/frame family 30

901 1 antique frame family 40

902 1 metal egg store 30

903 1 ceramic utensile holder store 15

904 1 antique key rack store 10

905 1 plate holder store 5

906 1 mini china tea set gift 200

907 1 tweezers store used 4

908 40 sheets of recpies store 1-20 220

909 1 recipee book store 15

910 14 magazines various store 1-5 90

911 1 pitcher thermos store 10

912 1 mixer toastmaster store 3-5 20

913 1 copper candlestick holder store 8

914 1 glass jar store 5

915 1 box of hair color store new 12

916 3 martini glasses store 15

917 2 wine glasses store 10

918 1 hand held cheese grader store 5

919 1 tin can store 3

920 1 blender ostersizer store 3-5 40

921 1 ceramic pitcher store 20

922 1 mouse trap store 15

923 7 photos family 140

924 10 pencils store new 10

925 1 toothbrush store used 5

926 1 little colds remedy store new 8

927 1 sm tape measure store 5

928 1 window scraper store 3

929 1 flower cork top store 3

930 1 calculator Sharp store 1-5 15

931 1 wooden dec egg store 2

932 1 pr of sunglasses store 1-3 15

933 1 plastic spoon store 2

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 19 of 39

Page 20: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

934 1 eyelash curler store 1-3 9

935 1 sm hammer store 10

936 1 nail file store new 2

937 1 stick recorder store 10-15 8

938 1 crazy glue store new 4

939 1 rosary store 5

940 2 heart wall decorations store 16

941 1 skeleton key store 20

942 1 bottle opener store 5

943 1 35mm camera store 120

944 1 lighter store 3

945 2 mini tea cups store 30

946 1 mini electronic game sega store 10-12 40

947 2 boxes of aluminum foil store new 4

948 2 candy bars Butterfinger store new 1

949 1 ceramic bowl store 8

950 1 marbles game store 5-10 15

951 2 sqirt bottles store 1-3 4

952 1 fondue pot store 25

953 1 lunch bag store 1-3 10

954 2 cake pans metal/ceramic store 20

955 1 cookie jar magic store 5

956 4 metal bowls store 20

957 1 glass bowls store 10

958 4 bunt pans store 24

959 1 measuring sifter store 8

960 1 cake pans store 10

961 5 cookie sheets store 40

962 1 serving tray store 10

963 2 brownie sheets store 16

964 5 muffin pans store 40

965 1 kitchen scale store 10

966 7 baking pans store 35

967 1 glass baking pan store 10

968 1 turkey spacer for pan store 3

969 1 box of plastic cutlery store 3

970 1 measuring cup sifter store 5

971 1 metal tin store 3

972 1 pressure cooker store 5-10 45

973 1 lrg pot store 15

974 1 thermos store 10

975 1 frying pan store 10

976 1 heart cake pan store 8

977 1 Grill George Foreman store 3-5 120

978 1 sm turkey pan store 15

979 1 pressure cooker store 3-5 45

980 4 lrg frying pans store 40

981 3 pots store 15

982 2 sm sauce pans store 8

983 3 paintings w/frame gift 300

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 20 of 39

Page 21: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

984 75 various tupperware containers gift/store used/new 225

985 1 cake pan store 5

986 1 napkin holder store 3

987 1 serving dish store 3

988 1 ceramic hand basket store 35

989 1 plant holder store 10

990 5 clay pumpkins store 50

991 2 vases store 20

992 2 candle holder yankee candle store 20

993 1 ceramic photo frame store 8

994 8 lrg plates store 80

995 8 sm plates store 40

996 1 glass heart candy dish store 15

997 8 spices store new 16

998 2 salt & pepper shakers store 10

999 1 35mm camera store 75

1000 1 cutting board store 10

1001 1 pr of glasses store 25

1002 1 microwave Sharp store 3-5 400

1003 1 cordless phone at&t store 2-5 50

1004 1 cheese grater store 5

1005 4 kids plates store 4

1006 1 tin store 5

1007 2 cinnamon stick decorations store 8

1008 1 clay pot store 20

1009 1 wicker basket store 20

1010 2 loaves of bread store new 3

1011 1 drawer utensile organizer store 5

1012 1 bag of candy store new 3

1013 1 bag of oranges store new 5

1014 30 sm dec apples store 60

1015 1 window wreath store 35

1016 13 sea shells store 13

1017 1 dec spice rack store 25

1018 1 can of coffee store new 7

1019 1 bag of sweet N low store new 5

1020 1 coffee maker continentail elec store 45

1021 1 bird house model CE23561 store 5-10 30

1022 2 spatulas store 4

1023 1 wisk store 2

1024 1 cheese slicer store 8

1025 1 potato masher store 4

1026 1 knife set store 40

1027 1 coffee grinder black & decker store 3-5 60

1028 1 water bottle store 2

1029 1 thermos store 10

1030 1 bog of coffee filters store new 3

1031 1 box of 100 index card recipies various store 1-10 200

1032 1 orange set measuring cups store 20

1033 1 childs cup store 5

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 21 of 39

Page 22: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

1034 1 metal creamer store 10

1035 2 cups store 10

1036 1 tin store 5

1037 1 snack box store 7

1038 2 coffee cups store 10

1039 1 hand held metal candle holder store 5

1040 1 toaster t-fal 8747.4 store 1-5 50

1041 1 toaster oven living home store 5-10 60

1042 1 metal serving plate store 10

1043 1 dinner bell store 10

1044 1 metal pot holder store 8

1045 1 cream cheese store 3

1046 1 ceramic rooster store 4

1047 2 wooden bowls store 6

1048 1 eyeliner store new 8

1049 4 dec house blocks store 20

1050 2 bowls store 10

1051 2 spatulas store 6

1052 2 ladels store 6

1053 1 dish rack store 5

1054 1 spagetti ladel store 5

1055 1 church birdhouse store 30

1056 2 jars store 10

1057 4 fridge magnets store 2 8

1058 75 various necklaces gift/store 1-30yr 3,750

1059 20 various rings gift/store 1-30+ 1,000

1060 45 various earrings gift/store 1-30+ 900

1061 1 antique chest family 75 250

1062 1 antique kitchen table family 75 300

1063 1 antique kitchen stand alone cabinet family 75 150

1064 1 antique sink/dishwasher Westing House family 30yr 800

1065 1 refridgerator maytag msd2456dew store 2yr 1,200

1066 1 oval fall box store 12

1067 7 candlestick holders store 35

1068 1 photo album family 10

1069 1 salon care clear developer store new 25

1070 7 x-mas stuffed dolls store 1-5 35

1071 1 hairbrush store 1-3 10

1072 1 wooden giraffe store 15

1073 1 x-mas vase light store 10

1074 1 tin store 5

1075 1 plastic pumpkin store 3

1076 3 mini pumpkins store 9

1077 1 picture frame store 10

1078 2 snowmen dolls store 40

1079 1 candle store used 2

1080 2 candle holders store 10

1081 1 sm pumpkin halloween bucket store 3

1082 1 full size candle holder store 10

1083 1 fake candle light fixture store 25

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 22 of 39

Page 23: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

1084 1 roll of wall paper store new 20

1085 1 XL candle holder store 8

1086 1 bottle of green hair coloring store new 25

1087 1 table cloth store 15

1088 2 lightening crystals Redken store 60

1089 8 hairbrushes store 1-3 80

1090 1 plastic containers store used 6

1091 21 photos family 420

1092 4 table cloths store 40

1093 1 happy birthday banner store 5

1094 20 happy birthday plates store 5

1095 1 happy birthday table cloth store 5

1096 1 hair bleaching kit store new 50

1097 1 highlighting hat store used 10

1098 3 lights store 30

1099 4 corks store 20

1100 1 bottle of conditioner store new 20

1101 1 processing solution Redken store new 20

1102 1 conditioning color gloss Redken store new 20

1103 1 lightening solution Redken store new 20

1104 1 hand held candle stick holder store 8

1105 1 color graphics conditioner Matrix store new 15

1106 1 sewing kit store 10

1107 1 plastic container store 3

1108 1 dec circular servin tray store 5

1109 35 spools of thread store 35

1110 2 3ring binders store 10

1111 2 hair dressing notebooks store 80

1112 4 frames store 60

1113 1 wall mount candlestick holder store 8

1114 2 mini crochet hooks store 10

1115 1 bookstand store 45

1116 1 color graphics lightening solution Matrix store new 20

1117 1 hair dryer All American store 3-5 45

1118 40 spools of thread various store 1-5 40

1119 1 color graphics quick lighting kit store new 30

1120 1 sewing kit store 10

1121 1 antique lrg dining room cupboard store 100+ 600

1122 1 antique dining room table w/6 chairs store 100+ 1,200

1123 1 antique end table store 100+ 75

1124 1 dec x-mas tree w/ box stand store 40

1125 1 antique 4 drawer dining room chest store 75+ 400

1126 1 antique dining room hutch store 75+ 500

1127 1 antique swiss carving wall hanging store 200

1128 1 antique trash bin cover store 200

1129 1 plate set Cranberry Charger gift 40

1130 1 sm bench handmade gift 10yrs 350

1131 1 sm home stereo Panasonic SA-PM16 gift new 250

1132 1 candle store new 2

1133 1 candle holder store 5

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 23 of 39

Page 24: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

1134 1 bookstand store 45

1135 1 maroon lamp store 25

1136 4 blueberry muffins Big Y store new 4

1137 1 wooden alligator pic frame store 35

1138 1 rose box store 10

1139 1 bird feeder store 12

1140 1 dec pillow store 15

1141 2 bracelettes various gift/store 1-10 20

1142 2 pins various store 1-10 10

1143 1 ceramic bird store 5

1144 1 norton Anti-virus store 1-5 45

1145 2 greeting cards store 6

1146 1 dec plate store 10

1147 1 stuffed snow man store 5

1148 1 stained glass lamp store 35

1149 1 dec old bicycle store 50

1150 1 set of pear candles store new 10

1151 1 lrg photo store 20

1152 1 curtain rope store 6

1153 1 dec wreath store 10

1154 1 infant pajamas store 1-3 20

1155 1 place mat store 4

1156 3 lamp shades store 45

1157 1 clay statues store 10

1158 1 antique serving plate store 40

1159 1 antique sewing basket store 60

1160 1 circular carpet store 30

1161 Teal 22karat dinette set Harker Pottery co gift 150

1162 1 candle store new 10

1163 20 wooden tubes/threaded inserts spindles store 100

1164 1 x-mas candy dish store 6

1165 2 glass lantern taps store 30

1166 1 candlestick holders store 8

1167 1 antique lantern lamp store 175

1168 1 sun mirror wall hanging store 50

1169 30 photo frames store 600

1170 2 cd's various store 1-5 30

1171 1 ceramic pitcher planter store 25

1172 5 plants store 50

1173 1 wicker basket store 20

1174 2 antique pendulums store 120

1175 6 napkin rings store 12

1176 1 antique dec oval mirror w/ flowers store 120

1177 1 set of 5 collectable gold spoons family 250

1178 1 pitcher store 15

1179 1 wall mount candlestick holder store 10

1180 1 ceramic jar store 15

1181 7 wooden picture frames store 105

1182 17 photos family 1-10 340

1183 1 antique serving tray store 30

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 24 of 39

Page 25: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

1184 1 antique photo w/frame store 30+ 150

1185 6 rolls of wallpaper store new 120

1186 1 photo album store 10

1187 7 gift bags store new 21

1188 5 picture frames store 55

1189 10 placemats store 20

1190 1 silver pic frame store 30

1191 2 bags of holiday napkins store 6

1192 4 medical books various store 100

1193 3 baskets store 30

1194 2 dec ornaments (deer,pig) store 10

1195 1 dec candle burner angel store 5

1196 1 compaq presario 7550 store 2yr 600

1197 1 hp printer 3650 store 2 400

1198 1 cable modem store 2 60

1199 1 webcam store 2 30

1200 2 jbl computer speakers store 2 40

1201 1 hand towel store 5

1202 1 antique ladder back arm chair store 100+ Steve W.

1203 1 antique birdhouse motel store 75 60

1204 1 table cloth store 10

1205 2 dec pilliows store 20

1206 9 jugs store 180

1207 1 basket w/fake plants store 20

1208 1 sm antique cabinet store 70

1209 4 children's books store 1-5 20

1210 1 antique rocking chair family 400

1211 1 antique pottery jug large store 150

1212 3 home magazines various store 1-5 36

1213 4 salon magazines various store 1-5 45

1214 1 step ladder store 15

1215 1 large wicker magnetic basket store 20

1216 1 step stool store 10

1217 1 circular corper store 20

1218 1 antique side table family 75

1219 1 hand held candle stick holder store 8

1220 1 sm dec x-mas pillow store 5

1221 1 antique school desk store 50+ 120

1222 4 rolls of x-mas ribbon store new 8

1223 7 present toppers store new 3

1224 2 gift bags store new 6

1225 10 ribbon toppers store new 30

1226 10 hairclips store 1-5 16

1227 7 hairbrushes store 1-5 70

1228 2 combs store 1-5 14

1229 1 scissors store 1-5 5

1230 1 dual mirror case (small) store 1-5 10

1231 1 scissors store 1-5 5

1232 4 hair clips store 1-5 4

1233 3 combs store 1-5 6

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 25 of 39

Page 26: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

1234 2 lip glosses store 1-5 10

1235 2 photos store 1-5 40

1236 4 hair ties store 1-5 4

1237 1 ring necklace store 1 50

1238 1 wicker basket store 10

1239 1 make-up bag store 1-3 20

1240 4 hand lotions store new 20

1241 1 x-mas wreath store 10

1242 1 photo album prom pictures family 100

1243 1 pair of hair cutting shears shizuka store 1-5 25

1244 2 tweezers store 1-5 10

1245 1 hair straitener global beauty network store 1-5 30

1246 1 candle holder store 5

1247 1 sm tray store 5

1248 1 lrg mirror store 60

1249 1 silver cabinet living room store 300

1250 13 hair brushes store 1-5 130

1251 1 set of hair curlers store 2 15

1252 1 body butter secert store used 8

1253 2 lint brushes store 6

1254 1 hair dryer sunbeam model SVPC48 store 1-5 30

1255 2 eyelash enhancers store 1-5 14

1256 1 deoderent store new 4

1257 1 bottle of shampoo Paul Mitchell store new 20

1258 1 hair straitener store 1-5 30

1259 1 hot tools mod1188 store 1-5 40

1260 1 first alert smoke detector store 1-5 20

1261 1 umbrella store 1 10

1262 1 leather sachet store 50

1263 3 sachet corderoy store 90

1264 1 womans pea trench coat (red) store 1-3 140

1265 2 leather jackets store 1-5 400

1266 2 womens faux lined jackets store 1-5 300

1267 2 kids coats store 1-3 60

1268 11 various jackets store 1-10 330

1269 1 hair curling set store 1-3 15

1270 7 vacuum bags store new 21

1271 1 plastic mask store used 5

1272 2 shirts store 1-3 40

1273 2 women's hand bags store 1-5 35

1274 3 scarves store 1-5 15

1275 1 leather repair kit store 30

1276 1 kids back pack store 1-5 20

1277 1 camera case store 10

1278 1 wooden fruit painting store 45

1279 1 half mirror half glass decoration store 20

1280 1 pair of snowpants store 1-3 120

1281 1 pair of ski goggles Carrerra store 1-3 60

1282 12 pairs of gloves store 1-5 72

1283 14 scarves store 1-10 70

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 26 of 39

Page 27: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

1284 1 leather boots store 2 100

1285 2 neckties store 3 24

1286 8 hats store 1-5 64

1287 10 sweaters store 1-5 500

1288 1 plastic laundry basket store 12 15

1289 1 children's leather boots store 1-3 50

1290 1 iron Sunbeam store 7 35

1291 1 ironing board store 7 25

1292 2 pairs of socks store 1-3 12

1293 2 button up shirts Oxford,Banana republic store new 40

1294 1 curtains store 1-5 10

1295 1 sweatshirt store 1-5 30

1296 13 pairs of women's dress shoes store 1-10 780

1297 1 purse store 2 15

1298 1 plastic laundry basket store 12 15

1299 8 bras victoria/filenes store 1-2yr 320

1300 3 nightgowns victoria/filenes store 1-3yr 30

1301 12 sweaters filenes store 1-10yr 600

1302 20 pairs of pants store 1-12yr 600

1303 8 dresses store 1-10yr 720

1304 19 various shirts store 1-10yr 1,200

1305 18 dress shirts store 1-10 900

1306 2 pairs of underwear Victoria's Secert store new 10

1307 4 belts store 1-5 40

1308 2 women's dress suits filenes store 1-5 100

1309 4 jackets store 1-5 400

1310 2 pantyhose store new 10

1311 1 book store 40

1312 1 Queen size matress/ box spring filene's 7 1,100

1313 1 matress cover store used 20

1314 3 pillows store 1-3 30

1315 1 lamp store 65

1316 1 pair of shoes store 1-3 60

1317 1 antique nightstand/magazine rack store 160

1318 14 various magazines store 1-5 70

1319 1 vase w/roses store 20

1320 1 antique purple pendent necklace1 aunt lou 100 175

1321 1 pearl necklace gift 10 300

1322 15 pendents various grandmother 1-100 450

1323 3 pairs of earrings store/gift 1-10 90

1324 1 belt chain store 60

1325 1 liquid lip shine store new 5

1326 1 mirror part of dresser store included

1327 7 earrings various store 1-10 210

1328 12 necklaces various store/gift 1-50 600

1329 1 set of dry flowers store 65

1330 1 face washing basin store 125

1331 1 face washing pitcher store included

1332 2 bankets 1 pillow store

1333 2 carpets oriental northampton antique new 1,110

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 27 of 39

Page 28: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

1334 1 runner carpet oriental northampton antique new 460

1335 1 antique dresser family 150+ Steve W.

1336 1 antique chest family 150+ Steve W.

1337 1 antique mirror for dresser family 150+ Steve W.

1338 1 jacket store 1-5 100

1339 1 towel store 8

1340 4 table cloth store 40

1341 2 bras Victoria's Secert store 1-3 80

1342 2 underwear Victoria's Secert store 1-5 12

1343 1 pair of stockings Victoria's Secert store new 5

1344 2 pajama bottems filenes store 1-5 20

1345 1 dress pants filenes store 1-5 50

1346 3 dress shirts filenes store 1-5 150

1347 2 t-shirts filenes store 3-5 40

1348 2 make-up mirrors store new 10

1349 10 gold pendent necklaces various store/gift clean 1-10 500

1350 1 roll of tape store new 5

1351 2 make-up brushes store 6

1352 1 tea tree shaping cream store 20

1353 3 watches store 1-5 180

1354 12 various make-up containers store new 96

1355 7 necklaces various store 350

1356 1 razor store used 5

1357 2 spools of thread store new 2

1358 2 bracelettes store 3-5 40

1359 1 eye glass case store 10

1360 1 pair of nylons store new 5

1361 26 painties Victoria's Secert store 1-10 208

1362 17 bras Victoria's Secert store 1-10 680

1363 6 pairs of pants various store 1-3 180

1364 22 sweaters various store 1-10 1,100

1365 32 pairs of stockings various store 1-5 160

1366 8 lingere victoria/filenes stores 1-5 400

1367 7 summer scarves various stores 1-3 35

1368 1 hat various store 8

1369 2 dresses various store 100

1370 17 shirts various store 2-6 340

1371 2 belts store 20

1372 8 pearl necklace various store 1-10 400

1373 6 various necklaces store gifts 1-10 300

1374 1 antique sm dresser family 400

1375 2 antique bed frames (queen,twin) family 1,600

1376 1 gift bags store new 3

1377 2 gift boxes store new 10

1378 16 various x-mas ornaments store 48

1379 7 dresses various store 350

1380 11 various dress coats (women's) filenes store 1-10 1,100

1381 4 women's jackets various store 1-5 400

1382 5 shirts various store 1-10 100

1383 6 pairs of pants various store 1-5 90

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 28 of 39

Page 29: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

1384 1 sweater store 50

1385 4 girl's dresses various store 4-10 120

1386 1 scale store 45

1387 23 towels store 184

1388 10 bed sheets store 100

1389 10 reuseable diapers store 4-10 30

1390 1 bed skirt store 10

1391 1 alarm clock (Dream Machine) Sony ICF-C153V store 18

1392 1 doll house bedroom set store 60

1393 1 doll house bathroom set store 40

1394 1 statue of mary store 20

1395 1 bag of toliet paper store new 5

1396 6 curtains store 60

1397 1 kid's video tape store 20

1398 2 bedsheets (twin) store 3-5 20

1399 1 pillow case store 5

1400 1 electric heat pad store 40

1401 1 full set of curtains store new 30

1402 1 bathroom doll store 15

1403 1 curtains store 10

1404 2 bathroom rugs store 16

1405 1 toy vampire teeth gift 2

1406 1 lamp family 30

1407 7 toothbrushes store used 21

1408 1 razor store 5

1409 1 bathroom cup store 2

1410 1 candle holder store 3

1411 1 sm 3 drawer mini chest store 90

1412 1 magazine rack store 40

1413 1 paper towel holder store 1-5 10

1414 1 bathroom toy store 5

1415 10 bottles of health care products various store new 100

1416 20 bottles of cleaning products various store new 120

1417 20 hair care products various store new 300

1418 20 beauty products various store new 275

1419 1 antique child's toy chest family 100 200

1420 1 antique child's nightstand farm 150 75

1421 1 antique bureau aunt 100 300

1422 1 antique tall cabinet grandmother 150+ 250

1423 1 table cloth family 120

1424 1 wooden table top store 80

1425 2 Antique stained glass window panes store 300

1426 1 Egg Crate Padding w/matress cover store 130

1427 2 bed sheets 300 count store 80

1428 1 body pillow store 15

1429 1 lrg oriental carpet store 1yr 2,000

1430 3 Med. Child's toys Fisher Price store 3-5 60

1431 6 purses various store 48

1432 1 leather mini-backpack store 8

1433 1 baby carrier store 4-10 16

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 29 of 39

Page 30: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

1434 1 snow pants store 4-10 50

1435 1 scarf store 10

1436 1 lrg cotton padding store 45

1437 63 various children's books store 1-50 630

1438 64 various stuffed toys store 1-15 320

1439 5 various lrg stuffed toy store 1-10 100

1440 1 waterbed matteress store 300

1441 1 gift boxes store new 5

1442 2 paper weights store 4

1443 2 dec. ceramic dolls store 24

1444 5 sm photos w/frames store 150

1445 1 lrg fitted table cloth store 15

1446 1 unicorn costume store 5-10 25

1447 1 woven basket store 10

1448 1 bookshelf store 45

1449 1 halloween candy pumpkin store 5

1450 1 antique birdhouse store 60

1451 1 antique lantern store 100

1452 1 metal basket store 5

1453 1 antique desk lamp store 250

1454 1 Athletic bag Nike store 3-5 80

1455 1 hand bag store 8

1456 1 Pane of glass store

1457 1 bed quilt store 60

1458 2 pillows Sealy Posture-pedic store 30

1459 1 baby crib bed sheet set store 15

1460 1 Paper Mache King Tut store 40

1461 1 easter basket store 5

1462 25 gift bags store new 75

1463 1 antique 2-tier bookshelf store 140

1464 2 clothes baskets store 12 20

1465 33 pairs of women's shoes various store 1-10 1,980

1466 8 pairs of sandles various store 1-5 160

1467 3 sets of fake flowers store 30

1468 85 various children's books store gifts 1-30 850

1469 3 x-mas ornaments store 15

1470 1 Antique Nurse bookend Van Vaevonberg z store 250

1471 1 lrg asortment wood flooring (150 LF) store

1472 3 purses various store 3-5 45

1473 1 Humidifier Duracraft 3B68 store 40

1474 5 fake lillies store 15

1475 1 vacuum head store 4

1476 2 glass light tops store 90

1477 1 Tutu store 30

1478 1 Lrg Comforter store 60

1479 1 baby memory box store 4-10 40

1480 1 pair of baby shoes store 4-10 20

1481 22 Various Greeting cards store 66

1482 1 mini kid's suitcase store 25

1483 1 basket store 10

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 30 of 39

Page 31: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

1484 16 VHS movies various store 1-10 352

1485 3 pic frames store 30

1486 2 prints w/frames store 60

1487 2 clocks store 2-5 40

1488 4 cermaic decorations store 20

1489 1 mini branch rocking chair store 15

1490 1 beanie baby store 10

1491 5 rolls of wallpaper store new 200

1492 1 wall mounted coat hanger store 8

1493 2 pilows Sealy Posture-pedic store 40

1494 1 set of fake flowers store 5

1495 1 tall mirror w/frame store 50

1496 3 paintings w/frames store 180

1497 1 yearbook store 25

1498 1 cetificate w/frame store 100

1499 1 game boy Nintendo store 5-10 60

1500 1 Smirnoff bottle store 25

1501 1 3 drawer jewlery box store 75

1502 1 pic w/frame store 22

1503 200 baseball cards various store 1-50+ 200

1504 4 antique mirrors store 300

1505 2 photos w/frames store 10

1506 1 Japanese elec heated teapot gift 65

1507 1 first communion book church 5-10 40

1508 1 Autumn colored garland store 25

1509 20 Various figurines hummels aunt gifts 20-40yr 1,400

1510 1 antique mirror wallshelf gift 135

1511 2 lamp shades store 48

1512 3 Master Bedroom Doll Set American Heritage gift 225

1513 1 lamp store 25

1514 1 metal reindeer store 11

1515 1 roll of wrapping paper store new 6

1516 1 plastic doll store 15

1517 1 Window fan Holmes store 3-5 13

1518 1 bag of easter grass store 2

1519 1 State Quarters Collector's map store 1-5 20

1520 1 Ancient Painting w/frame store 110

1521 1 Vacuum Electrolux Embassador 3 store 1-5 335

1522 1 Quilting liner material store 25

1523 1 Back pack LL Bean store 5yr 45

1524 1 lrg mattress cover store 19

1525 1 backpack store 20

1526 2 lamp shades store 30

1527 24 SF linoleum flooring store

1528 6 pairs of woman shoes various store 2-5 360

1529 1 bathing suit store 90

1530 1 toy gears building set store 55

1531 5 plastic child's toys store 25

1532 1 disney's jewlery case gift 45

1533 1 Elmo purse gift 12

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 31 of 39

Page 32: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

1534 1 Infant activity center Graco gift 1-3 26

1535 56 infant shirts store 1-3 560

1536 61 infant pants store 1-3 610

1537 14 infant sweaters store 1-3 140

1538 13 infant pajamas store 1-3 190

1539 1 baby crib family 25+ 150

1540 1 x-mas stocking gift 3

1541 5 pairs of jeans various store 1-10 150

1542 1 skirt store 1 30

1543 33 woman's shirts various store 1-10 660

1544 6 pairs of shorts various store 1-5 120

1545 1 baby play pen store 4-10 60

1546 2 hat boxes store 20

1547 1 baby swinger 2speed Graco store 4-10 35

1548 1 crib mattress store 40

1549 53 baby shirts various store 1-3 530

1550 20 baby pants various store 1-3 200

1551 15 baby pajamas various store 1-3 150

1552 22 pairs of baby shoes various store 1-3 660

1553 27 baby shirts various store 1-3 270

1554 52 baby pajamas various store 1-3 520

1555 10 baby shoes various store 1-3 300

1556 7 baby pants various store 1-3 140

1557 63 woman's shirts various store 1-10 1,120

1558 1 mattress protector store 45

1559 1 Mattress Egg Crate Pad store 65

1560 1 sm bag of fabric store 20

1561 27 baby sweatshirts various store 1-3 810

1562 21 baby pajamas various store 1-3 210

1563 1 baby crib sheet set store 15

1564 3 blankets store 60

1565 1 pair of crutches hospital 150

1566 2 picture frames store 20

1567 1 antique coat rack store 140

1568 1 wooden sifter w/scoop store 10

1569 2 down pillows store 30

1570 1 blanket store 20

1571 1 crib sheet store 8

1572 1 wall mounted candle holder store 15

1573 6 hummel wall hangings store 300

1574 1 sm basket store 10

1575 1 dec wal plate store 10

1576 12 baby dresses various store 1-3 360

1577 1 jacket store 2-5 60

1578 1 lrg bag of fabric store 30

1579 23 various bathing suits store 1-10 460

1580 1 Comforter set (Queen size) filene's new 600

1581 6 pairs of jeans various filene's 1-5 450

1582 1 Suede leather skirt Eddie Bauer store 2 150

1583 1 box of various fabric store 350

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 32 of 39

Page 33: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

1584 12 womens's shirts various store 1-10 240

1585 13 women's pants various store 1-10 390

1586 8 women's skirts/dresses various store 1-10 400

1587 3 antique mini wall shelves family 100+ 600

1588 2 antique wall cabinet aunt 100+ 450

1589 1 pic w/frame family 1-5 30

1590 2 "one dollar bills" 1921/1923 gift 85/87yrs 86

1591 3 sports plaques earned 1-3yr 300

1592 7 photos family 140

1593 1 sm wooden box store 10

1594 2 metal candlestick holders store 10

1595 7 child's blankets store 1-3 140

1596 1 dec heart wreath store 15

1597 1 artificial flower set store 5

1598 1 leather fannypack store 40

1599 1 punch bowl store 15

1600 1 basket store 10

1601 2 blow dryers store 1-5 70

1602 1 Big Curls Conair store 1-5 35

1603 5 bags of hair rollers store 100

1604 1 hair highlightening kit store new 20

1605 2 embroidered pics w/frame store 60

1606 1 print w/pics family 20

1607 1 Garden discovery gym store 60

1608 1 baby bouncer Safety 1st gift 4-10 45

1609 1 baby jumper Graco gift 4-10 45

1610 1 x-mas wine bottle holder store 20

1611 1 lrg candle store 5

1612 1 sm clock store 10

1613 1 ceramic figurine store 5

1614 1 baby book gift 20

1615 1 shot glass checkers store 5

1616 2 lamp shades store 30

1617 1 wooden box store 10

1618 1 pic w/frame family 20

1619 1 dec lamp candle holder store 15

1620 2 photos w/frames family 50

1621 1 embroidered wall hangings store 30

1622 1 crib light store 10

1623 1 baby shoe box store 5

1624 1 pair of velvet pants store 30

1625 1 cd case store 1-5 10

1626 100 music cd's various store 1-5yr 1,500

1627 1 antique lantern store 40

1628 1 antique wall light store 20

1629 2 candle sticks store new 4

1630 25 various x-mas decorations store 125

1631 2 fans store 1-5 30

1632 1 futon store 160

1633 1 folding chair store 10

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 33 of 39

Page 34: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

1634 1 bed frame store 120

1635 1 tricycle store 40

1636 8 books various store 5-10 80

1637 1 picture frame store 10

1638 3 curtain rods store 30

1639 3 lanterns store 45

1640 1 birdhouse nightnight store 12

1641 1 Vacuum Electrolux #450724T store 175

1642 1 pair of jeans Mudd store 1-3 40

1643 1 set of Fireplace tools store 25

1644 1 metal shelf store 20

1645 1 pair of slippers store 20

1646 1 plastic planter store 10

1647 1 wicker basket store 60

1648 6 rolls of wrapping paper store new 120

1649 1 Bed frame w/mattress store 240

1650 1 sm bookcase store 40

1651 1 pink blanket store 20

1652 1 sofa w/arm chair store 1-5 1,500

1653 2 pillows store 1-3 40

1654 1 bed sheet store 1-5 10

1655 1 x-mas wreath store 10

1656 1 x-mas rope garland store 5

1657 1 tricycle Radio Flyer gift 1yr 60

1658 1 VHS movie (Finding Nemo) gift 1yr 15

1659 1 sm dec pillow store 10

1660 1 outdoor table store 80

1661 1 boxspring w/mattress (twin) store 2yr 350

1662 1 pillow store 1yr 20

1663 1 dec x-mas beads store 5

1664 1 pair of girls slippers store 20

1665 2 shirts various store 1-5 40

1666 1 coloring book store 1-5 4

1667 1 vhs movie store 2-5 22

1668 1 x-mas tree stand store 10

1669 1 x-mas tree store 30

1670 1 string of x-mas lights store 8

1671 1 wooden desk store 100

1672 1 mini recliner store 75

1673 1 basket store 10

1674 12 x-mas ornaments various 60

1675 1 VCR store 125

1676 1 25'' TV Samsung store 225

1677 1 Gas Grill w/tank store 2yr 200

1678 1 antique oval mirror family 100 450

1679 3 various antique necklaces family 50-100 300

1680 1 antique gooseneck lamp aunt 100 150

1681 1 set of fake flowers store new 30

1682 1 candle holder w/fluted globe gift 5

1683 1 dec egg gift 2

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 34 of 39

Page 35: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

1684 1 windchime family 15

1685 1 tropical plant w/planter store new 20

1686 3 lean cuisine Big Y store new 18

1687 1 hot dog rolls Big Y store new 2

1688 1 tortellini Big Y store new 4

1689 1 bread loaf Big Y store new 2

1690 6 frozen juice Big Y store new 12

1691 1 4 lbs sausage Big Y store new 12

1692 1 vermouth Big Y store new 15

1693 3 ham steaks Big Y store new 20

1694 3 boxes ice cream Big Y store new 15

1695 1 1 lb hash browns Big Y store new 8

1696 1 pkg klondike bars Big Y store new 4

1697 1 4 lbs fresh salmon Big Y store new 20

1698 1 lb mozarella cheese Big Y store new 6

1699 1 lb pasta and shells Big Y store new 2

1700 1 lb bacon Big Y store new 5

1701 2 lean pockets Big Y store new 8

1702 1 lb box spinach Big Y store new 2

1703 1 pizza Big Y store new 8

1704 1 lb hot italian sausage Big Y store new 6

1705 1 2 lbs shrimp Big Y store new 22

1706 1 3 lbs chicken breast Big Y store new 12

1707 1 lb pepperoni Big Y store new 6

1708 1 lb chop suey Big Y store new 4

1709 1 2 lbs hot dogs Big Y store new 10

1710 1 4 lbs ham burger Big Y store new 15

1711 1 4 lbs frozen peas Big Y store new 8

1712 3 bags muffins Big Y store new 12

1713 1 22 lb turkey Big Y store new 66

1714 1 pkg basel Big Y store new 4

1715 8 bottles salad dressing Big Y store new 24

1716 1 7 lb cheese (sharp, cheddar, american, x-sharp, mozarella) new 30

1717 1 pickles Big Y store new 5

1718 1 aspargus Big Y store new 3

1719 1 lettuce Big Y store new 2

1720 1 carrots Big Y store new 2

1721 1 cucumber Big Y store new 1

1722 1 tomatoes Big Y store new 1

1723 1 maple sugar Big Y store new 2

1724 1 salsa Big Y store new 3

1725 1 soda Big Y store new 1

1726 1 beer Big Y store new 3

1727 1 hummus Big Y store new 10

1728 1 lemon juice Big Y store new 2

1729 1 ketchup Big Y store new 2

1730 1 mayo Big Y store new 4

1731 1 relish Big Y store new 2

1732 1 mustard Big Y store new 2

1733 1 ice cream toppings Big Y store new 12

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 35 of 39

Page 36: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

1734 1 tuna fish Big Y store new 1

1735 1 honey Big Y store new 8

1736 1 peanut sauce Big Y store new 5

1737 1 vinegar Big Y store new 2

1738 1 maple cream Big Y store new 6

1739 1 vinegar cider Big Y store new 2

1740 1 feta Big Y store new 6

1741 1 apple sauce Big Y store new 2

1742 1 olives Big Y store new 3

1743 1 jam/ jelly Big Y store new 4

1744 2 gallons milk Big Y store new 6

1745 1 various toys (Peyton) store gifts 15

1746 1 clothes store 20

1747 10 dresses store 1,000

1748 1 25" tv rca store 225

1749 1 25" tv hitachi store 225

1750 1 maple lazy susan store 65

1751 1 tv stand store 45

1752 1 chess table store 50

1753 2 night lights store 30

1754 1 window treatments store 75

1755 1 shades store 20

1756 1 comforter store 80

1757 1 pillow cases store 5

1758 1 dust ruffle store 23

1759 1 rug store 200

1760 1 lamp store 50

1761 1 ceramic birds store 41

1762 1 children's framed prints store 20

1763 1 recently purchased clothes store 450

1764 1 present store 400

1765 1 leap frog w/ pad store 35

1766 1 old vanity table/ mirror store 130

1767 1 pillows store 20

1768 1 chair stool mathcing mirror store 60

1769 1 sheets store 40

1770 1 blankets store 45

1771 1 maple night stand w/ glass store 125

1772 1 vhs movies store 3-5 20

1773 1 dvd movies store 1-3 25

1774 1 mirror on door store 25

1775 1 jewlery store 225

1776 2 pr curtains store 50

1777 2 shades store 40

1778 1 portable cd player sony store 2-5 25

1779 4 year books store 240

1780 40 photographs store 200

1781 1 set of 4 harry potter hard collection store 1-3 65

1782 1 sony alarm clock store 23

1783 1 lights store 15

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 36 of 39

Page 37: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

1784 1 columbia ski jacket store 260

1785 1 ll bean jacket store new 265

1786 3 x-mas presents ( 2 fulls sets victoria's secret perfumes, butterfly luminess light 145

1787 1 shirt hurley store new 35

1788 1 sweatshirt champion store new 25

1789 1 fleece northface store new 150

1790 1 pea coat gap store new 75

1791 1 sweatshirt hurley store new 45

1792 1 sweat pants store new 20

1793 1 dress pants store new 65

1794 5 pr. Shoes store new 375

1795 5 pr sneakers store new 425

1796 1 $400 cash bank 1 400

1797 1 underwear Victoria's Secert store 1-3 22

1798 1 socks store 1-3 3

1799 1 ski pants store 1-5 130

1800 1 gloves store 1-5 26

1801 1 ski goggles store 1-5 40

1802 1 camping pillow store 16

1803 4 window shades LR store 120

1804 4 sets country curtains store 160

1805 1 hardware store 5

1806 1 pillows 5-Jan 15

1807 1 dine coffee table LR store 125

1808 1 orange vase w/ vines store 35

1809 1 pine stand w/ dawers store 200

1810 1 brass log holder gift 120

1811 1 fireplace tools store 65

1812 1 wooden ansel 10"x18" Carrel folk art gift 20 165

1813 1 oak mirror above couch farm 100+ 475

1814 1 Black ceramic swan lamp store 165

1815 1 picture at tarsot family 135

1816 1 3 small mirrors store 180

1817 1 decorative x-mas pillows store new 25

1818 1pr brass candle holders gift 3yr 75

1819 4 hard cover books (country living decorating) store 5-10 160

1820 4 glass hurricane w/ globe oil lamps farm 100+ 500

1821 3 glass pear ornaments store 45

1822 1 gold octagon dish store 25

1823 1 wingback chair gift 365

1824 1 4x6' mirror store 350

1825 1 box of make-up various store new 100

1826 1 35" sony tv casey store 650

1827 1 antique ornaments store 50 45

1828 1 videos store 5 22

1829 1 picture store 3

1830 1 christmans lights store 1-5 13

1831 1 little wooden apples store 25

1832 1 etched mirror store 45

1833 1 antique picture from farm house farm 100+ 275

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 37 of 39

Page 38: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

1834 1 antique box family 75-100 170

1835 1 coffee table store 450

1836 1 table store 230

1837 1 child's laptop computer v-tech store 1 100

1838 1 wooden pine rack w/ magazine family 50-100 62

1839 1 engraved cow print gift 36

1840 10 wooden spools making yarn farm 50-100 300

1841 1 yarn & twine store included

1842 1 berry vines store 12

1843 1 neddle print picture 22x30 gold frame ashfield 650

1844 1 mahogony table gift 45

1845 1 antique 3 mirror store 35

1846 1 potpourri lamp store 15

1847 1 blue jugs store 250

1848 2 red dec boxes store 40

1849 4 photos w/ frames family 20

1850 1 spool table store 40

1851 1 brass log holder store 44

1852 1 iron candle holder w/ glass store 23

1853 4 pointsettas store new 40

1854 2 stockings store 10

1855 1 bed frame twin size store 75

1856 1 rug shampooer hoover Sears 2-5 150

1857 1 box children's books various store 5-10 335

1858 24 stair treads store 528

1859 1 octagon maple table store 275

1860 1 maple twin bed family 40yr 475

1861 1 maple bureau family 40yr 750

1862 1 tricycle store new 52

1863 1 rocking horse gift 1yr 75

1864 5 huge boxes toys various 1-10yr 1,500

1865 2 horse heads on sticks aunt 30

1866 1 antique wooden frame family 65

1867 1 runner for downstairs hallway oriental store 50plus 350

1868 1 the firm steppers store 20

1869 2 boxes books various store 10-30 400

1870 2 black frames w/ glass store 20

1871 2 Ivy's farm new 42

1872 1 shelving target store 1yr 45

1873 6 pr baby shoes various store 1-2 180

1874 3 1960's fisher price toys farm 40 300

1875 1 dried flowers store new 45

1876 1 grand mothers handmade blanket grandmother 70-80yrs 450

1877 1 water bed mattress w/ 8 chambers store 4yr 375

1878 2 shaker boxes (12x14x8), (14x16x10) family 100+ 4,500

1879 15 hummels family 20-50 1,950

1880 1 dish rack family 200 600

1881 1 cider press aunt 100 375

1882 1 antique church castle aunt 100 175

1883 1 wreath w/ lights store 5 65

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 38 of 39

Page 39: Brian D. Birmingham, Public Adjusterbdbirmingham.com/SampleContents.pdf · Item No.Quant. Description Mfr/Brand Name PurchasedActionAge R/C 84 4 bowls gift 1-5yr 300 85 4 jars candy

Item No. Quant. Description Mfr/Brand Name Purchased Action Age R/C

1884 10 antique books aunt 200+ 1,000

tax 5% 3,744

Total 197,392

The above information is true to the best of my knowledge.

_____________________________________________Signed / Dated Page 39 of 39