↩ back to dashboard
⚠ SECURITY · this document contains reproduced signatures
When you save this as a PDF for transmission to Liberty Mutual:
  1. In the print dialog (Cmd+P), click "Show Details".
  2. Go to "PDF" → "Save as PDF…" or use Preview's Security Options.
  3. Set "Require password to open" with a strong password (12+ chars).
  4. Communicate the password to your Liberty handler by a separate channel (phone call to Taylor Guishard-Drummond: 469-997-8854) — never embed the password in the same email as the PDF.
Treat the signed PDF like a signed cheque. The on-screen warning won't print into the PDF.

Affidavit packet · claim 046414618

From:
Dan Sellars and Audrey Lam
6279 Greenhill Road
New Hope, PA 18938-9646
Date: May 22, 2026
To:
Taylor Guishard-Drummond, Sr. Claims Resolution Specialist I
Property — Inside
Liberty Mutual Insurance
PO Box 5014
Scranton, PA 18505-5014
Re: Claim 046414618-01 / 046414618-02 — Personal Property Affidavits Enclosed

Dear Ms. Guishard-Drummond,

Enclosed are the signed affidavits of purchase and/or repair for the personal-property items listed below, submitted in support of the recoverable-depreciation release on claim 046414618. Each affidavit follows the format provided in your office's 1/13/2026 settlement letter and is supported by paid receipts or invoices attached as Exhibit A where applicable.

The pre-loss inventory evidence for several items is also enclosed in support of the original claimed values. Where items are still pending replacement or repair, the affidavit notes this explicitly and will be amended once the supporting receipts are in hand.

Manifest of items in this packet (in claim-line order):

#ItemOriginal brand · modelClaimed
#1agrifabAgri-Fab$214.00
#2bbqWeber 2005 6721001 Genesis Silver B Propane, Black$517.00
#3bike trailerDoggyRide Mini Dog Bike Trailer, Rebel Red/Black$216.00
#4blowerMakita BHX2500CA Commercial Grade 4-Stroke 24.5cc Handheld Blower (CARB Compliant)$205.00
#5blowerHusqvarna 150BT 50.2cc 2-Cycle Gas Backpack Blower (likely — sidecar brand was 'Husqvarna'; model from pa/equipment/ ledger)$225.00
#6dehumidifiersAlorAir Basement/Crawl Space Dehumidifier 198 PPD (Saturation), 90 PPD (AHAM), 5-Year Warranty, HGV Defrosting System$2,191.00
#8impact wrenchDeWalt DCF889B 20V MAX Cordless Impact Wrench, 1/2-Inch (Tool Only)$115.00
#12ladderLouisville Ladder L-3022-28PT Pro Top Fiberglass Extension Ladder, 300-Pound Capacity, 28-Foot$347.00
#14pool cleanerPolaris Vac-Sweep 280$462.00
#15saw horseLogosol Smart-Holder Saw Horse, Folding Wood Holder$135.00
#17sprayerChapin International SureSpray 20020$53.00
#18toiletPorcher (American Standard) 1 Champion One-Piece Elongated Toilet, model 97420$519.00
#21tazz chipper shredderTazz (Ardisam) K32 Chipper Shredder with 212cc Viper Engine$636.00
#22worxWORX WG430 13 Amp Foldable Bladeless Electric Leaf Mulcher, Red$164.00
Sum of items in this packet:$5,999.00

Please note that our personal-property file remains open and we may submit additional documentation for the remaining items as we recover additional evidence. We continue to appreciate your office's cooperation in moving this claim to closure.

Respectfully,

Dan Sellars · named insured · 2026-05-22
Audrey Lam · named insured · 2026-05-22
Item #1 · agrifab · originally claimed $214.00
Liberty Mutual · purchase affidavit packet · v1

Item #01 · agrifab

Print + sign (both insureds) + attach paid receipt + mail to claims address. 28 USC §1746 self-sworn declaration — no notary required for federal courts; Liberty accepts in lieu of notarisation for replacement-cost releases.

⚠ Security · this document carries reproduced signatures
When exporting to PDF for transmission to Liberty, set a PDF password in the Save dialog (macOS Preview: Show Details → Security Options → Require password to open). Share the password with Liberty by a separate channel (phone call to your handler) — never embed the password in the same email as the PDF. Treat this artefact like a signed cheque.
Claim 046414618-01 / 046414618-02 · Item #01 Affidavit · sheet 1 of 2

AFFIDAVIT OF PURCHASE

Replacement-cost coverage · personal property contents
Commonwealth of Pennsylvania
County of Bucks

We, DAN SELLARS and AUDREY LAM, being the named insureds under the policy referenced below, declare under penalty of perjury under the laws of the United States of America that the following is true and correct:

  1. We are the named insureds on Liberty Mutual Personal Insurance Company homeowners policy H3V-281-240408-75, claim number 046414618-01 / 046414618-02, on the insured property at 6279 GREENHILL RD, NEW HOPE, PA 18938-9646.
  2. The covered loss occurred on 2021-07-29 and is described in Liberty's records as: Storm/tree damage — tree fall with associated structural and electrical damage.
  3. Replacement of the destroyed item has not yet been completed. We will purchase a like-kind functional replacement and amend this affidavit accordingly, attaching the paid receipt as Exhibit A.
  4. A paid receipt evidencing this purchase is attached to this affidavit as Exhibit A ([receipt filename — attach when finalised]).
  5. We make this declaration knowing that it will be relied upon by Liberty Mutual Personal Insurance Company in evaluating our claim and releasing the recoverable depreciation withhold associated with this line item.
Dan Sellars · named insured · 2026-05-22
Audrey Lam · named insured · 2026-05-22

Pursuant to 28 U.S.C. § 1746, we declare under penalty of perjury that the foregoing is true and correct. Executed at New Hope, Pennsylvania on the date(s) signed above.

Claim 046414618-01 / 046414618-02 · Item #01 Exhibit A · receipt · sheet 2 of 2
Attach paid receipt here Receipt PDF/image will be embedded here once captured via dropzone and synced.

Workflow: 1. Buy item from ________________ · 2. Save paid receipt PDF to 30-invoices/ · 3. Re-render this affidavit with --receipt <filename> · 4. Print packet (Cmd+P or button above) · 5. Both insureds sign sheet 1 · 6. Paperclip receipt to sheet 2 · 7. Mail to Taylor Guishard-Drummond at Liberty Mutual.

Item #2 · bbq · originally claimed $517.00
Liberty Mutual · purchase affidavit packet · v1

Item #02 · bbq

Print + sign (both insureds) + attach paid receipt + mail to claims address. 28 USC §1746 self-sworn declaration — no notary required for federal courts; Liberty accepts in lieu of notarisation for replacement-cost releases.

⚠ Security · this document carries reproduced signatures
When exporting to PDF for transmission to Liberty, set a PDF password in the Save dialog (macOS Preview: Show Details → Security Options → Require password to open). Share the password with Liberty by a separate channel (phone call to your handler) — never embed the password in the same email as the PDF. Treat this artefact like a signed cheque.
Claim 046414618-01 / 046414618-02 · Item #02 Affidavit · sheet 1 of 2

AFFIDAVIT OF PURCHASE

Replacement-cost coverage · personal property contents
Commonwealth of Pennsylvania
County of Bucks

We, DAN SELLARS and AUDREY LAM, being the named insureds under the policy referenced below, declare under penalty of perjury under the laws of the United States of America that the following is true and correct:

  1. We are the named insureds on Liberty Mutual Personal Insurance Company homeowners policy H3V-281-240408-75, claim number 046414618-01 / 046414618-02, on the insured property at 6279 GREENHILL RD, NEW HOPE, PA 18938-9646.
  2. The covered loss occurred on 2021-07-29 and is described in Liberty's records as: Storm/tree damage — tree fall with associated structural and electrical damage.
  3. Pre-loss inventory evidence — item destroyed in the covered event:Weber 2005 6721001 Genesis Silver B Propane, Black, originally purchased from Amazon.com on 2005-07-19 for a total of $505.18 USD (order #104-1800223-2241504), 5854 days before the loss event of 2021-07-29.
  4. On ________________ we purchased a Weber Spirit II E-310 3-burner for the sum of $549.00 USD from ________________, as the like-kind functional replacement for the destroyed item(s) described above.
  5. Original = Weber Genesis Silver B (model 6721501), purchased July 2005 from Amazon ($516.17), destroyed in 2021-07-29 tree fall. Weber Genesis Silver B is discontinued; the current Weber 3-burner mid-tier line is Spirit II E-310 ($549) — same trade class (3 burners, propane, similar BTU output, comparable cooking area). Like-kind functional equivalent. No upgrade premium absorbed (within 6% of $517 claimed amount).
  6. A paid receipt evidencing this purchase is attached to this affidavit as Exhibit A ([receipt filename — attach when finalised]).
  7. We make this declaration knowing that it will be relied upon by Liberty Mutual Personal Insurance Company in evaluating our claim and releasing the recoverable depreciation withhold associated with this line item.
Dan Sellars · named insured · 2026-05-22
Audrey Lam · named insured · 2026-05-22

Pursuant to 28 U.S.C. § 1746, we declare under penalty of perjury that the foregoing is true and correct. Executed at New Hope, Pennsylvania on the date(s) signed above.

Claim 046414618-01 / 046414618-02 · Item #02 Exhibit A · receipt · sheet 2 of 2
Attach paid receipt here Receipt PDF/image will be embedded here once captured via dropzone and synced.

Workflow: 1. Buy item from ________________ · 2. Save paid receipt PDF to 30-invoices/ · 3. Re-render this affidavit with --receipt <filename> · 4. Print packet (Cmd+P or button above) · 5. Both insureds sign sheet 1 · 6. Paperclip receipt to sheet 2 · 7. Mail to Taylor Guishard-Drummond at Liberty Mutual.

Item #3 · bike trailer · originally claimed $216.00
Liberty Mutual · purchase affidavit packet · v1

Item #03 · bike trailer

Print + sign (both insureds) + attach paid receipt + mail to claims address. 28 USC §1746 self-sworn declaration — no notary required for federal courts; Liberty accepts in lieu of notarisation for replacement-cost releases.

⚠ Security · this document carries reproduced signatures
When exporting to PDF for transmission to Liberty, set a PDF password in the Save dialog (macOS Preview: Show Details → Security Options → Require password to open). Share the password with Liberty by a separate channel (phone call to your handler) — never embed the password in the same email as the PDF. Treat this artefact like a signed cheque.
Claim 046414618-01 / 046414618-02 · Item #03 Affidavit · sheet 1 of 2

AFFIDAVIT OF PURCHASE

Replacement-cost coverage · personal property contents
Commonwealth of Pennsylvania
County of Bucks

We, DAN SELLARS and AUDREY LAM, being the named insureds under the policy referenced below, declare under penalty of perjury under the laws of the United States of America that the following is true and correct:

  1. We are the named insureds on Liberty Mutual Personal Insurance Company homeowners policy H3V-281-240408-75, claim number 046414618-01 / 046414618-02, on the insured property at 6279 GREENHILL RD, NEW HOPE, PA 18938-9646.
  2. The covered loss occurred on 2021-07-29 and is described in Liberty's records as: Storm/tree damage — tree fall with associated structural and electrical damage.
  3. Pre-loss inventory evidence — item destroyed in the covered event:DoggyRide Mini Dog Bike Trailer, Rebel Red/Black, originally purchased from Amazon.com on 2015-09-02 for a total of $216.66 USD (order #114-9023615-2623440), delivered to the insured property on 2015-09-03, 2156 days before the loss event of 2021-07-29.
  4. On ________________ we purchased a DoggyRide Mini Dog Bike Trailer (or successor) — like-kind for the sum of $250.00 USD from Amazon, as the like-kind functional replacement for the destroyed item(s) described above.
  5. A paid receipt evidencing this purchase is attached to this affidavit as Exhibit A ([receipt filename — attach when finalised]).
  6. We make this declaration knowing that it will be relied upon by Liberty Mutual Personal Insurance Company in evaluating our claim and releasing the recoverable depreciation withhold associated with this line item.
Dan Sellars · named insured · 2026-05-22
Audrey Lam · named insured · 2026-05-22

Pursuant to 28 U.S.C. § 1746, we declare under penalty of perjury that the foregoing is true and correct. Executed at New Hope, Pennsylvania on the date(s) signed above.

Claim 046414618-01 / 046414618-02 · Item #03 Exhibit A · receipt · sheet 2 of 2
Attach paid receipt here Receipt PDF/image will be embedded here once captured via dropzone and synced.

Workflow: 1. Buy item from Amazon · 2. Save paid receipt PDF to 30-invoices/ · 3. Re-render this affidavit with --receipt <filename> · 4. Print packet (Cmd+P or button above) · 5. Both insureds sign sheet 1 · 6. Paperclip receipt to sheet 2 · 7. Mail to Taylor Guishard-Drummond at Liberty Mutual.

Item #4 · blower · originally claimed $205.00
Liberty Mutual · purchase affidavit packet · v1

Item #04 · blower

Print + sign (both insureds) + attach paid receipt + mail to claims address. 28 USC §1746 self-sworn declaration — no notary required for federal courts; Liberty accepts in lieu of notarisation for replacement-cost releases.

⚠ Security · this document carries reproduced signatures
When exporting to PDF for transmission to Liberty, set a PDF password in the Save dialog (macOS Preview: Show Details → Security Options → Require password to open). Share the password with Liberty by a separate channel (phone call to your handler) — never embed the password in the same email as the PDF. Treat this artefact like a signed cheque.
Claim 046414618-01 / 046414618-02 · Item #04 Affidavit · sheet 1 of 2

AFFIDAVIT OF PURCHASE

Replacement-cost coverage · personal property contents
Commonwealth of Pennsylvania
County of Bucks

We, DAN SELLARS and AUDREY LAM, being the named insureds under the policy referenced below, declare under penalty of perjury under the laws of the United States of America that the following is true and correct:

  1. We are the named insureds on Liberty Mutual Personal Insurance Company homeowners policy H3V-281-240408-75, claim number 046414618-01 / 046414618-02, on the insured property at 6279 GREENHILL RD, NEW HOPE, PA 18938-9646.
  2. The covered loss occurred on 2021-07-29 and is described in Liberty's records as: Storm/tree damage — tree fall with associated structural and electrical damage.
  3. Pre-loss inventory evidence — item destroyed in the covered event:Makita BHX2500CA Commercial Grade 4-Stroke 24.5cc Handheld Blower (CARB Compliant), originally purchased from Amazon.com on 2016-07-14 for a total of $205.77 USD (order #107-6373232-6420257), delivered to the insured property on 2016-07-15, 1840 days before the loss event of 2021-07-29.
  4. On ________________ we engaged ________________ (pending — at the shop now) to repair the destroyed item for the sum of $____________ USD, restoring it to working condition. A paid repair invoice is attached as Exhibit A. Repair was elected in lieu of full replacement as the lower-cost path to functional restoration; per Liberty's settlement-email language of 2026-01-13 ("if you spend less than estimated for the items replacement, we will release the recoverable depreciation payment up to the amount you spent"), the recoverable depreciation for this line is hereby requested up to the actual repair cost.
  5. REPAIR mode (item at the shop). Like-kind argument deferred until invoice arrives; repair restores the unit to working condition per Liberty's settlement-email language.
  6. A paid receipt evidencing this purchase is attached to this affidavit as Exhibit A ([receipt filename — attach when finalised]).
  7. We make this declaration knowing that it will be relied upon by Liberty Mutual Personal Insurance Company in evaluating our claim and releasing the recoverable depreciation withhold associated with this line item.
Dan Sellars · named insured · 2026-05-22
Audrey Lam · named insured · 2026-05-22

Pursuant to 28 U.S.C. § 1746, we declare under penalty of perjury that the foregoing is true and correct. Executed at New Hope, Pennsylvania on the date(s) signed above.

Claim 046414618-01 / 046414618-02 · Item #04 Exhibit A · receipt · sheet 2 of 2
Attach paid receipt here Receipt PDF/image will be embedded here once captured via dropzone and synced.

Workflow: 1. Buy item from ________________ · 2. Save paid receipt PDF to 30-invoices/ · 3. Re-render this affidavit with --receipt <filename> · 4. Print packet (Cmd+P or button above) · 5. Both insureds sign sheet 1 · 6. Paperclip receipt to sheet 2 · 7. Mail to Taylor Guishard-Drummond at Liberty Mutual.

Item #5 · blower · originally claimed $225.00
Liberty Mutual · purchase affidavit packet · v1

Item #05 · blower

Print + sign (both insureds) + attach paid receipt + mail to claims address. 28 USC §1746 self-sworn declaration — no notary required for federal courts; Liberty accepts in lieu of notarisation for replacement-cost releases.

⚠ Security · this document carries reproduced signatures
When exporting to PDF for transmission to Liberty, set a PDF password in the Save dialog (macOS Preview: Show Details → Security Options → Require password to open). Share the password with Liberty by a separate channel (phone call to your handler) — never embed the password in the same email as the PDF. Treat this artefact like a signed cheque.
Claim 046414618-01 / 046414618-02 · Item #05 Affidavit · sheet 1 of 2

AFFIDAVIT OF PURCHASE

Replacement-cost coverage · personal property contents
Commonwealth of Pennsylvania
County of Bucks

We, DAN SELLARS and AUDREY LAM, being the named insureds under the policy referenced below, declare under penalty of perjury under the laws of the United States of America that the following is true and correct:

  1. We are the named insureds on Liberty Mutual Personal Insurance Company homeowners policy H3V-281-240408-75, claim number 046414618-01 / 046414618-02, on the insured property at 6279 GREENHILL RD, NEW HOPE, PA 18938-9646.
  2. The covered loss occurred on 2021-07-29 and is described in Liberty's records as: Storm/tree damage — tree fall with associated structural and electrical damage.
  3. On ________________ we engaged ________________ (pending — at the shop now) to repair the damaged item described above (item #05 on the claim inventory, originally claimed at $225.00) item for the sum of $____________ USD, restoring it to working condition. A paid repair invoice is attached as Exhibit A. Repair was elected in lieu of full replacement as the lower-cost path to functional restoration; per Liberty's settlement-email language of 2026-01-13 ("if you spend less than estimated for the items replacement, we will release the recoverable depreciation payment up to the amount you spent"), the recoverable depreciation for this line is hereby requested up to the actual repair cost.
  4. REPAIR mode (Husqvarna 150BT at the shop). Like-kind argument N/A — repair restores the existing unit to working condition.
  5. A paid receipt evidencing this purchase is attached to this affidavit as Exhibit A ([receipt filename — attach when finalised]).
  6. We make this declaration knowing that it will be relied upon by Liberty Mutual Personal Insurance Company in evaluating our claim and releasing the recoverable depreciation withhold associated with this line item.
Dan Sellars · named insured · 2026-05-22
Audrey Lam · named insured · 2026-05-22

Pursuant to 28 U.S.C. § 1746, we declare under penalty of perjury that the foregoing is true and correct. Executed at New Hope, Pennsylvania on the date(s) signed above.

Claim 046414618-01 / 046414618-02 · Item #05 Exhibit A · receipt · sheet 2 of 2
Attach paid receipt here Receipt PDF/image will be embedded here once captured via dropzone and synced.

Workflow: 1. Buy item from Amazon · 2. Save paid receipt PDF to 30-invoices/ · 3. Re-render this affidavit with --receipt <filename> · 4. Print packet (Cmd+P or button above) · 5. Both insureds sign sheet 1 · 6. Paperclip receipt to sheet 2 · 7. Mail to Taylor Guishard-Drummond at Liberty Mutual.

Item #6 · dehumidifiers · originally claimed $2,191.00
Liberty Mutual · purchase affidavit packet · v1

Item #06 · dehumidifiers

Print + sign (both insureds) + attach paid receipt + mail to claims address. 28 USC §1746 self-sworn declaration — no notary required for federal courts; Liberty accepts in lieu of notarisation for replacement-cost releases.

⚠ Security · this document carries reproduced signatures
When exporting to PDF for transmission to Liberty, set a PDF password in the Save dialog (macOS Preview: Show Details → Security Options → Require password to open). Share the password with Liberty by a separate channel (phone call to your handler) — never embed the password in the same email as the PDF. Treat this artefact like a signed cheque.
Claim 046414618-01 / 046414618-02 · Item #06 Affidavit · sheet 1 of 2

AFFIDAVIT OF PURCHASE

Replacement-cost coverage · personal property contents
Commonwealth of Pennsylvania
County of Bucks

We, DAN SELLARS and AUDREY LAM, being the named insureds under the policy referenced below, declare under penalty of perjury under the laws of the United States of America that the following is true and correct:

  1. We are the named insureds on Liberty Mutual Personal Insurance Company homeowners policy H3V-281-240408-75, claim number 046414618-01 / 046414618-02, on the insured property at 6279 GREENHILL RD, NEW HOPE, PA 18938-9646.
  2. The covered loss occurred on 2021-07-29 and is described in Liberty's records as: Storm/tree damage — tree fall with associated structural and electrical damage.
  3. On ________________ we purchased a AlorAir Sentinel HDi65 Pro commercial dehumidifier × 2 units (refined per Dan 2026-05-22 — Pro variant of the HDi65 line) for the sum of $2198.00 USD from Amazon, as the like-kind functional replacement for item #06 on the claim inventory (originally claimed at $2191.00).
  4. Original = two large commercial-grade crawl-space dehumidifiers (specific brand/model TBD from original receipt; class confirmed as commercial-grade per damage photo evidence). Brand AlorAir Sentinel HDi65 is current mid-tier commercial crawl-space line at $1,099 × 2 = $2,198, matching original $2,191 claim within $7 (0.3% variance). Same trade class (commercial crawl-space dehumidifier), same operational role (humidity control for mold prevention).
  5. A paid receipt evidencing this purchase is attached to this affidavit as Exhibit A ([receipt filename — attach when finalised]).
  6. We make this declaration knowing that it will be relied upon by Liberty Mutual Personal Insurance Company in evaluating our claim and releasing the recoverable depreciation withhold associated with this line item.
Dan Sellars · named insured · 2026-05-22
Audrey Lam · named insured · 2026-05-22

Pursuant to 28 U.S.C. § 1746, we declare under penalty of perjury that the foregoing is true and correct. Executed at New Hope, Pennsylvania on the date(s) signed above.

Claim 046414618-01 / 046414618-02 · Item #06 Exhibit A · receipt · sheet 2 of 2
Attach paid receipt here Receipt PDF/image will be embedded here once captured via dropzone and synced.

Workflow: 1. Buy item from Amazon · 2. Save paid receipt PDF to 30-invoices/ · 3. Re-render this affidavit with --receipt <filename> · 4. Print packet (Cmd+P or button above) · 5. Both insureds sign sheet 1 · 6. Paperclip receipt to sheet 2 · 7. Mail to Taylor Guishard-Drummond at Liberty Mutual.

Item #8 · impact wrench · originally claimed $115.00
Liberty Mutual · purchase affidavit packet · v1

Item #08 · impact wrench

Print + sign (both insureds) + attach paid receipt + mail to claims address. 28 USC §1746 self-sworn declaration — no notary required for federal courts; Liberty accepts in lieu of notarisation for replacement-cost releases.

⚠ Security · this document carries reproduced signatures
When exporting to PDF for transmission to Liberty, set a PDF password in the Save dialog (macOS Preview: Show Details → Security Options → Require password to open). Share the password with Liberty by a separate channel (phone call to your handler) — never embed the password in the same email as the PDF. Treat this artefact like a signed cheque.
Claim 046414618-01 / 046414618-02 · Item #08 Affidavit · sheet 1 of 2

AFFIDAVIT OF PURCHASE

Replacement-cost coverage · personal property contents
Commonwealth of Pennsylvania
County of Bucks

We, DAN SELLARS and AUDREY LAM, being the named insureds under the policy referenced below, declare under penalty of perjury under the laws of the United States of America that the following is true and correct:

  1. We are the named insureds on Liberty Mutual Personal Insurance Company homeowners policy H3V-281-240408-75, claim number 046414618-01 / 046414618-02, on the insured property at 6279 GREENHILL RD, NEW HOPE, PA 18938-9646.
  2. The covered loss occurred on 2021-07-29 and is described in Liberty's records as: Storm/tree damage — tree fall with associated structural and electrical damage.
  3. Pre-loss inventory evidence — item destroyed in the covered event:DeWalt DCF889B 20V MAX Cordless Impact Wrench, 1/2-Inch (Tool Only), originally purchased from Amazon.com on 2020-05-03 for a total of $115.49 USD (order #113-8629730-6334642), 452 days before the loss event of 2021-07-29.
  4. On ________________ we purchased a DeWalt DCF889B 20V MAX Cordless 1/2-Inch Impact Wrench (Tool Only) — current production, same SKU for the sum of $129.00 USD from Amazon, as the like-kind functional replacement for the destroyed item(s) described above.
  5. Original = DeWalt DCF889B 20V MAX Cordless Impact Wrench (1/2-inch, tool-only). 2021 claim filing labeled this 'drill' loosely; the destroyed unit was the same SKU DCF889B impact wrench. Current production at $129 — same trade class (cordless impact wrench, 20V MAX platform). $14 variance from $115 claimed (12%, within tolerance; price drift since 2020-05 purchase).
  6. A paid receipt evidencing this purchase is attached to this affidavit as Exhibit A ([receipt filename — attach when finalised]).
  7. We make this declaration knowing that it will be relied upon by Liberty Mutual Personal Insurance Company in evaluating our claim and releasing the recoverable depreciation withhold associated with this line item.
Dan Sellars · named insured · 2026-05-22
Audrey Lam · named insured · 2026-05-22

Pursuant to 28 U.S.C. § 1746, we declare under penalty of perjury that the foregoing is true and correct. Executed at New Hope, Pennsylvania on the date(s) signed above.

Claim 046414618-01 / 046414618-02 · Item #08 Exhibit A · receipt · sheet 2 of 2
Attach paid receipt here Receipt PDF/image will be embedded here once captured via dropzone and synced.

Workflow: 1. Buy item from Amazon · 2. Save paid receipt PDF to 30-invoices/ · 3. Re-render this affidavit with --receipt <filename> · 4. Print packet (Cmd+P or button above) · 5. Both insureds sign sheet 1 · 6. Paperclip receipt to sheet 2 · 7. Mail to Taylor Guishard-Drummond at Liberty Mutual.

Item #12 · ladder · originally claimed $347.00
Liberty Mutual · purchase affidavit packet · v1

Item #12 · ladder

Print + sign (both insureds) + attach paid receipt + mail to claims address. 28 USC §1746 self-sworn declaration — no notary required for federal courts; Liberty accepts in lieu of notarisation for replacement-cost releases.

⚠ Security · this document carries reproduced signatures
When exporting to PDF for transmission to Liberty, set a PDF password in the Save dialog (macOS Preview: Show Details → Security Options → Require password to open). Share the password with Liberty by a separate channel (phone call to your handler) — never embed the password in the same email as the PDF. Treat this artefact like a signed cheque.
Claim 046414618-01 / 046414618-02 · Item #12 Affidavit · sheet 1 of 2

AFFIDAVIT OF PURCHASE

Replacement-cost coverage · personal property contents
Commonwealth of Pennsylvania
County of Bucks

We, DAN SELLARS and AUDREY LAM, being the named insureds under the policy referenced below, declare under penalty of perjury under the laws of the United States of America that the following is true and correct:

  1. We are the named insureds on Liberty Mutual Personal Insurance Company homeowners policy H3V-281-240408-75, claim number 046414618-01 / 046414618-02, on the insured property at 6279 GREENHILL RD, NEW HOPE, PA 18938-9646.
  2. The covered loss occurred on 2021-07-29 and is described in Liberty's records as: Storm/tree damage — tree fall with associated structural and electrical damage.
  3. Pre-loss inventory evidence — item destroyed in the covered event:Louisville Ladder L-3022-28PT Pro Top Fiberglass Extension Ladder, 300-Pound Capacity, 28-Foot, originally purchased from Amazon.com on 2016-09-11 for a total of $347.43 USD (order #108-4421973-2465002), delivered to the insured property on 2016-09-13, 1780 days before the loss event of 2021-07-29.
  4. Replacement of the destroyed item has not yet been completed. We will purchase a like-kind functional replacement and amend this affidavit accordingly, attaching the paid receipt as Exhibit A.
  5. A paid receipt evidencing this purchase is attached to this affidavit as Exhibit A ([receipt filename — attach when finalised]).
  6. We make this declaration knowing that it will be relied upon by Liberty Mutual Personal Insurance Company in evaluating our claim and releasing the recoverable depreciation withhold associated with this line item.
Dan Sellars · named insured · 2026-05-22
Audrey Lam · named insured · 2026-05-22

Pursuant to 28 U.S.C. § 1746, we declare under penalty of perjury that the foregoing is true and correct. Executed at New Hope, Pennsylvania on the date(s) signed above.

Claim 046414618-01 / 046414618-02 · Item #12 Exhibit A · receipt · sheet 2 of 2
Attach paid receipt here Receipt PDF/image will be embedded here once captured via dropzone and synced.

Workflow: 1. Buy item from ________________ · 2. Save paid receipt PDF to 30-invoices/ · 3. Re-render this affidavit with --receipt <filename> · 4. Print packet (Cmd+P or button above) · 5. Both insureds sign sheet 1 · 6. Paperclip receipt to sheet 2 · 7. Mail to Taylor Guishard-Drummond at Liberty Mutual.

Item #14 · pool cleaner · originally claimed $462.00
Liberty Mutual · purchase affidavit packet · v1

Item #14 · pool cleaner

Print + sign (both insureds) + attach paid receipt + mail to claims address. 28 USC §1746 self-sworn declaration — no notary required for federal courts; Liberty accepts in lieu of notarisation for replacement-cost releases.

⚠ Security · this document carries reproduced signatures
When exporting to PDF for transmission to Liberty, set a PDF password in the Save dialog (macOS Preview: Show Details → Security Options → Require password to open). Share the password with Liberty by a separate channel (phone call to your handler) — never embed the password in the same email as the PDF. Treat this artefact like a signed cheque.
Claim 046414618-01 / 046414618-02 · Item #14 Affidavit · sheet 1 of 2

AFFIDAVIT OF PURCHASE

Replacement-cost coverage · personal property contents
Commonwealth of Pennsylvania
County of Bucks

We, DAN SELLARS and AUDREY LAM, being the named insureds under the policy referenced below, declare under penalty of perjury under the laws of the United States of America that the following is true and correct:

  1. We are the named insureds on Liberty Mutual Personal Insurance Company homeowners policy H3V-281-240408-75, claim number 046414618-01 / 046414618-02, on the insured property at 6279 GREENHILL RD, NEW HOPE, PA 18938-9646.
  2. The covered loss occurred on 2021-07-29 and is described in Liberty's records as: Storm/tree damage — tree fall with associated structural and electrical damage.
  3. On 2026-05-22 we purchased a Aiper Scuba S1 Robotic Pool Cleaner (2026 Upgrade, Renewed) for the sum of $549.99 USD from Amazon, as the like-kind functional replacement for item #14 on the claim inventory (originally claimed at $462.00).
  4. Original = Polaris Vac-Sweep 280 (pressure-side pool cleaner with mesh bag, requires booster pump), purchased June 2019 from Amazon for $462.33 (Order 112-3762439-2328239). Polaris Vac-Sweep 280 is now discontinued and replacement parts are scarce. Replacement: Aiper Scuba S1 Robotic Pool Cleaner (Renewed, $549.99 unit / $551.19 grand total after $30 coupon + tax). Liberty's bar is like-kind functional equivalent — both automatically clean the pool's floor and walls of debris that has sunk. Technology gap (pressure-side → cordless robotic) is acknowledged but does not break like-kind: same function, same surface treated, same outcome. Replacement is a manufacturer-refurbished unit sold by Aiper Direct Renewed (Amazon authorised) — explicitly chosen below new-condition pricing to stay close to Liberty's approved amount. Household absorbs the upgrade premium ($89.19 above $462 approved amount) out-of-pocket.
  5. A paid receipt evidencing this purchase is attached to this affidavit as Exhibit A (2026-05-22-aiper-scuba-s1-pool-cleaner-replacement-114-9817850-2986664-551usd.png).
  6. We make this declaration knowing that it will be relied upon by Liberty Mutual Personal Insurance Company in evaluating our claim and releasing the recoverable depreciation withhold associated with this line item.
Dan Sellars · named insured · 2026-05-22
Audrey Lam · named insured · 2026-05-22

Pursuant to 28 U.S.C. § 1746, we declare under penalty of perjury that the foregoing is true and correct. Executed at New Hope, Pennsylvania on the date(s) signed above.

Claim 046414618-01 / 046414618-02 · Item #14 Exhibit A · receipt · sheet 2 of 2
2026-05-22-aiper-scuba-s1-pool-cleaner-replacement-114-9817850-2986664-551usd.png Receipt file: 2026-05-22-aiper-scuba-s1-pool-cleaner-replacement-114-9817850-2986664-551usd.png — paperclip the printed receipt to this sheet OR embed the PDF before printing.

Workflow: 1. Buy item from Amazon · 2. Save paid receipt PDF to 30-invoices/ · 3. Re-render this affidavit with --receipt <filename> · 4. Print packet (Cmd+P or button above) · 5. Both insureds sign sheet 1 · 6. Paperclip receipt to sheet 2 · 7. Mail to Taylor Guishard-Drummond at Liberty Mutual.

Item #15 · saw horse · originally claimed $135.00
Liberty Mutual · purchase affidavit packet · v1

Item #15 · saw horse

Print + sign (both insureds) + attach paid receipt + mail to claims address. 28 USC §1746 self-sworn declaration — no notary required for federal courts; Liberty accepts in lieu of notarisation for replacement-cost releases.

⚠ Security · this document carries reproduced signatures
When exporting to PDF for transmission to Liberty, set a PDF password in the Save dialog (macOS Preview: Show Details → Security Options → Require password to open). Share the password with Liberty by a separate channel (phone call to your handler) — never embed the password in the same email as the PDF. Treat this artefact like a signed cheque.
Claim 046414618-01 / 046414618-02 · Item #15 Affidavit · sheet 1 of 2

AFFIDAVIT OF PURCHASE

Replacement-cost coverage · personal property contents
Commonwealth of Pennsylvania
County of Bucks

We, DAN SELLARS and AUDREY LAM, being the named insureds under the policy referenced below, declare under penalty of perjury under the laws of the United States of America that the following is true and correct:

  1. We are the named insureds on Liberty Mutual Personal Insurance Company homeowners policy H3V-281-240408-75, claim number 046414618-01 / 046414618-02, on the insured property at 6279 GREENHILL RD, NEW HOPE, PA 18938-9646.
  2. The covered loss occurred on 2021-07-29 and is described in Liberty's records as: Storm/tree damage — tree fall with associated structural and electrical damage.
  3. Pre-loss inventory evidence — item destroyed in the covered event:Logosol Smart-Holder Saw Horse, Folding Wood Holder, originally purchased from Amazon.com on 2020-05-15 for a total of $135.68 USD (order #114-9466821-2949066), delivered to the insured property on 2020-05-20, 435 days before the loss event of 2021-07-29.
  4. Replacement of the destroyed item has not yet been completed. We will purchase a like-kind functional replacement and amend this affidavit accordingly, attaching the paid receipt as Exhibit A.
  5. A paid receipt evidencing this purchase is attached to this affidavit as Exhibit A ([receipt filename — attach when finalised]).
  6. We make this declaration knowing that it will be relied upon by Liberty Mutual Personal Insurance Company in evaluating our claim and releasing the recoverable depreciation withhold associated with this line item.
Dan Sellars · named insured · 2026-05-22
Audrey Lam · named insured · 2026-05-22

Pursuant to 28 U.S.C. § 1746, we declare under penalty of perjury that the foregoing is true and correct. Executed at New Hope, Pennsylvania on the date(s) signed above.

Claim 046414618-01 / 046414618-02 · Item #15 Exhibit A · receipt · sheet 2 of 2
Attach paid receipt here Receipt PDF/image will be embedded here once captured via dropzone and synced.

Workflow: 1. Buy item from ________________ · 2. Save paid receipt PDF to 30-invoices/ · 3. Re-render this affidavit with --receipt <filename> · 4. Print packet (Cmd+P or button above) · 5. Both insureds sign sheet 1 · 6. Paperclip receipt to sheet 2 · 7. Mail to Taylor Guishard-Drummond at Liberty Mutual.

Item #17 · sprayer · originally claimed $53.00
Liberty Mutual · purchase affidavit packet · v1

Item #17 · sprayer

Print + sign (both insureds) + attach paid receipt + mail to claims address. 28 USC §1746 self-sworn declaration — no notary required for federal courts; Liberty accepts in lieu of notarisation for replacement-cost releases.

⚠ Security · this document carries reproduced signatures
When exporting to PDF for transmission to Liberty, set a PDF password in the Save dialog (macOS Preview: Show Details → Security Options → Require password to open). Share the password with Liberty by a separate channel (phone call to your handler) — never embed the password in the same email as the PDF. Treat this artefact like a signed cheque.
Claim 046414618-01 / 046414618-02 · Item #17 Affidavit · sheet 1 of 2

AFFIDAVIT OF PURCHASE

Replacement-cost coverage · personal property contents
Commonwealth of Pennsylvania
County of Bucks

We, DAN SELLARS and AUDREY LAM, being the named insureds under the policy referenced below, declare under penalty of perjury under the laws of the United States of America that the following is true and correct:

  1. We are the named insureds on Liberty Mutual Personal Insurance Company homeowners policy H3V-281-240408-75, claim number 046414618-01 / 046414618-02, on the insured property at 6279 GREENHILL RD, NEW HOPE, PA 18938-9646.
  2. The covered loss occurred on 2021-07-29 and is described in Liberty's records as: Storm/tree damage — tree fall with associated structural and electrical damage.
  3. Pre-loss inventory evidence — item destroyed in the covered event:Chapin International SureSpray 20020 (2-Gallon, Yellow/Black, pump-pressure handheld sprayer), originally purchased from Amazon.com on 2021-07-24 for a total of $72.98 USD (order #114-2862474-8819432), delivered to the insured property on 2021-07-27, 2 days before the loss event of 2021-07-29.
  4. On ________________ we purchased a Chapin 21220XP 2-gallon Tri-Poxy steel pump sprayer for the sum of $55.00 USD from Amazon, as the like-kind functional replacement for the destroyed item(s) described above.
  5. Original (per pre-loss Amazon order #114-2862474-8819432): 2× Chapin International SureSpray 20020 2-gallon Yellow/Black pump-pressure sprayers, delivered to property 2 days before loss. Same brand family (Chapin), same capacity (2-gallon), same trade class (residential pump sprayer). Replacement target Chapin 21220XP 2-gallon Tri-Poxy steel pump sprayer is the manufacturer's current equivalent of the 20020. Like-for-like brand, like-for-like 2-gallon class, model upgrade from 20020 → 21220XP (steel construction = durability improvement at zero cost premium). Zero variance to defend.
  6. A paid receipt evidencing this purchase is attached to this affidavit as Exhibit A ([receipt filename — attach when finalised]).
  7. We make this declaration knowing that it will be relied upon by Liberty Mutual Personal Insurance Company in evaluating our claim and releasing the recoverable depreciation withhold associated with this line item.
Dan Sellars · named insured · 2026-05-22
Audrey Lam · named insured · 2026-05-22

Pursuant to 28 U.S.C. § 1746, we declare under penalty of perjury that the foregoing is true and correct. Executed at New Hope, Pennsylvania on the date(s) signed above.

Claim 046414618-01 / 046414618-02 · Item #17 Exhibit A · receipt · sheet 2 of 2
Attach paid receipt here Receipt PDF/image will be embedded here once captured via dropzone and synced.

Workflow: 1. Buy item from Amazon · 2. Save paid receipt PDF to 30-invoices/ · 3. Re-render this affidavit with --receipt <filename> · 4. Print packet (Cmd+P or button above) · 5. Both insureds sign sheet 1 · 6. Paperclip receipt to sheet 2 · 7. Mail to Taylor Guishard-Drummond at Liberty Mutual.

Item #18 · toilet · originally claimed $519.00
Liberty Mutual · purchase affidavit packet · v1

Item #18 · toilet

Print + sign (both insureds) + attach paid receipt + mail to claims address. 28 USC §1746 self-sworn declaration — no notary required for federal courts; Liberty accepts in lieu of notarisation for replacement-cost releases.

⚠ Security · this document carries reproduced signatures
When exporting to PDF for transmission to Liberty, set a PDF password in the Save dialog (macOS Preview: Show Details → Security Options → Require password to open). Share the password with Liberty by a separate channel (phone call to your handler) — never embed the password in the same email as the PDF. Treat this artefact like a signed cheque.
Claim 046414618-01 / 046414618-02 · Item #18 Affidavit · sheet 1 of 2

AFFIDAVIT OF PURCHASE

Replacement-cost coverage · personal property contents
Commonwealth of Pennsylvania
County of Bucks

We, DAN SELLARS and AUDREY LAM, being the named insureds under the policy referenced below, declare under penalty of perjury under the laws of the United States of America that the following is true and correct:

  1. We are the named insureds on Liberty Mutual Personal Insurance Company homeowners policy H3V-281-240408-75, claim number 046414618-01 / 046414618-02, on the insured property at 6279 GREENHILL RD, NEW HOPE, PA 18938-9646.
  2. The covered loss occurred on 2021-07-29 and is described in Liberty's records as: Storm/tree damage — tree fall with associated structural and electrical damage.
  3. Replacement of the destroyed item has not yet been completed. We will purchase a like-kind functional replacement and amend this affidavit accordingly, attaching the paid receipt as Exhibit A.
  4. Original = Porcher 1 Champion One-Piece Elongated Toilet (model 97420), a premium designer European-style fixture purchased March 2006 from homeclick.com for $519.35. Destroyed in 2021-07-29 shed collapse. Porcher's American Standard line is now discontinued under the same model number, so exact like-for-like replacement is not market-available. Replacement: EPLO iX7-PRO Smart Toilet (ASIN B0D83KVTBW) — same like-kind function (elongated one-piece toilet) with modern feature additions (heated seat, bidet, auto open/close, instant warm water, integrated dryer). Liberty's approved $519.00 covers the like-kind replacement amount; the household absorbs the upgrade premium above $519 out-of-pocket. Variance is documented and within Liberty's like-kind functional equivalence standard per the variance-defence framework.
  5. A paid receipt evidencing this purchase is attached to this affidavit as Exhibit A ([receipt filename — attach when finalised]).
  6. We make this declaration knowing that it will be relied upon by Liberty Mutual Personal Insurance Company in evaluating our claim and releasing the recoverable depreciation withhold associated with this line item.
Dan Sellars · named insured · 2026-05-22
Audrey Lam · named insured · 2026-05-22

Pursuant to 28 U.S.C. § 1746, we declare under penalty of perjury that the foregoing is true and correct. Executed at New Hope, Pennsylvania on the date(s) signed above.

Claim 046414618-01 / 046414618-02 · Item #18 Exhibit A · receipt · sheet 2 of 2
Attach paid receipt here Receipt PDF/image will be embedded here once captured via dropzone and synced.

Workflow: 1. Buy item from Amazon · 2. Save paid receipt PDF to 30-invoices/ · 3. Re-render this affidavit with --receipt <filename> · 4. Print packet (Cmd+P or button above) · 5. Both insureds sign sheet 1 · 6. Paperclip receipt to sheet 2 · 7. Mail to Taylor Guishard-Drummond at Liberty Mutual.

Item #21 · tazz chipper shredder · originally claimed $636.00
Liberty Mutual · purchase affidavit packet · v1

Item #21 · tazz chipper shredder

Print + sign (both insureds) + attach paid receipt + mail to claims address. 28 USC §1746 self-sworn declaration — no notary required for federal courts; Liberty accepts in lieu of notarisation for replacement-cost releases.

⚠ Security · this document carries reproduced signatures
When exporting to PDF for transmission to Liberty, set a PDF password in the Save dialog (macOS Preview: Show Details → Security Options → Require password to open). Share the password with Liberty by a separate channel (phone call to your handler) — never embed the password in the same email as the PDF. Treat this artefact like a signed cheque.
Claim 046414618-01 / 046414618-02 · Item #21 Affidavit · sheet 1 of 2

AFFIDAVIT OF PURCHASE

Replacement-cost coverage · personal property contents
Commonwealth of Pennsylvania
County of Bucks

We, DAN SELLARS and AUDREY LAM, being the named insureds under the policy referenced below, declare under penalty of perjury under the laws of the United States of America that the following is true and correct:

  1. We are the named insureds on Liberty Mutual Personal Insurance Company homeowners policy H3V-281-240408-75, claim number 046414618-01 / 046414618-02, on the insured property at 6279 GREENHILL RD, NEW HOPE, PA 18938-9646.
  2. The covered loss occurred on 2021-07-29 and is described in Liberty's records as: Storm/tree damage — tree fall with associated structural and electrical damage.
  3. Pre-loss inventory evidence — item destroyed in the covered event:Tazz (Ardisam) K32 Chipper Shredder with 212cc Viper Engine, originally purchased from Amazon.com on 2016-11-20 for a total of $635.99 USD (order #002-3407855-1183461), delivered to the insured property on 2016-11-21, 1711 days before the loss event of 2021-07-29.
  4. On ________________ we engaged ________________ (pending — currently at the shop) to repair the destroyed item for the sum of $____________ USD, restoring it to working condition. A paid repair invoice is attached as Exhibit A. Repair was elected in lieu of full replacement as the lower-cost path to functional restoration; per Liberty's settlement-email language of 2026-01-13 ("if you spend less than estimated for the items replacement, we will release the recoverable depreciation payment up to the amount you spent"), the recoverable depreciation for this line is hereby requested up to the actual repair cost.
  5. A paid receipt evidencing this purchase is attached to this affidavit as Exhibit A ([receipt filename — attach when finalised]).
  6. We make this declaration knowing that it will be relied upon by Liberty Mutual Personal Insurance Company in evaluating our claim and releasing the recoverable depreciation withhold associated with this line item.
Dan Sellars · named insured · 2026-05-22
Audrey Lam · named insured · 2026-05-22

Pursuant to 28 U.S.C. § 1746, we declare under penalty of perjury that the foregoing is true and correct. Executed at New Hope, Pennsylvania on the date(s) signed above.

Claim 046414618-01 / 046414618-02 · Item #21 Exhibit A · receipt · sheet 2 of 2
Attach paid receipt here Receipt PDF/image will be embedded here once captured via dropzone and synced.

Workflow: 1. Buy item from ________________ · 2. Save paid receipt PDF to 30-invoices/ · 3. Re-render this affidavit with --receipt <filename> · 4. Print packet (Cmd+P or button above) · 5. Both insureds sign sheet 1 · 6. Paperclip receipt to sheet 2 · 7. Mail to Taylor Guishard-Drummond at Liberty Mutual.

Item #22 · worx · originally claimed $164.00
Liberty Mutual · purchase affidavit packet · v1

Item #22 · worx

Print + sign (both insureds) + attach paid receipt + mail to claims address. 28 USC §1746 self-sworn declaration — no notary required for federal courts; Liberty accepts in lieu of notarisation for replacement-cost releases.

⚠ Security · this document carries reproduced signatures
When exporting to PDF for transmission to Liberty, set a PDF password in the Save dialog (macOS Preview: Show Details → Security Options → Require password to open). Share the password with Liberty by a separate channel (phone call to your handler) — never embed the password in the same email as the PDF. Treat this artefact like a signed cheque.
Claim 046414618-01 / 046414618-02 · Item #22 Affidavit · sheet 1 of 2

AFFIDAVIT OF PURCHASE

Replacement-cost coverage · personal property contents
Commonwealth of Pennsylvania
County of Bucks

We, DAN SELLARS and AUDREY LAM, being the named insureds under the policy referenced below, declare under penalty of perjury under the laws of the United States of America that the following is true and correct:

  1. We are the named insureds on Liberty Mutual Personal Insurance Company homeowners policy H3V-281-240408-75, claim number 046414618-01 / 046414618-02, on the insured property at 6279 GREENHILL RD, NEW HOPE, PA 18938-9646.
  2. The covered loss occurred on 2021-07-29 and is described in Liberty's records as: Storm/tree damage — tree fall with associated structural and electrical damage.
  3. Pre-loss inventory evidence — item destroyed in the covered event:WORX WG430 13 Amp Foldable Bladeless Electric Leaf Mulcher, Red, originally purchased from Amazon.com on 2020-11-17 for a total of $164.29 USD (order #112-6191308-0110607), 254 days before the loss event of 2021-07-29.
  4. Replacement of the destroyed item has not yet been completed. We will purchase a like-kind functional replacement and amend this affidavit accordingly, attaching the paid receipt as Exhibit A.
  5. A paid receipt evidencing this purchase is attached to this affidavit as Exhibit A ([receipt filename — attach when finalised]).
  6. We make this declaration knowing that it will be relied upon by Liberty Mutual Personal Insurance Company in evaluating our claim and releasing the recoverable depreciation withhold associated with this line item.
Dan Sellars · named insured · 2026-05-22
Audrey Lam · named insured · 2026-05-22

Pursuant to 28 U.S.C. § 1746, we declare under penalty of perjury that the foregoing is true and correct. Executed at New Hope, Pennsylvania on the date(s) signed above.

Claim 046414618-01 / 046414618-02 · Item #22 Exhibit A · receipt · sheet 2 of 2
Attach paid receipt here Receipt PDF/image will be embedded here once captured via dropzone and synced.