10 Aviva Way, Markham, Ontario L6G 0G1 Toll free phone: 1 (866) 692-8482 Toll free Fax: 1 (866) 805-8585 December 8, 2025 GRETER GONZALEZ DIAZ 402-120 ST PAUL AVE BRANTFORD, Ontario N3T 4G2 Re: Policy Number: A97474794PLA Legal Entity: Aviva Insurance Company of Canada Insured Name: GRETER GONZALEZ DIAZ Claim Number: 36047401 Date of Loss: December 6, 2025 Claimant Name: GRETER GONZALEZ DIAZ Dear GRETER GONZALEZ DIAZ, We are writing this letter to confirm our telephone conversation with you on December 6th, 2025. We understand that you do not wish to proceed with the above-mentioned claim at this time. Please note this is a 100% at fault loss. We will be closing our file accordingly with no indemnity payment. Please be advised that you have until December 6th, 2026 to pursue your claim. After such time, your right to claim is Statute Barred. In accordance with the Insurance Act of Ontario, we enclose a blank Proof of Loss form. We are not requesting you complete the document or return it at this time. Should you have any further questions, please do not hesitate to contact the writer. Sincerely, William Le, Auto Claims Advisor, Aviva Insurance Company of Canada Phone: (866) 692-8482 x30882 E-mail: william.le@aviva.com Private & Confidential / Privé et Confidentiel Page 1 of 2 Proof of Loss - Automobile Insurance This form is provided to comply with the Insurance Act, and without prejudice to the liability of the Insurer. Insurance Company Claim Number Policy Number Insured name and address Vehicle Make and model Year Serial number Date purchased Place Price Loss or damage Date Time Location Cause of loss or damage Reported to police on at Amount of damages Deductible Total amount claimed Goods and services tax/Harmonized sales tax Is the insured registered for GST/HST? Yes No If the answer is yes, please state: Registration number Percent recoverable I, the undersigned, declare that: A. the insured is the actual owner of the insured vehicle which is registered in the insured name; B. during the term of the policy, there has been no other insurance, valid or invalid, on the vehicle, and no person, firm, or corporation, other than the insured has any interest therein, and there is no lien, chattel mortgage, or conditional sales agreement thereon, except: (Please indicate if applicable) C. the loss or damage did not occur through any willful act or neglect, procurement, or connivance of the insured or this declarant, neither is there included in this claim any amount for anything which was not lost or damaged and owned by the insured at the time of the occurrence. Payment of this claim to (Loss payable to) is hereby authorized and in consideration of such payment, the insurer is discharged forever from all further claim by reason of the said loss or damage. All rights to recovery from any other person are hereby transferred to the insurer which is authorized to bring the action in the insured name to enforce such rights. All right, title and interest in the vehicle or any part or equipment thereof is hereby transferred to the insurer only in the event that this claim is based upon the whole value of the vehicle because it has been lost, destroyed or damaged beyond economical repair and the insured agrees immediately to notify the insurer in the event of its recovery. I, the undersigned, (Please print name) do solemnly declare that the foregoing claim and statements are to the best of my knowledge and belief true in every particular, and I make this solemn declaration conscientiously believing it to be true and knowing that it is of the same force and effect as if made under oath. DECLARED severally before me at on Witness Insured Commissioner of Oaths or Affidavits Insured Private & Confidential / Privé et Confidentiel Page 2 of 2