06D-106-060821-Redacted — File 212592

ELIZABETH A. FLEMING ATTORNEY AT LAW P.O. BOX 440132 SOMERVILLE, MA 02144 Federal Tax ID#: 04-3479081 Hourly rate: $140.00 Contract #: 190010 / PO #: 20210322 Acct#: 0191052-530010 / Vendor#: 15314 Remit #1 EE: ER: City of Somerville IR: City of Somerville DOI: 05-23-2018 DIA#: 014434-18 EAF#: 06D-106 Claim #: 2018-0523-ADB Invoice #: 06D-106-060821 Services rendered from 03-09-2021 through 06-08-2021 03-09-2021 Correspondence with Atty Kantrovitz re report due 03-10-2021 with Conciliator; request signed proposed Sec 19 Agreement .10 hours 14.00 TCs with Atty Kantrovitz re status of WC claim and 3rd party claim .20 hours 28.00 Received and reviewed EE’s Form109, Withdrawal of claim .10 hours 14.00 Received and reviewed medical records and HCFA forms .30 hours 42.00 Correspondence with Atty Kantrovitz re above .10 hours 14.00 03-10-2021 Correspondence with Atty Kantrovitz re payment on medicals to be added to WC lien .10 hours 14.00

EE: ER: City of Somerville 03-10-2021 Correspondence with Conciliator Lydon re scheduled Conciliation and withdrawal of EE’s claim .10 hours 14.00 Correspondence with Claims Manager re above; attached medical records/HCFA forms; payment to be made .10 hours 14.00 03-17-2021 Correspondence with Claims Manager re total amount of additional bills for WC lien; processing payment .10 hours 14.00 04-01-2021 TCs with Atty Kantroviz re status of 3rd party claim/settlement .30 hours 42.00 Correspondence with Atty Kantrovitz with ourline of 3rd party settlement offer and breakdown of distribution monies .20 hours 28.00 Correspondence with Claims Manager re above; breakdown of WC lien and settlement apportionment .20 hours 28.00 04-07-2021 Correspondence with Atty Kantrovitz re status of SI’s WC lien proposed release .10 hours 14.00 TCs with Claims Manager re WC lien apportionment with net to SI .30 hours 42.00 Correspondence with Atty Kantrovitz re above .10 hours 14.00 04-08-2021 Received and reviewed draft proposed Section 15 Petition .30 hours 42.00 Brief review of file .30 hours 42.00

EE: ER: City of Somerville 04-09-2021 Correspondence with Atty Kantrovitz re draft proposed Section 15 Petition .10 hours 14.00 05-04-2021 Received and reviewed signed proposed Section 15 Petition .30 hours 42.00 Edited/revised portions of proposed Section 15 Petition .10 hours 14.00 Correspondence with Atty Kantrovitz re above .10 hours 14.00 05-06-2021 Received and reviewed revised/edited proposed Section 15 Petition .20 hours 28.00 Brief review of file .20 hours 28.00 Executed proposed Section 15 Petition with correspondence with Atty Kantrovitz .10 hours 14.00 05-13-2021 Received and reviewed rejected proposed Sec 15 Petition and correspondence from Atty Kantrovitz re issues .10 hours 14.00 TCs with Atty Kantrovitz re above .20 hours 28.00 TCs with Claims Manager re above .10 hours 14.00 Received and reviewed amended proposed Sec 15 Petition; executed said amended Sec 15 Petition .10 hours 14.00 Correspondence with ALJ Fabricant and Atty Kantrovitz with attached amended Section 15 Petition .10 hours 14.00 05-19-2021 Received and reviewed approved Section 15 Petition .10 hours 14.00

EE: ER: City of Somerville 05-19-2021 Correspondence with Claims Manager re above with attached approved Section 15 Petition .10 hours 14.00 06-08-2021 Received and reviewed check in the amount of WC lien .10 hours 14.00 Correspondence with Claims Manager re above with attached check in satisfaction of WC lien .30 hours 42.00 Total file hours @ $140.00/hour 5.30 hours 742.00 TOTAL AMOUNT DUE $742.00