5 C FILLMORE RD_1.16.24_CLAIM •r:
TRAVELERS
CLAIM PROFESSIONAL
City of Salem
Building Inspector
120 Washington Street
Salem, MA 01970
Claim Number
IXE2552
January 17,2024
Dear City of Salem, Date of loss
To: Board of Selectmen January 16,2024
Building Commissioner
Inspector of Buildings
Board of Health
A claim has been made involving loss,damage or destruction of the above O —\
captioned property which may either exceed$1,000 or cause Massachusetts Loss location
General Laws Chapter 143 Section 6 to be applicable.If any notice under 5C FILLMORE RD
Massachusetts General Laws Chapter 139 Section 36 is appropriate,please direct
itto my attention and include a reference to our insured,the policy number,the SALEM MA 01970
claim/file number,the date of loss,and the location.
Insured name:
Questions? Underwriting TRAVELERS
Company: PERSONAL
If you have any questions,please contact us. INSURANCE
COMPANY
On this date,I caused copies of this notice to be sent to the persons named above
at the addresses indicated above by first class mail.
Signature Date
P00627/21