43 ENDICOTT ST_12.15.23_ CLAIM `000026•
American States Insurance Company
P.O. Box5014 • 'CO Insurance,.
Scranton PA 18505-5014
A Liberty Mutual Company
CONTACT US
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Town of Salem Nicholas.Pabich@LibertyMutual.
93 Washington St com
va Salem, MA, 01970-3527 Direct: (800) 225-2467
Fax: (888) 268-8840
American States Insurance
Company
P.O. Box 5014
Scranton PA 18505-5014
United States
(800) 332-3226
December 28, 2023
Safeco.com
ATTN
Insured: DAVID BARIBEAULT
Policy Number: OK6247368
Claim Number: 055615201-01
Date of Loss: 12/15/2023
Loss Location: 43 ENDICOTT ST, SALEM, MA 01970-3050
To Whom It May Concern,
Pursuant to M.G.L. c. 139, §313, please be aware that a homeowners insurance claim has been made
involving loss, damage or destruction of the above captioned property, which may either exceed
$1,000.00 or causes the condition of a building or other structure to render Mass. General Laws, Ch. 143,
§ 6 applicable. You are required to notify Safeco by certified mail in accordance with Mass. General Laws
Ch. 175, §99, if you intend to initiate proceedings designed to perfect a lien pursuant to Mass. General
Laws, Ch. 139, §3A&B, or Mass. General Laws, Ch. 143, § 9, or Mass. General Laws, Ch. 111, § 127B.
N
o This letter should not be construed as a waiver or estoppel of any of the terms, conditions or defenses
afforded by the policy or applicable law. Please direct your notice to the attention of the undersigned and
include a reference to the above captioned property address, policy number, claim number, and date of
S loss. If you have any questions or concerns, please feel free to contact me, either by phone or by email.
S When contacting me by email, please include the claim number in the subject line.
0
0
g Sincerely,
NICHOLAS PABICH
Safeco Claims
MAL2020A Massachusetts Property Lien Letter 055615201-01 Page 1 of 1