40 First St & 45 Traders Way_ Claim Notice 8.19.22 TRAVELERSJ� CLAIM PROFESSIONAL
City of Salem Building Inspector
120 Washington Street
Salem, MA 01970
Claim Number
FQP4539
December 30,2022
Dear City of Salem Building Inspector, Date of loss
To: Board of Selectmen August 19,2022
Building Commissioner
Inspector of Buildings
Board of Health
A claim has been made involving loss,damage or destruction of the above
captioned property which may either exceed$1,000 or cause Massachusetts I Loss location
General Laws Chapter 143,Section 6 to be applicable.If any notice under
Massachusetts General Laws Chapter139 Section 3B is appropriate,please direct 40 FIRST ST/45 TRADERS WA
it to 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.
Questions? Insured name: THE DOLBEN
COMPANY,INC.
Underwriting THE PHOENIX
If you have any questions,please contact us. Company: INSURANCE
On this date,I caused copies of this notice to be sent to the persons named above COMPANY
at the addresses indicated above by first class mail.
Signature Date
JAN
1'� 6'A
P00627121
19
C0107 000099 M197 CGUCT01 MM