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9 Fortune Way_ Claim Notice 9.02.22 TRAVELERS I' 269 THE TRAVELERS HOME AND MARINE INSURANCE COMPANY P.O. Box 430 Buffalo, NY 14240-0430 09/15/2022 City of Salem Building Inspector 120 Washington Street Salem MA 01970 Insured: Carol Barry Claim Number: IMV2061 Policy Number: OCTC80-610886337-636-1 Date of Loss: 09/02/2022 Loss Location: 9 Fortune Way Salem MA To: Board of Selectmen 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 General Laws Chanter 143, Section 6 to be applicable. If any notice under Massachusetts General Laws Chapter 139, Section 3B is appropriate, please direct it to my attention and include a reference to our insured, the policy number, the claim/file number, the date of loss, and the location. If you have any questions, please feel free to contact me at (774)527-0251 or email me at MPHAN@travelers.com. Sincerely, My Phan Claim Professional (774)527-0251 Ext. 7745270251 Fax: (877)786-5584 Email: MPHAN@travelers.com 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 sp P0062 F3162C1S22259000269 00001 N