11 JANUS LN_ CLAIM LOSS 8.24.23 ,w.
TRAVELERSJ
CLAIM PROFESSIONAL
CITY OF SALEM
BUILDING INSPECTOR
120 Washington St
Salem, MA 01970
Claim Number
IMV9337
August 28,2023
Dear CITY OF SALEM, Date of loss
To: Board of Selectmen August 24,2023
Building Commissioner
Inspector of Buildings
Board of Health m
A claim has been made involving loss,damage or destruction of the above
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
Massachusetts General Laws Chapter 139,Section 3B is appropriate,please direct 11 JANUS LN
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:
Underwriting THESTANDARD
Company: FIRE INSURANCE
If you have any questions,please contact us. 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
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P0062 7/21
86107 00.3661 007839 CGEFCT6t 23241