22 HERSEY STREET_ DAMAGE CLAIM NOTICE 1-6-2025 Massachusetts Branch
jM CONCORD GROUP 1 Research Drive, Suite 301E I Westborough, MA
TT® INSURANCE 01581
4MEMREROFnfA m NERSINWR�NCEO - (p)800.422.5246 (f) 800.459.5659
January 9,2025
Town of Salem (City Hall)
Attn: Tax Collector
93 Washington Street
Salem,MA 01970
Insured: James Weener(Jim's Collision)
Loss Location:22 Hersey Street Salem,MA 019704519
Insurance Company: The Concord Group Ins. Companies
Policy No: 20035002
Date of Loss: 01/06/2025
Claim Number: 0030104289
Type of Loss: Property Damage
Dear Sir or Madam:
A claim has been made involving loss, damage,or destruction of the above captioned property,which
may either exceed $1,000.00 or cause"Mass. Gen. Laws, Chapter 143, Section 6"to be applicable. If any
notice under"Mass.Gen. Laws,Chapter 139, Section 3B"is appropriate, please direct it to the writer and
include a reference to the captioned insured,location,policy number,date of loss, and file or claim
number.
Claim has been made involving loss,damage or destruction of the above-captioned property,which
may exceed $1,000. If any notice under Massachusetts General Laws,Chapter 175,Section 97A is
appropriate, please direct it to the attention of this writer and include a reference to the above-
captioned insured,location,policy number, date of loss and claim number.
If you have any questions,please let me know.
Sincerely,
Marc Marquis,AIC
Property Adjuster