18 VALIANT WAY_ NOTICE OF LOSS 6-2-25 TRAVELERSJw
CLAIM PROFESSIONAL
City of Salem
Building Inspector
120 Washington Street
Salem, MA 01970 = —
Claim Number
IXE9729
June13,2025
Dear City of Salem, Date of loss
To: Board of Selectmen June 2,2025
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 Loss location
General Laws Chapter 143.Section 6 to be applicable.If any notice under 18 VALIANT WAY
Massachusetts General Laws Chapter 139 Section 36 is appropriate,please direct
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.
UeS�IOBs� Insured name: JOHANNE
Q COUGH LI N
Underwriting The Standard Fire
If you have any questions,please contact us. Company: Insurance
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
P00627121
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