INS LOSS CLAIM @ 11 LINDEN AVENUE C The Commerce Insurance Company"
MAPFRE Citation Insurance Company"'
NSl!RAN CE 1 1 Gore Road,Webster,Massachusetts 01570
508.949.1500 1 www.mapfreinsurance.com
August 23, 2019
BUILDING COMMISSIONER or Board of Health or
INSPECTOR OF BUILDINGS Board of Selectmen
TOWN/CITY HALL Town/City Hall
SALEM MA 01970
T)r11 Our Insured: e�iMi '-�ir.SHI ,V
1\L. - _- -_- - --- --
Property Address: 11 LINDEN AVE
Policy#: BHXMWZ
Date of Loss: 08/12/2019
File#: RVRT79-PTMMXO
Claim has been made involving loss, damage, or destruction of the above captioned
property which may exceed $1,000, or cause Massachusetts General Laws, Chapter 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. Please reference the above captioned insured, location,
policy number, date of loss, and file number on any correspondence.
MARIA RIVAS Telephone: (508)949-1500 Ext: 15057
Sr Claim Representative, Property Toll Free: 1-800-221-1605, Ext: 15057
On this date; I cause copies of this notice to be sent to the persons indicated above, at the
address above,by first class mail.
August 23, 2019
CIC 254 (Rev.4/95) MAIL Z55