INS CLAIM LOSS LTR 12/05/2019 The Commerce Insurance Companys"'
MAPFRE Citation Insurance Company
11 Gore Road,Webster,Massachusetts 01570
INSURANCE 508.949.15001www.mapfreinsurance.com
April 15, 2020
BUILDING COMMISSIONER or Board of Health or
INSPECTOR OF BUILDINGS Board of Selectmen
TOWN/CITY HALL Town/City Hall
SALEM MA 01970-2859
RE: Our Insured: ANN MARIE ROBERTS
Property Address: 6 CASTLE RD
Policy#: P36958
Date of Loss: 12/05/2019
File#: TAKM54-PYNJK3
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.
DANIEL WISNIEWSKI Telephone: (508)949-1500 Ext: 15312
Claim Specialist, Property Toll Free: 1-800-221-1605,Ext: 15312
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.
April 15, 2020
CIC 254 (Rev.4/95) MAIL L54