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INS LOSS LTR 10D RUSSELL DR 04/19/2021 4A. TRAVELERS J 426 The Travelers Indemnity Company P.O. Box 430 Buffalo, NY 14240-0430 04/27/2021 City of Salem Building Inspector 120 Washington St Salem MA 01970 Insured: Patrick J Regan Claim Number: IAW4050 Policy Number: 012166-975636876-636 -1 Date of Loss: 04/19/2021 Loss Location: 10D Russell Dr Salem MA. To: Board of Selectmen 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 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 and include a reference to our insured, the policy number, the claim/file number, the date of loss, and the location. If you have any questions, please feel free to contact me at (207)303-4895 or email me at TGULLIVE©travelers.com. Sincerely, Travis Gulliver Claim Professional (207)303-4895 Ext. 303-4895 Fax: (877)786-5584 Email: TGULLIVE©travelers.com 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 Y3F,M2_23 sk;-..�„u z P0062 F3162C1S21118000426 00001 N