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118 WASHINGTON STREET - CLAIM NOTICE Ad4K TRAVELERS J 381 TRAVELERS CASUALTY INSURANCE COMPANY OF AMERICA P.O. Box 430 Buffalo, NY 14240-0430 12/21/2021 City of Salem Building Inspector Department 120 Washington Street Salem MA 01970 Insured: Fspc Claim Number: FLP9922 Policy Number: 680 -9J507647 Date of Loss: 11/06/2021 Loss Location: 118 Washington St 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 313 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 (508)209-7901 or email me at IHERZIG@travelers.com. Sincerely, Claim Professional (508)209-7901 Ext. 5082097901 Fax: (877)786-5584 Email: [HERZIG@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 AN 4 ,r...l 3 P0062 F3162C1S21356000381 00001 N