3 LAURENT ROAD UNIT 3 - CLAIM NOTICE United Service Adjustment, Inc.
P.O. Box 269
Framingham,MA 01704-0269
Phone: 1-888-633-4855 Fax: 1-508-879-7385
Building Commissioner/Inspector of Buildings
93 Washington Street
Salem, MA 01970
RE:
Insured(s):
DBA: The Laurent road Condominium Trust
Property Address: 3 Laurent Road, Unit 3
Salem, MA 01970
Company Policy Number: BOP0003622-16
Date of Loss: 9/5/2021
Company Claim Number: CLM55079
USA File Number: USA28638
Claim has been made involving loss, damage, or destruction of the above-captioned property,
which may either exceed $1,000.00 or cause Massachusetts General Laws, Chapter 143, Section 6,
to be applicable. If any notice under Massachusetts General Laws, Chapter 139, Sec 3B is
appropriate, please direct it to the attention of the writer and include reference to the captioned
insured, location,policy number, date of loss, and claim number.
On this date, I caused copies of this notice to be sent by first class mail to the municipal officials
named above at the address shown.
Adjuster: Chris Loeb
Date: 9/23/2021 SEP 27 Pm12° 5
SE