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25 EAST COLLIN STREET - CLAIM NOTICE 1�r4.LJ I;yl National General Auto,Home&Health Insurance PO Box 1623•Winston-Salem,NC 27102-1623 0 March 22 2021 INSPECTOR OF BUILDINGS -SALEM 93 WASHINGTON ST BLD: CITY HALL SALEM, MA 01970 RE: Claim Number: 210117514 Date of Loss: August 15,2020 Named Insured: Ronald Beaudoin Policy Number: 2003764317 Loss Property: 25 E Collins St Salem MA 01970 To whom it may concern, A claim has been made involving loss,damage or destruction of the above-captioned property,which may either exceed$1000 or cause Massachusetts General Laws,Chapter 143,Section 6 to be applicable.This statute addresses structures that are"unused,uninhabited or abandoned"and may be dangerous to the community. If any notice under Massachusetts General Laws, Chapter 139,Section 313 regarding the disbursement of insurance proceeds for loss, damage or destruction of building or structure, is appropriate, please direct it to me. Patrick Davis Homeowners Field Rep On behalf of Integon National Insurance Company PO BOX 1623 Winston Salem, NC 27102-1623 Direct(617)729-4265•Toll Free(800)468-3466• Fax(800)924-0273 APR 6„;O-0 If you are emailing me a claim-specific communication, please send it to CLAIMS@NGIC.COM with the claim number in thpip, ject line.Thank you. 1 157623363-MA-01/20/2016