193-195 LAFAYETTE STREET - CLAIM NOTICE .. Ik.
TRAVELERS J 331
The Standard Fire Insurance Company
P.O. Box 430 _
Buffalo, NY 14240-0430
04/05/2021
Town of Salem Building Inspector
120 Washington St
Salem MA 01970
Insured: John Henkelman
Claim Number: IAW3782
Policy Number: 002897-994070385-636 -1
Date of Loss: 04/01/2021
Loss Location: 193-195 Lafayette St 4 Salem MA
To: Board of Selectmen
Building Commissioner
Inspector of Buildings APR AMS 45
Board of Health APR
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. 209-7901
Fax: (877)786-5584
Email: IHERZIG@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
P0062 F3162C1S21096000331 00001 N