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11 CHURCH STREET UNIT G14 - CLAIM NOTICE TRAVELERS JR 531 THE STANDARD FIRE INSURANCE COMPANY P.O. Box 430 Buffalo, NY 14240-0430 09/02/2021 City of Salem Building Inspector Department 120 Washington Street Salem MA 01970 Insured: Georgia Flamburis Claim Number: IAW6112 Policy Number: OTE630-601519983-636 -1 Date of Loss: 08/19/2021 Loss Location: 11 Church St Unit G-14 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. 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 EP 9 Hm8: 7 SJ& P0062 F3162C1S21246000531 00001 N