193-195 LAFAYETTE STREET UNIT 6 - CLAIM NOTICE ® The Commerce Insurance Companysm
MAPFRE Citation Insurance Company1m
INSURANCE 11 Gore Road,Webster,Massachusetts01570
508.949.1500 1 www.mapfreinsurance.com
April 16, 2021
BUILDING COMMISSIONER or Board of Health or
INSPECTOR OF BUILDINGS Board of Selectmen
TOWN/CITY HALL Town/City Hall
SALEM MA 01970
RE: Our Insured: STEPHEN A GOMES
Property Address: 195 LAFAYETTE ST UNIT 6
Policy#: BCCYGJ
Date of Loss: 04/01/2021
File#: TXVJ25-RXPPXI
Claim has been made involving loss, damage, or destruction of the above captioned
property which may 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 3B is appropriate,
please direct it to my attention. Please reference the above captioned insured, location,
policy number, date of loss, and file number on any correspondence.
LINDA BORGESON-HAMPTON Telephone: (508)949-1500 Ext: 76717
CLAIM REP SR,PROPERTY Toll Free: 1-800-221-1605,Ext:76717
On this date, I cause copies of this notice to be sent to the persons indicated above, at the
address above,by first class mail.
April 16, 2021
CIC 254 (Rev.4/95) MAIL LB 1