11 GREENLAWN AVENUE - CLAIM NOTICE ® The Commerce Insurance Companysm
MAPFRE Citation Insurance Companysm
INSURANCE" 11 Gore Road,Webster,Massachusetts 01570
508.949.15001 www.ma pfrei n s u ra nce.com
September 13, 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: JOSHUA GERRARD
Property Address: 11 GREENLAWN AVE
Policy#: BGKJXM
Date of Loss: 09/11/2021
File#: VAWH63-TATWY0
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.
MARINA JANCZYK Telephone: (508)949-1500 Ext: 15905
CLAIM REP II,PROPERTY Toll Free: 1-800-221-1605,Ext:15905
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.
September 13, 2021
SEP
CIC 254 (Rev.4/95) MAIL. MJ2