12 Cabot Street- Claim Notice ICS INDEPENDENT
CLAIMS SERVICE, INC.
Service Integrity • Experience
Notice of Casualty Loss to Building
Under Massachusetts General Laws, Chapter 139, Section 3B
April 22, 2022
Salem, MA Building Inspector
1 Salem Green
Salem, MA 01970
Salem, MA Board of Health
9 North Street
Salem, MA 01970
Salem, MA Fire Department
48 Lafayette Street
Salem, MA 01970
INSURED: Michael Farias
ADDRESS: 12 Cabot St, Salem, MA 01970-4850
LOCATION OF LOSS: 12 Cabot St, Salem, MA 01970-4850, US
COMPANY: MAPFRE Insurance
POLICY#: 4987566487
CLAIM#: 22-91370
DATE OF LOSS: 01/26/2022
TYPE OF LOSS: Vehicle
Dear Sir or Madam:
Independent Claims Service is the insurance adjusting firm hired by the above referenced client to handle the
captioned loss on behalf of their insured.
A claim has been made involving loss, damage, or destruction of the above-captioned property which may
either exceed $1,000.00 or cause Massachusetts General Laws, Chapter 143, Section 6 to be applicable. If
notice under Massachusetts General Laws, Chapter 139, Section 3B is appropriate, please bring it to our
attention, and include a reference of the captioned insured: Location, policy number, and/or date of loss.
Sincerely,
INDEPENDENT CLAIMS SERVICE, f�PR Lrrnr , .n
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22 Water Street • Westborough,MA 01581 • 508.366.8535 • FAX 508.366.0917 • www.icsclaims.com