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Insurance Adjustment Service Inc.
435 King Street - Second Floor
Littleton, MA 01460
978-952-6966 - Fax 978-952-2459
Email: iaslittleton@netlplus.com
Date: f- Z 1-o
Board of Health: _ �.. Ahtgy_u,
Building Inspector:
Fire Department:
Re: Insured: 43c.,
Location: 1F&
Claim Number: A.
Policy Number:
Our File Number: 2 -
Cause of Loss:D,n�
Date of Loss:_
-Dear Sir/Madam:
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 applied.
If any notice under Massachusetts General Laws, Chapter 139, Section 3B is
appropriate, please direct that information to my attention and include a
reference to the captioned insured, location, date of loss and file number.
Thank you for your cooperation.
Very truly yours,
Scott O'Neil
Adjuster,, .
Ext. 129'
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