HomeMy WebLinkAboutInsurance Letter - Correspondence - 476 WAVERLY ROAD 8/8/2023 CONNECT, powered by American Family Insurance
Underwritten By:
American Family Connect Property And Casualty Insurance
CONNECT Company
1nUffXMMz3M=. Tel: 1-800-535-2001
Fax: 1-866-935-2858
6000 American Parkway
Madison,W1 53783-0001
003960FC6500MO1032270315 Q03A 001 Claim Number: 01-006-554402
Date Of Loss: 08/08/2023
WJEFFREY CROCKER Policy Number: H102061486
120 MAIN ST Policyholder: Jeffrey Crocker And Christine Crocker
NORTH ANDOVER, MA 01845-2420
August 15, 2023
ATTENTION: Buildina Commissioner or Inspector of Buildings Fire Department or Arson Squad, Board of Health or
Board of Selectmen /0 City or Town Hall
NOTICE PURSUANT TO MASS. GEN. LAWS, CHAPTER 139, SECTION 313
Our Insured: Jeffrey Crocker
Property Address: 476 Waverley Rd North Andover, MA, 01845-4213
Policy Number: H102061486
Claim Number: 01-006-554402
Date of Loss 08/08/2023
(0
This correspondence shall serve as notice that, pursuant to Massachusetts General Laws Chapter 139, Section
0
8 3B, a claim has been made involving loss, damage or destruction to a building or other structure which may either
exceed$1,000 or cause Massachusetts General Laws, Chapter 143, Section 6 to be applicable.
C)
8 If any notice pursuant to Massachusetts General Laws Chapter 139, Section 313 is appropriate, please direct such
notice to my attention and kindly, pursuant to the information provided above, include the insured's name, address,
policy number, claim number and date of loss. If you contact us via email, please use claimdocuments@afics.com
and be sure to reference the claim number in the subject line of your email.
®R Please contact me with any questions.
Sincerely,
Candice Jackson
Claim Adjuster 11
AFICS on behalf of American Family Connect Property and Casualty Insurance Company
Candice.Jackson@afics.com
Phone: 1-608-722-2914 1 Fax: 1-866-935-2858
Mail: 6000 American Parkway, Madison, WI 53783-0001
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