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Home My WebLink AboutInsurance Claim - Miscellaneous - 14 DOUGLAS ROAD 7/14/2024 GEICO Insurance Agency, LLC Underwritten By: Homesite Insurance Company Of The Midwest Homesite Tel: 1-800-566-1518 HOME INSURANCE Fax: 1-866-935-2858 6000 American Parkway Madison,WI 53783-0001 66259002 NN RP 30 20240730 NNNNNNNN 0002630 0009 Claim Number: 01-007-914604 TOWN CLERK Date Of Loss: 07/14/2024 120 MAIN ST Policy Number: 32870903 NORTH ANDOVER, MA 01845-2420 Policyholder: Judith A Coyne And Christopher T Coyne III"II'Illlllllllllllllllll"IIII'Il'Illil'Illll'I'I'Illll'Illll July 29, 2024 ATTENTION: Building Commissioner or Inspector of Buildings Fire Department or Arson Squad, Board of Health or Board of Selectmen C/O City or Town Hall NOTICE PURSUANT TO MASS. GEN. LAWS, CHAPTER 139, SECTION 3113 Our Insured: JUDITH A COYNE Property Address: 14 Douglas Rd North Andover, MA, 01845-3802 Policy Number: 32870903 Claim Number: 01-007-914604 Date of Loss 07/14/2024 This correspondence shall serve as notice that, pursuant to Massachusetts General Laws Chapter 139, Section 36, 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. If any notice pursuant to Massachusetts General Laws Chapter 139, Section 3B 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. Please contact me with any questions. Sincerely, 74p/�WC4"' April Ciletti Desk Adjuster AFICS on behalf of Homesite Insurance Company of the Midwest April.Ciletti@afics.com Phone: 1-602-627-6526 1 Fax: 1-866-935-2858 Mail: 6000 American Parkway, Madison, WI 53783-0001 Page 1 of 1 66259002 NN PP 30202407M NNNNNNNN 00026300009 36W&804A 495"W5-57e9-1116 P.O.1 d2