Claim of Loss ICS INDEPENDENT
CLAIMS SERVICE. INC.
Service • Integrity • Experience
Notice of Casualty Loss to Building
Under Massachusetts General Laws, Chapter 139, Section 3B
November 2,2018
• Yarmouth MA Building Inspector
1146 Rte 28
Yarmouth, MA 02664
Yarmouth MA Board of Health
1146 Rte 28
South Yarmouth, MA 02664
Yarmouth Ma Fire Department
96 Old Main Street
Yarmouth, MA 02664
INSURED: Albert&Bonnie Mutter
ADDRESS: 243 W Great Western Rd ,Yarmouth Port,MA 02675
LOCATION OF LOSS: 243 W Great Western Rd,Yarmouth Port,MA 02675
COMPANY: Narragansett Bay Insurance
POLICY#: 11106618
CLAIM#: 18-79380
DATE OF LOSS: 11/01/2018
TYPE OF LOSS: Water
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,INC.
22 Water Street • Westborough.MA 01 581 • 508.366.8535 • FAX 508.366.09 I7 • www.icsclaims.com