HomeMy WebLinkAboutNotice of Loss 102823 Progressive Home, by Homesite
PROGRESSIVE Underwritten By:
r3ata� Homesite Insurance Company
Tel: 1-866-960-8609
Fax: 1-866-935-2858
6000 American Parkway
Madison,WI 53783-0001
66259002 NN RP 06 20231106 NNNNNNNN 0010780 0035 Claim Number: 01-006-883585
YARMOUTH TOWN CLERKS OFFICE Date Of Loss: 10/28/2023
1146 ROUTE 28 Policy Number: 37751109
SOUTH YARMOUTH, MA 02664-4463 Policyholder: Enerio M Rivas
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V 16 2023 `
November 3, 2023 L --
BUILDING OE PARTMENT By:
ENTIOf�: 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 3B
Our Insured: ENERIO M RIVAS
Property Address: 15 Musket Ln Yarmouth Port, MA, 02675-2129
Policy Number: 37751109
Claim Number: 01-006-883585
Date of Loss 10/28/2023
This correspondence shall serve as notice that, pursuant to Massachusetts General Laws Chapter 139, Section
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.
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,
S'euw Lam(
Savannah Lueckert
Claim Adjuster I
AFICS on behalf of Homesite Insurance Company
Savannah.Lueckert@afics.com
Phone: 1-608-621-9539 I Fax: 1-866-935-2858
Mail: 6000 American Parkway, Madison, WI 53783-0001
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