204 Insurance Loss Letter 2017 1(2S INDEPENDENT
CLAIMS SERVICE, INC .
Service • Integrity • Experience
Notice of Casualty Loss to Building
Under Massachusetts General Laws, Chapter 139, Section 3B
03/29/2017
Northampton, MA Building Inspector
210 Main Street, #100
Northampton, MA 01060
Northampton, MA Board of Health
210 Main Street,#8
Northampton, MA 01060
Northampton, MA Fire Department
26 Carlon Drive
Northampton, MA 01060
INSURED: Nora Verni
ADDRESS: 204 North Elm St, Northampton,MA 01060
LOCATION OF LOSS: 204 North Elm St,Northampton,MA 01060, US
COMPANY: The Commerce Insurance Company
POLICY#: Bhcktm
CLAIM#: 17-70394
DATE OF LOSS: 03/27/2017
TYPE OF LOSS: Sewage
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 508.366.091 7 • www.icsclaims.com