I am submitting this claim for: Motorcycle Damages and Losses by Champion Cycle Center at 3625 N. Western Avenue, Chicago, Illinois 60618 USA
I am submitting a claim as a: Policyholder
Policy number: 0070558406
Date of incident: 11/11/2004
Time of incident: 12:00 PM
Loss description: Attn. Josh Sumner, Adjuster For Your Information, I, Gardenia C. Hung, have faxed you (40) forty pages, last October 30, 2009 to support the Foremost Insurance Group Claim No.8448474 for Motorcycle Losses and Damages to the 2003 Derbi Boulevard 150 CC by Champion Cycle Center at 3625 N. Western Avenue in Chicago, Illinois 60618. Please provide a status payment compensation for this Foremost Insurance Group Claim. I look forward to your response. Sincerely, Gardenia C. Hung
11/6/2009
11:38:26 AM
