Request for Insurance Claim

01st February 2012

Mr. ______ Perera
Claims Manager
________ _______ Insurance
Colombo - 03


Dear Sir

PUBLIC LIABILITY - POLICY NO : G/111/PL/16724

Relating to the above Policy, Please be good enough to send a Representative to inspect the damage cause to the above unit due to water seepage.

Thanking You

Yours faithfully,



...................................

R P Y Pathirana
Manager Maintenance