10 AMES ST MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108.1904
(6171723.3800 Ma Only(8001392-6108,FAX(800)851.8424
6/10/2023
Form of Notice of Casualty Loss to Building
Under Mass Gen. Laws Ch.139,Sec.3B
SALEM BUILDING COMMISSIONER
SALEM CITY HALL
SALEM MA 01970
Re: Insured: CRAIG BILODEAU
Property Address: 10 AMES STREET,SALEM, MA 01970
Policy Number: 0713707
Type Loss: Water Damage:All Other Water Damage
Date of Loss: 06104/2023
Claim Number: 473015
Claim has been made involving loss,damage or destruction of the above captioned property,which may either
exceed$1000.00 or cause Massachusetts General Laws Chapter 143,section 6 to be applicable. If any
notice under Massachusetts General Laws Chapter 139, Section 3B is appropriate, please direct it to the
attention of the writer and include a reference to the captioned insured, location, policy number, date of loss
and claim or file number.
MPIUA Claims Division
CMA00021
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