126 FEDERAL STREET 8-15-23 CLAIM W. Springfield, MA RECEIVED Pittsfield, MA
(413)781-2897 (888)881-4598
Quincy, MA Worcester, MA
(617)479-2619 AUG 31 2023 (888)881-4598
Mattapoisett, MA Cape Cod&Islands
(508)758-6633 L CITY OF SALEM (888)881-4598
Rhode Island BOARD OF HEALTH Hartford, CT
(888)881-4598 BUTLER (888)881-4598
Building Commissioner or Board of Health or
Inspector of Bu' ings Board of Selectmen
City of Sale City of Salem
120 Was ' gton Street 120 Washington Street
Salem, A 01970 Salem, MA 01970
Atte ion: Records Attention: Records
COMPANY: Certain Underwriters at Lloyds, London c/o Vanguard Claims
Administration, Inc.
POLICY NUMBER: XSZ203281
CLAIM NUMBER: XS 10617
INSURED: 126 Federal Street Condo
LOSS LOCATION: 126 Federal Street, Salem, MA
DATE OF LOSS: 08/15/2023
DESCRIPTION: Wind
OUR FILE NUMBER: P23-13420
To Whom It May Concern:
Claim has been made involving loss, damage, or destruction of the above captioned property which
may either exceed $1,000, or cause Massachusetts General Law, Chapter 143, Section 6, to be
applicable. If any notice under Massachusetts General Law, Chapter 139, Section 313, is appropriate,
please direct it to the attention of this writer and include a reference to the captioned insured,
location,policy number, company claim number, date of loss, and claim or file number.
Sincerely,
John Schillizzi
Claims Adjuster
P—(978) 818-5453
F—617-470-1740
JohnS@georgebutleradjusters.com
On this date, I caused copies of this notice to be sent to the persons named above at the address
indicated above, by first class mail.
Secretary
August 22, 2023
P.O.Box 710120,Quincy,MA 02171