27 HERBERT STREET 11-4-23 CLAIM W. Springfield, MA Georg RECEIVED Pittsfield, MA
(413) 781-2897 ' (888)881-4598
Quincy, MA + I Butler Worcester, MA
(617)479-2619 DEC 12 2023 (888)881-4598
Mattapoisett, MA Adjuster_ Cape Cod&Islands
(508) 758-6633 CITY OF SALEM (888)881-4598
Rhode Island Inc. BOARD OF HEALTH Hartford, CT
(888)881-4598 BUTLER (888) 881-4598
Building Commissioner or Board of Health or
Inspector of Bui gs Board of Selectmen
City of Sale City of Salem
120 Wa- ington Street 120 Washington Street
3rd or 4th Floor
S• em, MA 01970 Salem, MA 01970
ttention: Records Attention: Records
COMPANY: Certain Underwriters at Lloyd's, London c/o Quaker Special Risk
POLICY NUMBER: QM2343976
CLAIM NUMBER: N/A
INSURED: Nancy Corral
LOSS LOCATION: 27 Herbert Street, Salem, MA
DATE OF LOSS: 11/04/2023
DESCRIPTION: Wind& Water
OUR FILE NUMBER: P23-13523
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 3B, 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
December 1, 2023
209 Park Avenue,West Springfield,MA 01089