76 BOSTON ST_7.21.22_Claim Notice UNION MUTUAL
Live life well protected
August 4,2022
Building Inspector
Board of Health
93 Washington Street
Salem, MA 01970
MASSACHUSETTS GENERAL LAWS,
CHAPTER 139 LETTER
RE: Insured: River Rock Residences Leasehold Condo
Loss Location: 76 Boston Rd.
Salem, MA
Policy Number: BOP0180175
Date of Loss: 7/21/2022
Type of Loss: Vehicle damage to bldg
Claim#: CLM59414
Dear Sir or Madam:
A claim has been made involving loss, damage or destruction of the property captioned above,
which may either exceed $1,000.00 or cause Massachusetts General Laws, Chapter 143, Section
6 to be applicable. If any notice under Massachusetts General Laws,Chapter 139, Section 313 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, cause of loss and claim number.
On this date, I caused copies of this notice to be sent to the persons named above at the addresses
indicated above by first class mail.
Sincerely,
Jeff Staples
Regional General Adjuster
1-800-671-8550 ext. 616
jstaples@unionmutual.com
Union Mutual Fire Insurance Company 139 State Street,P.O.Box t58
t Community Mutual Insurance Company Montpelier, o 6o
158 New England Guaranty Insurance Company,Inc. 800-300-51 >ll
wmv.unionmutuaLcom