17-23 SALEM STREET 5-29-26 CLAIM W. Springfield, MA Pittsfield, MA
(413)781-2897 (888)881-4598
Quincy, MA Worcester, MA
(617)479-2619 (888)881-4598
Mattapoisett, MA Cape Cod&Islands
(508) 758-6633 (888)881-4598
Rhode Island Hartford, CT
(888)881-4598 011-0 (888)881-4598
Building Commissioner or Board of Health or
Inspector of Buildings Board of Selectmen
City of Salem City of Salem
120 Washington Street 120 Washington Street
Salem, MA 01970 Salem, MA 01970
Attention: Records Attention: Records
COMPANY: Certain Underwriters at Lloyds, London c/o Vanguard Claims
Administration, Inc.
POLICY NUMBER: XSZ233361
CLAIM NUMBER: XS 11319
INSURED: Casa Marigold LLC
LOSS LOCATION: 17-23 Salem Street, Salem, MA
DATE OF LOSS: 05/29/2026
DESCRIPTION: Water
OUR FILE NUMBER: P26-14562
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, RECEIVED
John Schillizzi
Claims Adjuster JUN 112026
P—(978) 818-5453 CITY OF SALEM
F—617-470-1740 BOARD OF HEALTH
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
June 3, 2026
PO Box 1557,Mattapoisett,MA 02739