6 Loring Hills Avenue, Apt. B5 RECEIVED
MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION JUL 2 7 2018
Two Center Plaza
Boston,Massachusetts 02108-1904 CITY OF SALEM
(617)723.3800 Ma Only(800)392.6108,FAX(800)851-8424 BOARD OF HEALTH
7/24/2018
Form of Notice of Casualty Loss to'Wu1lu11 g
Under Mass. Gen.Laws, Ch.139, Sec.313
SALEM HEALTH DEPT.
SALEM CITY HALL
SALEM MA 01970
Re: Insured: MAXIM KRAVETS&YANA KRAVETS
Property Address: 6 LORING HILLS AVE APT B5, SALEM,MA 01970
Policy Number: 1246068
Type Loss: Water Damage:All Other Water Damage
Date of Loss: 07/15/2018
Claim Number: 430763
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 36 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