9 ABBOTT STREET 3-2-18 CLAIM MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108.1904
(617)723.3800 Ma Only(8001392.6108. FAX(800)851-8424
5/18/2018
Farm of Notice of Casualty Loss to Building �+
Under Mass. Gen. Laws,Ch.139, Sec.36 RECEIVED
MAY 2 3 2018
SALEM HEALTH DEPT.
SALEM CITY HALL CITY OF SALEM
SALEM MA 01970 BOARD OF HEALTH
Re: Insured: JOSEPH NJUGUNA NGOTHO
Property Address: 9 ABBOTT ST, SALEM,MA 01970-1101
Policy Number: 0754099
Type Loss: Windstorm Other than Hurricane or Tornad
Date of Loss: 03/02/2018
Claim Number: 429215
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 3B 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
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