4 Union Street 10-26-18 claim W.Springfield, MA GeorgePittsfield, MA
(413)781-2897 (888)881-4598
Quincy, MA Sutler Worcester, MA
(617)479-2619 a (888)881-4598
Mattapoisett, MA 1,, Adjusters Cape Cod& Islands
(508)758-6633 (888) 881-4598
Rhode Island Inc. Hartford, CT
(888)881-4598 BUTLER (888) 881-4598
Building Commissioner or Board of Health or RECEIVED
Inspector of Buildings Board of Selectmen
City of Salem City of Salem N 0 V 0 5 2018
120 Washington Street 120 Washington Street
3rd Floor 4th Floor CITY OF SALEM
Salem, MA 01970 Salem, MA 01970 BOARD OF HEALTH
Attention: Records Attention: Records
COMPANY: Certain Underwriters at Lloyds, London c/o Vanguard Claims
Administration, Inc.
POLICY NUMBER: XSZ98370
CLAIM NUMBER: XS05782
INSURED: Union Street Condominium Trust
LOSS LOCATION: 4 Union Street, Salem, MA
DATE OF LOSS: 10/26/2018
DESCRIPTION: Vehicle Property Damage
OUR FILE NUMBER: B 18-42120
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,
Jeff Mangarpan
Claims Adjuster
P—603-742-9747 -office
F—617-479-1740
jeffm@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
October 30, 2018
P.O.Box 1557,Mattapoisett,MA 02739