20 Rice Street 11-29-18 claim W. Springfield, MA Gent RECEIVED Pittsfield, MA
(413)781-2897 (888)881-4598
Quincy, MA Butler Worcester, MA
(617)479-2619 DEC-01,2018 (888)881-4598
Mattapoisett, MA Ad (,tTY OF SALEM Cape Cod&Islands
(508)758-6633 9-- BOARD OF HEALTH (888)881-4598
Rhode Island Inc• Hartford, CT
(888)881-4598 BUTLER (888)881-4598
Building Com n
issioner or Board of Health or
Inspector of ldings Board of Selectmen
City of S m City of Salem
120 W ington Street 120 Washington Street
3rd Fl or 4th Floor
Sale , MA 01970 Salem, MA 01970
A ntion: Records Attention: Records
COMPANY: Certain Underwriters at Lloyds, London c/o Vanguard Claims
Administration, Inc.
POLICY NUMBER: XSV11421
CLAIM NUMBER: XS05895
INSURED: Cache Development LLC
LOSS LOCATION: 20 Rice Street, Salem, MA
DATE OF LOSS: 11/29/2018
DESCRIPTION: Freeze Up
OUR FILE NUMBER: B 18-42200
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 313, 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
j effm@georgebutleradj usters.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
November 30, 2018
209 Park Avenue,West Springfield,MA 01089