30 CHURCH STREET 12-11-18 CLAIM l
UNION UTUAL
RECEIVED
FEB 18 2019
February 22,2019
CITY OF
BOARD OF HEAT H
Health Department and Building Inspector
City of Salem Inspectional Services
120 Washington St.3rd Floor
Salem,MA 01970
MASSACHUSETTS GENERAL LAWS,
CHAPTER 139 LETTER
RE: Insured: N i a,,-s Bay Colony Properties LLC
Loss Ioocation: 30 Church St, Salem,MA 01970-3714
Policy#: BOP0149678
Date of Loss: 12/11/2018
Type of Water-Sewers&Drains
Claim#: CLM-00041478
Dear Sir or Madam,
A claim has been made involving loss, damage or destruction of the property captioned above, which may
either exceed$1,000.00 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,
cause of loss and claim number.
Sincerely,
Shawn Kimon,AIC
Claims Representative
(800)671-8550 ext.574
skimon@unionmutual.com
Fax: 802-229-2119
Union Mutual Fire Insurance Company, 139 State Street,P.O.Box is8
Community Mutual Insurance Company Montpelier,VT o56or
(�Fr
Eastern Mutual Insurance Company 80o-3oa-526i New England Guaranty:insurance Company,Inc. www.unionmutual.com
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