60 Webb Street 6-6-20 claim MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston,Massachusetts 02108-1904
(617)723.3800 Ma Only(800)392-6108,FAX(800)851-8424
6/9/2020
Form of Notice of Casualty Loss to Building
Under Mass.Gen. Laws Ch.139 Sec.3B
SALEM HEALTH DEPT.
SALEM CITY HALL
SALEM MA 01970
Re: Insured: SUSAN QUIRK
Property Address: 60 WEBB STREET,SALEM, MA 01970
Policy Number: 1043253
Type Loss: Water Damage:All Other Water Damage
Date of Loss: 06/06/2020
Claim Number: 448345
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