321 Jefferson Avenue 3-2-18 claim W. Springfield, MA L CEIVED
(413)781-2897 Pittsfield, MA
1"7
ua (888)881-4598
Quincy, MA Worcester, MA
(617)479-2619 MAR 3 02018 (888)881-4598
Mattapoisett, MA CITY OF SALEM Cape Cod&Islands
(508)758-6633 BOARD OF HEALTH (888)881-4598
Rhode Island nr- = Hartford, CT
(888)881-4598 BUTLER (888)881-4598
Building Co issioner or Board of Health or
Inspector o uildings Board of Selectmen
City of S em City of Salem
120 W hington Street 120 Washington Street
3rd F or 4th Floor
Sal MA 01970 Salem, MA 01970
A ention: Records Attention: Records
COMPANY: Certain Underwriters at Lloyds, London c/o Vanguard Claims
Administration, Inc.
POLICY NUMBER: XSZ96744
CLAIM NUMBER: XS05070
INSURED: Marc Galardi & Cole, Brad
LOSS LOCATION: 321 Jefferson l d, Salem, MA
DATE OF LOSS: 03/02/2018 /n
DESCRIPTION: Property - Other Lv
OUR FILE NUMBER: B18-41646
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,
Tom Murphy
Claims Adjuster
P—413-824-4201
F—413-731-5553
tom.murphy@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
March 27, 2018
209 Park Avenue,West Springfield,MA 01089