71 Valley Street 10-27-21 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
10/31/2021
Form of Notice of Casualty Loss to Building
Under Mass. Gen. Laws Ch.139, Sec.313 R CENE®
NOV 16 2021
SALEM HEALTH DEPT, CITY OF SALEM
SALEM CITY HALL BOARD OF HEALTH
SALEM MA 01970
Re: Insured: LAKSHMIDEVI SREERAMAREDDY
Property Address: 71 VALLEY STREET,SALEM, MA 01970
Policy Number: 1437465
Type Loss: Windstorm Other than Hurricane or Tornad
Date of Loss: 10/27/2021
Claim Number: 459689
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