71 VALLEY STREET 2-4-22 CLAIM MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108.1904
(6171723.3800 Ma Only(800)392.6108. FAX(800)851-8424
2/12/2022
Form of Notice of Casualty Loss to Building
Under Mass. Gen. Laws. Ch.139, Sec.36
RECEIVED
SALEM HEALTH DEPT. FEB 16 2022
SALEM CITY HALL CITY OF SALEM
SALEM MA 01970 BOARD OF HEALTH
Re: Insured: LAKSHMIDEVI SREERAMAREDDY
Property Address: 71 VALLEY STREET, SALEM, MA 01970
Policy Number: 1437465
Type Loss: Vehicle Damage
Date of Loss: 02/04/2022
Claim Number: 463539
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. Charter 143 section 6 to be applicable. If any
notice under Massachusetts General Laws Charter 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