155 FEDERAL STREET - CERTIFIED MAIL CLAIM NOTICE Providing Insurance and Financial services AWL A-
Home Office, Bloomington, IL Ow
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November 11, 2021
The City Of Salem Inspectional Services State Farm Claims
93 Washington St PO Box 106169
Salem MA 01970-3530 Atlanta GA 30348-6169
CERTIFIED MAIL: RETURN RECEIPT REQUESTED
RE: Claim Number: 21-26T8-06V
Our Insured: Andi Kociaj
Date of Loss: October 7, 2021
Loss Location: 155 Federal St, Salem, MA 01970-3243
Tax Block: **TAX BLOCK**
Tax Lot: **TAX LOT**
To Whom It May Concern:
State-Farm Fire & Casualty Insurance Company writes to provide notice as required by
Massachusetts law in connection with the matter referenced above. State Farm®received notice
of loss or damage in excess of$1,000 at 155 Federal St., Salem, MA 01970-3243.
We hereby notify your office pursuant to General Laws c. 139, §313 that State Farm
intends to make a payment of$1,000 or more in connection with the above referenced
insurance claim.
Further, the applicable amendatory Policy Endorsement informs the insured of the
Massachusetts requirement by stating the following:
"We are required by Massachusetts law that we must notify the local inspector of
buildings or Board of Health at least 10 days before we make a payment of$1,000 or
more for loss to a building or structure.
We must also give notice if there is damage which makes a building a health or safety
hazard or dangerous or unsafe for occupancy regardless of the amount of our payment.
If, prior to payment, we receive official notice of a pending or existing lien against your
premises, we must delay payment until the matter is settled. If we are required to pay all
or part of the amount of the lien, we will not be obligated to pay that amount to you."
If you have questions or need assistance, call us at (205) 916-6547.
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