126 FEDERAL STREET - CLAIM NOTICE W. Springfield, MA Pittsfield, MA
George
(413) 781-2897 (888)881-4598
Quincy, MA Butler Worcester, MA
(617)479-2619 (888)881-4598
Mattapoisett, MA Ad*iusters Cape Cod& Islands
(508) 758-6633 (888)881-4598
Rhode Island = Inc. Hartford, CT
(888)881-4598 BUTLER (888)881-4598
Building Commissioner or /bor
alt r
Inspector of Buildings l tmen
City of Salem m
120 Washington Street gton Street
3rd Floor Salem, MA 01970 01970Attention: Records Records
COMPANY: Certain Underwriters at Lloyds, London c/o Vanguard Claims
Administration, Inc.
POLICY NUMBER: XSZ170324
CLAIM NUMBER: XS08791
INSURED: 126 Federal Street Condo
LOSS LOCATION: 126 Federal Street, Salem, MA
DATE OF LOSS: 04/16/2021
DESCRIPTION: Wind
OUR FILE NUMBER: P21-11350
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,
John Schillizzi
Claims Adjuster
P—(978) 818-5453
F—617-470-1740
Johns@georgebutleradjusters.com APR 26;A-"'
APR
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
April 21, 2021
209 Park Avenue,West Springfield,MA 01089