10 DERBY SQUARE CLAIM NOTICE Samuel F. McCormack Co., Inc.
Insurance Adjusters and Appraisers
58muel F.McCormack Co.,Inc.
ADJUSTERS AND APPRAISERS
March 21, 2022
Salem City Hall
Building Inspector
93 Washington Street
Salem. MA 01970
RE ASSURED: 10 Derby Square Condo Trust, c/o Gibraltar Management
Cc Inc
LOSS LOCATION: 5 Higginson Sq aka 10 Derby Sq, Salem, MA 01970
POLICY NO: BP18020795
TYPE OF LOSS: Water
DATE OF LOSS: 03/21/2022
OUR FILE NO: 22-00828
To Whom It May Concern:
Claim has been made involving loss, damage or destruction of the above-captioned property, which
may either exceed $1,000.00 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 this writer and include a reference to the above-
captioned insured, location, policy number, date of loss and claim or file number.
Thank you for your anticipated cooperation.
Very truly yours,
Edward Bennett
Adjuster
efb@mccormackadjuster.com
cc: Board of Health
Fire Department
r M^_
42 Holbrook Avenue, Braintree,MA 02184 1-800-972-5399(781)843-1222 Fax(781)849-8191
125 Waterhouse Road, Bourne,MA 02532(508)403-2600 Fax(508)403-2602
www.mccormackadjuster.com