7 Majestic Way- Claim Notice Providing Insurance and Financial Services StateFafYi1®
Home Office, Bloomington, IL
May 31, 2022
Salem City Hall State Farm Claims
Building Department PO Box 106169
93 Washington St Atlanta GA 30348-6169
Salem MA 01970-3797
CERTIFIED MAIL: RETURN RECEIPT REQUESTED
RE: Claim Number: 21-34N5-16B
Our Insured: Tizita Mitiku
Date of Loss: May 22, 2022
Loss Location: 7 Majestic Way, Salem, MA 01970-6829
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 7 Majestic Way in Salem..
We hereby notify your office pursuant to General Laws c. 139, §3B 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 (844)458-4300 Ext. 3099941019.
:• *o
21-34N5-16B
Page 2
May 31, 2022
Sincerely,
Pam Hixson
Claim Specialist
(844) 458-4300 Ext. 3099941019
Fax: (844) 236-3646
State Farm Fire and Casualty Company