160 BRIDGE STREET 9-29-22 CLAIM W. Springfield, MA pp `' Pittsfield, MA
R(413)781-2897 E C E I V E D (888) 881-4598
Quincy, MA Worcester, MA
(617)479-2619 O C T 2 5 2022 (888) 881-4598
Mattapoisett, MA Cape Cod&Islands
(508) 758-6633 CITY OF SALEM (888) 881-4598
Rhode Island BOARD OF HEALTH Hartford, CT
(888)881-4598 BUTLER (888) 881-4598
Building Co issioner or Board of Health or
Inspector o' 3uildings Board of Selectmen
City of S em City of Salem
120 W shington Street 120 Washington Street
3rd oor 4th Floor
S em, MA 01970 Salem, MA 01970
ttention: Records Attention: Records
COMPANY: Certain Underwriters at Lloyd's, London c/o Quaker Special Risk
POLICY NUMBER: QSRMA37381
CLAIM NUMBER: N/A
INSURED: 160 Bridge Street Condo Association
LOSS LOCATION: 160 Bridge Street, Salem, MA
DATE OF LOSS: 09/29/2022
DESCRIPTION: Property Damage
OUR FILE NUMBER: P22-12683
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 313, 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
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
October 20, 2022
209 Park Avenue,West Springfield,MA 01089