HomeMy WebLinkAboutInsurance Claim W. Springfield, MA %5 Pittsfield, MA
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Building Commis.'oner or Board of Health or
Inspector of B. dings Board of Selectmen
Town of Y outh Town of Yarmouth
1146 Re d to 28 1146 Route 28
Sout armouth, MA 02664 South Yarmouth, MA 02664
Atte tion: Records Attention: Records
COMPANY: Certain Underwriters at Lloyds. London c/o Vanguard Claims
Administration, Inc.
POLICY NUMBER: XSZ126673
CLAIM NUMBER: XS06942
INSURED: Horse Pond Corporation dba Halcyon Condominiums
LOSS LOCATION: 300 Buck Island Road, Unit 11F, West Yarmouth, MA
DATE OF LOSS: 08/31/2019
DESCRIPTION: Sewer Back up
OUR FILE NUMBER: CCI19-7292
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,
Ed Dibona
Claims Adjuster
P—508-758-6633
F—508-758-6199
ed@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
September 11, 2019
209 Park Avenue, West Springfield,MA 01089