insurance claim 2019 unit 8 W. Springfield, MA Pittsfield, MA
(413)781-2897 (888)881-4598
Quincy, MA Worcester, MA
(617)479-2619 (888)881-4598
Mattapoisett, MA a Cape Cod&Islands
(508)758-6633 • : F (888)881-4598
Rhode Island Hartford, CT
(888)881-4598 BUTLER (888)881-4598
Building Commissioner or Board of Health or
Inspector of Buildings Board of Selectmen
Town of Yarmouth Town of Yarmouth
1146 Route 28 1146 Route 28
South Yarmouth, MA 02664 South Yarmouth, MA 02664
Attention: Records Attention: Records
COMPANY: Certain Underwriters at Lloyds, London c/o Vanguard Claims
Administration,-Inc.
POLICY NUMBER: XSZ113214
CLAIM NUMBER: XS07105
INSURED: Ocean Pool Condominium Trust Association
LOSS LOCATION: 7 Thatcher Road, Unit 8, South Yarmouth, MA
DATE OF LOSS: 07/15/2019
DESCRIPTION: Water
OUR FILE NUMBER: P19-10150
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
October 31, 2019
P.O. Box 1557,Mattapoisett,MA 02739