HomeMy WebLinkAbout2022 Property Loss Notice W. Springfield, MA Pittsfield, MA
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Building Commissioner or Board of Health or
Inspector of Bu' 'rigs Board of Selectmen
Town of Y outh Town of Yarmouth
1146 R e 28 1146 Route 28
So Yarmouth, MA 02664 South Yarmouth, MA 02664
ention: Records Attention: Records
COMPANY: Certain Underwriters at Lloyds, London c/o Vanguard Claims
Administration, Inc.
POLICY NUMBER: XSZ192898
CLAIM NUMBER: XS 10189
INSURED: Swaminarayan LLC dba Bass River Motel
LOSS LOCATION: 891 Route 28, South Yarmouth, MA
DATE OF LOSS: 12/21/2022
DESCRIPTION: Property Damage
OUR FILE NUMBER: P22-12809
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 JAM 0 3 Z022
P—(508)241-1923 HEALTH DEPT.
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
December 29, 2022
209 Park Avenue, West Springfield,MA 01089