HomeMy WebLinkAboutInsurance Letter - Correspondence - 561 MASSACHUSETTS AVENUE 4/6/2023 & P() ,F30X 67204,1:
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INSUR"El"): MARY PI-IONE NI.INIBE fir" ".1- 800-3,261-09 war
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DA"T"E OF LOSS,: A� ril 03,2023 FAX NUATBER: 877-292-9527
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PROPERTYADDRESS'. 5,61 MASSAC"'IBUSI 1"S,A VI tl,'NI(,',",'),'Rl,,'"l"l""I
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POLICYNO.: 000119842,165686
Foi�m of'Noticeol'Casualty 1-.oss to Build'urlig
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Bt,ifldliig C,ot'ranissiorier ot- Board of" ct
It'i,spector(',)fI,3u'1'kkri,gs, Boatl of Selecanen
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Clalm has dl&a,�,,iage or deSti-LICtion of the above-caj,)fioned pt,ople.rty wfill ri,,my eft her exceed
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Mass.Gen., LImiI',VV11Si Chliptlerf 1143 Sectlion 6 tol,, tWer Mass.Geti.
('"'ba, )tjc,�r, is please direct'. it,tot'llile attentiotfi. ofthe utidet,signed and 'nicluide a
refierence to the ca l 11 p ted itisured, location, ll"ll oficy rmnllbetm,,date oflossmid claim imrrtiber.,
On this date, I caused cloples ofthis,i-wtice to be setit tothe persim"is iturned above at t1wadc"Ilresses al,,),ovie by,
first,Class rruc'til.
SIGNATURE AND 1"'W"I"'F',"
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