HomeMy WebLinkAboutinsurance claim - Miscellaneous - 1 HARVEST DRIVE 213 1/25/2024 MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108-1904
(617)723-3800 Ma Onlv(800)392-6108.FAX(800)851-8424
12/23/2023
Form of Notice of Casualty Loss to Building
Under Mass. Gen. Laws, Ch.139, Sec.313
�° 5 tioti�
NORTH ANDOVER HEALTH DEPT. LPN ti
NORTH ANDOVER TOWN HALL e
NORTH ANDOVER MA 01845 ,; , + �'
Re: Insured: ZORAN KOSTIC
Property Address: 1 HARVEST DR UN 213, NORTH ANDOVER, MA 01845
Policy Number: 1403285
Type Loss: Water Damage:All Other Water Damage
Date of Loss: 12/14/2023
Claim Number: 477026
Claim has been made involving loss,damage or destruction of the above captioned property,which may either
exceed$1000.00 or cause Massachusetts General Laws, Chapter 143,section 6 to be applicable. If any
notice under Massachusetts General Laws, Chapter 139, Section 313 is appropriate, please direct it to the
attention of the writer and include a reference to the captioned insured, location, policy number,date of loss
and claim or file number.
MPIUA Claims Division
CMA00021