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129 Claim Involving Loss Letter 2016 W. Springfield, MA (413)781-2897 Quincy, MA (617)479-2619 Mattapoisett, MA (508)758-6633 Rhode Island (888)881-4598 Building Commissioner or Inspector of Buildings Northampton Town Hall 210 Main Street Northampton, MA 01060 Attention: Records COMPANY: POLICY NUMBER: CLAIM NUMBER: INSURED: LOSS LOCATION: DATE OF LOSS: DESCRIPTION: OUR FILE NUMBER: Gentlemen: BUTLER Board of Health or Board of Selectmen Northampton Town Hall 210 Main Street Northampton, MA 01060 Attention: Records MAPFRE Insurance H BCYXTR MJCK68-JXKRR2 Stephen Corbett 129 Spruce Hill Avenue, Florence, MA 02/01/2016 Water S16-53441 Pittsfield, MA (888)881-4598 Worcester, MA (888)881-4598 Cape Cod 8 Islands (888)881-4598 Hartford, CT (888)881-4598 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. ely, Steve ennedy Claims Adjuster P—413-781-2897 F—413-731-5553 Steve.kennedy @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 April 28, 2016 209 Park Avenue.Wes( Springfield,MA 01089