176 loss letter theft MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION (.--\\..-(....)
Two Center Plaza
Boston,Massachusetts 02108-1904
(617)723-3800 Ma Only(800)392-6108,FAX(800)851-8424
2/1612017
Form of Notice of Casualty Loss to Building
Under Mass.Gen.Laws,Ch.139,Sec.3B
NORTHAMPTON HEALTH DEPT.
212 MAIN STREET
NORTHAMPTON MA 01060
Re: Insured: ALAN C WOLF&MEGAN L MURPHY
Property Address: 176 SOUTH STREET,NORTHAMPTON,MA 01060
Policy Number: 1121379
Type Loss: Theft
Date of Loss: 02102/2017
Claim Number. 412155
Claim has been made involving loss,damage or destruction of the above captioned property,which may either
exceed S1000.00 or cause Massachusetts General Laws,Chapter 143,section 6 to be applicable. If any
notice under Massachusetts General Laws,Chapter 139,Section 3B is appropriate,please direct it to the
attention of the writer and indude a reference to the captioned insured,location,policy number,date of loss
and claim or file number.
MPIUA Claims Division
CMA00021