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181 NORTH STREET, #110 7-30-23 CLAIM RECEIVED 1100 Crown Colony Drive AUG 0 7 2023 P.O. Box 699195 Quincy,MA 02269-9952 ARBELLA CITY OF SALEM 617.328.2800 IN51i AN'CE GROUP BOARD OF HEALTH arbella.com July 31, 2023 SALEM HEALTH DEPARTMENT SALEM CITY HALL 93 WASHINGTON STREET SALEM, MA 01970 Claim Number: 034376818 Company Name: Arbella Indemnity Insurance Company Date of Loss: 07/30/2023 Insured: JACOB BARBATO Property Location: 181 NORTH ST#110, SALEM, MA To Whom It May Concern: A claim has been made involving loss, damage, or destruction of the above captioned property, which may either exceed $1,000 or cause Massachusetts General Laws, 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 the writer. Please include a reference to the captioned insured, location, date of loss and claim number. Thank you for your assistance. Best regards, Cynthia Holden-Amor Claim Service Specialist Property Claim Office 800-272-3552 ext.7549 Fax 617-773-4760