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58 WEATHERLY DRIVE 8-7-23 CLAIM 1100 Crown Colony Drive P.O.Box 699195 Quincy,MA 02269-9952 ARBIELLA617.32 8.2800 [NSURANCe 6ROUP arbella.com August 10, 2023 RECEIVED SALEM HEALTH DEPARTMENT AUG 14 2023 SALEM CITY HALL CITY OF SALEM 93 WASHINGTON STREET BOARD OF HEALTH SALEM, MA 01970 Claim Number: 034379515 Company Name: Arbella Protection Insurance Company Date of Loss: 08/07/2023 Insured: ALISSA GOODSTEIN Property Location: 58 WEATHERLY DR#58, 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 313 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, Sarah Monaco Claim Service Specialist Property Claim Office 800-272-3552 ext. 7323 Fax 617-773-4760