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15 BEACON STREET 1-13-24 CLAIM 1100 Crown Colony Drive P.O.Box 699195 A R B E L L�.�gg Quincy,MA 02269-9952 617.328.2800 INSURANCE GROUP arbella.com January 15, 2024 RECEIVED JAN 22 2024 SALEM HEALTH DEPARTMENT SALEM CITY HALL CITY OF SALEM 93 WASHINGTON STREET BOARD OF HEALTH SALEM, MA 01970 Claim Number: 034418598 Company Name: Arbella Protection Insurance Company Date of Loss: 01/13/2024 Insured: PAUL TOMCHYSITYN Property Location: 15 BEACON ST, 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, Jenny Ellis Claim Technical Specialist Property Claim Office 800-272-3552 ext. 2265 Fax 617-773-4760