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391 LAFAYETTE ST_ LOSS CLAIM 9.10.23 1100 Crown Colony Drive P.O. Box 699195 A R B E L LA Quincy,MA 6ozz69-9952 28.2800 6 U.328.2800 INSURANCE GROUP arbella.com September 12,2023 SALEM BUILDING COMMISSIONER SALEM CITY HALL 93 WASHINGTON STREET SALEM, MA 01970 Claim Number: 034387137 Company Name: Arbella Mutual Insurance Company Date of Loss: 09/10/2023 Insured: LOUIS WILLIAMS Property Location: 391 LAFAYETTE 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, Cynthia Holden-Amor Claim Service Specialist Property Claim Office 800-272-3552 ext.7549 Fax 617-773-4760