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19 WITCHCRAFT ROAD 10-20-25 CLAIM RECEIVED ,all 1 100 Crown Colony Drive P.O.Box 699195 OCT 2 7 2025 Quincy,MA 02269-9952 ARBE L L� 617.328.2800 INSUAANeE OROAJP CITY OF SALEM arbella.com BOARD OF HEALTH October 22, 2025 SALEM HEALTH DEPARTMENT SALEM CITY HALL 93 WASHINGTON STREET SALEM, MA 01970 Claim Number: 034569173 Company Name: Arbella Mutual Insurance Company Date of Loss: 10/20/2025 Insured: STEVEN OUELLETTE Property Location: 19 WITCHCRAFT RD, 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 781-213-6149 Fax 617-773-4760