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1 BROOKS COURT_ NOTICE OF LOSS 9-25-25 I100 Crown Colony Drive P.O.Box 699195 Quincy, MA 02269-9952 A R B E L TL A 61 arbell 2800 bella.com INSURANCE GROUP September 25, 2025 SALEM BUILDING COMMISSIONER SALEM CITY HALL 93 WASHINGTON STREET SALEM, MA 01970 Claim Number: - 034563431 Company Name: Arbella Indemnity Insurance Company Date of Loss: 09/25/2025 Insured: GARY AMES JR Property Location: 1 BROOKS COURT, 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, Douglas McGuirk Claim Service Specialist Property Claim Office 617-328-2454 Fax 617-773-4760