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INS LOSS LTR 08/22/2019 r it 1100 Crown Colony Drive P.O. Box 699195 A R B E L L A Quincy,MA 612269-9195 7.328 2800 INSURANCE GROUP arbella.com August 22, 2019 SALEM BUILDING COMMISSIONER SALEM CITY HALL 93 WASHINGTON STREET SALEM, MA 01970 Claim Number: 034051648 Policy Number: 45681400001 Company Name: Arbella Mutual Insurance Company Date,of Loss: 07/24/2019 Insured: NORMAN LEBLANC Property Location: 84 CAVANDISH CIRCLE, 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. Sincerely, Cynthia Holden-Amoy Claim Service Specialist - --sporty Claim Office — - 800-272-3552 ext.7549 Fax 617-773-4760 CC: SALEM HEALTH DEPARTMENT SALEM CITY HALL 93 WASHINGTON STREET SALEM, MA 01970 CC: SALEM FIRE DEPARTMENT 48 LAFAYETTE STREET SALEM, MA 01970