11 CHURCH STREET, #320 4-13-18 CLAIM 1100 Crown Colony Drive
P.O.Box 699195
A R B E L L A Quincy,MA 602269-9195
.328.2800
617.328.2800
INSURANCE GROUP arbella.com
May 9, 2018 RECEIVED
SALEM BUILDING COMMISSIONER MAY 14 2018
SALEM CITY HALL
93 WASHINGTON STREET CITY BOARD F AEA HEALTH
SALEM, MA 01970
Claim Number: 033927612
Policy Number: 15134400005
Company Name: Arbella Mutual Insurance Company
Date of Loss: 04/13/2018
Insured: MYUNGHEE JEON
Property Location: 1 I CHURCH ST#320, 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 313 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,
i
I
Karen Kimball
Claim Service Specialist
Property Claim Office
800-272-3552 ext. 7398
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