16 Scenic Avenue 1-1-18 claim 1100 Crown Colony Drive
P.p.Box 699103
-� Quincy,MA 02 03
617.329.2328.2800
arbella.com
ARBELLA
INSURANCE GROUP 7
RECEIVED I
January 12,2018 JAN 17 Zola I
CITY OF SALEM
SALEM BUILDING COMMISSIONER
BOARD OF HEALTH
SALEM CITY HALL
93 WASHINGTON STREET
SALEM,MA 01970
Claim Number: 033892028
Policy Number: 61725400005
Company Name: Arbella Mutual Insurance Company I
Date of Loss: O1/01/2018JANE NDEGWA
Insured:
16 SCENIC AVE, SALEM,MA
Property Location:
I
Dear Sir or Madam: property,
A claim has been made involving
loss, damage,or destruction of the above
143pSection 6,to be which
may either exceed$1,000 or cause Massachusetts General Laws,Chap
applicable. ter 139, Section 3B is appropriate,please direct it
If any tioned insured, location, date of loss
notice under Massachusetts General Law, Chap
to the attention of the writer.Please include a reference to the cap
and claim number.
Thank you for your assistance*
Sincerely,
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