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26 Oakland Street 12-31-17 claim 1100 Crown Colony Drive P.O. Box 699103 Quincy, MA 02269-9101 A R B E L L A 61 r abella 800 bella.com INSURANCE GROUP RECEIVE® January 2, 2018 JAN U 92013 CITY OF SALEM SALEM BUILDING COMMISSIONER BOARD OF HEALTH SALEM CITY HALL 93 WASHINGTON STREET SALEM, MA 01970 Claim Number: 033890013 Policy Number: 68949400005 Company Name: Arbella Indemnity Insurance Company Date of Loss: 12/31/2017 Insured: WILLIAM CONLEY Property Location: 26 OAKLAND STREET, SALEM, MA Dear: Madam/ Sir 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, Douglas McGuirk Claim Service Specialist Property Claim Office 800-272-3552 ext. 2454 Fax 617-773-4760 CC: SALEM HEALTH DEPARTMENT SALEM CPfY HALL 93 WASHINGTON STREET SALEM, MA 01970 CC: SALEM FIRE DEPARTMENT 48 LAFAYETTE STREET SALEM,tiIA 01970