68 Summer Street 10-2-19 claim �-A . RECEIVED 1100 Crown Colony Drive
llsv P.O.Box 699195
0 C T 15 2019 MA 02269-9195
A R B E L L A¢ Quincy,
617.328.2800
INSURANCE GROUP CITY OF SALEM arbella.com
BOARD OF HEALTH
October 7, 2019
SALEM BUILDING COMMISSIONER
SALEM CITY HALL
93 WASHINGTON STREET
SALEM, MA 01970
Claim Number: 034061923
Policy Number: 94846400004
Company Name: Arbella Mutual Insurance Company
Date of Loss: 10/02/2019
Insured: LINDA LUFKIN
Property Location: 68 SUMMER ST, 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-Amor
Claim Service Specialist
Property 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