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1 Riverbank Road 1-18-19 claim RECEIVED 1100 Crown Colony Drive aAN 3'0 2019 P.O.Box 699195 AT� �+ TT Quincy,MA 02269-9195 R B E L L A 617.328.2800 INSURANCE GROUP CITY OF SALEM arbella.com BOARD OF HEALTH January 21,2019 SALEM BUILDING COMMISSIONER SALEM CITY HALL 93 WASHINGTON STREET SALEM, MA 01970 Claim Number: 033994275 Policy Number: 97962400005 Company Name: Arbella Protection Insurance Company Date of Loss: 01/18/2019 Insured: ROBERT CURRAN Property Location: 1 RIVERBANK ROAD, 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, Douglas McGuirk Claim Service Specialist Property Claim Office 800-272-3552 ext. 2454 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