3 BRENTWOOD AVENUE 7-6-20 CLAIM 1100 Crown Colony Drive
P.O.Box 699195
Quincy,MA 02269-9195
A R B F L L A 617.328.2800
INSURANCE GROUP arbella.com
August 6, 2020 RECEIVED
AUG 10 2020
SALEM HEALTH DEPARTMENT
SALEM CITY HALL CITY OF SALEM
93 WASHINGTON STREET BOARD OF HEALTH
SALEM, MA 01970
Claim Number: 034125228
Policy Number: 51816400005
Company Name: Arbella Mutual Insurance Company
Date of Loss: 07/06/2020
Insured: PETER DRAGON
Property Location: 3 BRENTWOOD AVE, 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