5 Tanglewood Lane 1-3-18 claim 1100 Crown Colony Drive
p.0. Box 699103
Quincy,MA 02269-9103
617.328.2800
AR B E L LA arbella.com
INSURANCE GROUP RECEIVED
January
18, 2018 JAN 2 2 2018
CITY OF SALEM
BOARD OF HEALTH
SALEM BUILDING COMMISSIONER
SALEM CITY HALL
93 WASHINGTON STREET
SALEM, MA 01970
Claim Number: 033894148
Policy Number: 41252400002
Company Name: Arbella Mutual Insurance Company
Date of Loss:
01/03/2019
Insured: ELLEN SILVERMAN
Property Location: 5 TANGLEWOOD LANE, SALEM, MA
Dear Sir/Madam: eYt which
of the above captioned
ion
A claim either
exceed $1,000 or cause Mas damage,etts GeneraltLaws, Chapter 143, Section 6,to be
may erth
applicable. lease direct it
If any notice under Massachusetts General Law, Chapter 139, Section d i is appropriate,p
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: 48 LAFAYETTDE STREET
ENT
SALEM,MA 01970