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5 Weatherly Drive, Unit 18 1-7-18 claim 1100 Crown Colony Drive P.O.Box 699103 A R B E L L A 6 Quincy,M 003 17.328.28.328.2800 INSURANCE GROUP arbella.com RECEIVED January 31,2018 FEB 0 2 2018 SALEM HEALTH DEPARTMENT CITY OF SALEM SALEM CITY HALL BOARD OF HEALTH 93 WASHINGTON STREET SALEM, MA 01970 Claim Number: 601K187943 Policy Number: 8500067621 Company Name: Arbella Protection Insurance Company Date of Loss: 01/07/2018 Insured: WEATHERLY DRIVE CONDOMINIUM TRUST Property Location: 5 WEATHERLY DRIVE UNIT 18, SALEM, MA 01970 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 313 is appropriate, please direct it to the attention of the writer. Kindly include a reference to the captioned insured, location, date of loss and claim number. Sincerely, Mark Frechette Claim Service Specialist Property Claim Office 617-328-2203 Fax 617-773-4760 CC: SALEM BUILDING COMMISSIONER SALEM CITY HALL 93 WASHINGTON STREET SALEM, MA 01970 CC: SALEM FIRE DEPARTMENT 48 LAFAYETTE STREET SALEM, MA 01970