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5B Nimitz Way 1-4-18 claim 1100 Crown Colony Drive P.O.Box 699103 Quincy,MA 02269-9103 .328.2800 A R B E L LA 61 rbella.com INSURANCE GROUP arbella.com RECEIVED January 12, 2018 JAN 17 2018 SALEM BUILDING COMMISSIONER CITY OF SALEM SALEM CITY HALL BOARD OF HEALTH 93 WASHINGTON STREET SALEM, MA 01970 Claim Number: 033891839 Policy Number: 84279400004 Company Name: Arbella Mutual Insurance Company Date of Loss: 01/04/2018 Insured: BARRY WEENER Property Location: 5B NIMITZ WAY, SALEM, MA Dear Sir or Madam: 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