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6 CHARLOTTE STREET 2-19-18 CLAIM P.O. 2pt8 Quincy,MA 02269-9195 APR 2 3 61a be18a.com L L A00 AS OF SEAM H gppRD OF H INSURANCE GROUP April 17,2018 SALEM BUILDING COMMISSIONER SALEM CITY HALL 93 WASHINGTO STREET SALEM,MA Number: 033904081 policcyy Number:Claim14078400002 policy Company Name* Arbella Mutual Insurance Company 02i 19i20 i 8 Date of Loss: ERIK MANNINEN Insured: 6 CHARLOTTE ST, SALEM,MA Property Location: � i Concern: caption ion property, which To Whom It May Section 6,to be A claim has been made involving loss,damage,or destruction of the above may either exceed$1,000 or cause Massachusetts General Laws, Chap lease direct it applicable. Chapter 139, Section 3B is appropriate,p If any notice under Massachusetts General Law, captioned insured,location,date of loss to the attention o the writer.Please include a reference to the and claim number. Thank you for your assistance. Sincerely, Sarah Monaco Claim Service Specialist Property Claim Office 800-272-3552 ext. 7323 Fax 617-773-4760 CC: SALEM HEALTH DEPARTMENT SALEM CITY HALL 93 WASHINGTON STREET SALEM,MA 01970 CC:SA 48 LEM FIE LAFAYETTDEESTREE ENT SALEM,MA 01970