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8 Naples Road 10-31-18 claim EECEIVED 1100 Crown Colony Drive N O V 14 20% P.O.Box 699195 A 02269-9195 A R B E L L. Quincy.M 617.328.2800 CITY OF SALEM INSURANCE GROUP BOARD OF HEALTH arbella.com November 8, 2018 SALEM BUILDING COMMISSIONER SALEM CITY HALL 93 WASHINGTON STREET SALEM,MA 01970 Claim Number: 033976753 Policy Number: 56903400003 Company Name: Arbella Mutual Insurance Company Date of Loss: 10/31/2018 Insured: DONALD WARK Property Location: 8 NAPLES ROAD, SALEM, MA To `V"nom 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, Karen Kimball Claim Service Specialist Property Claim Office 800-272-3552 ext. 7398 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