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9 Lyme Street 1-24-18 claim 1100 Crown Colony Drive P.O. Box 699103 Quincy,MA 02269-9103 617328.2800 A R B E L L A arbella.com INSURANCE GROUP RECEIVED January 29, 2018 FEB 012018 CITY OF SALEM SALEM BUILDING COMMISSIONER BOARD OF HEALTH SALEM CITY HALL 93 WASHINGTON STREET SALEM,MA 01970 Claim Number: 033897606 Policy Number: 60234400001 Company Name: 01bella 1utualInsuranceCompany Date of Loss: Insured: LUCIEN LECLERC Property Location: 9 LYME ST, SALEM, MA Dear . 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