9 North Pine Street 3-1-20 claim 1100 Crown Colony Drive
Ad A P.O.Box 699195
A R B E L L A Quincy,MA 02269-9195
.328.2800
617.328.2800
INSURANCE GROUP arbella.com
March 4, 2020 RECEIVED
SALEM BUILDING COMMISSIONER MAR 10 2020
SALEM CITY HALL CITY OF SALEM
93 WASHINGTON STREET BOARD HEALTH
SALEM, MA 01970
Claim Number: 034097902
Policy Number: 54978400005
Company Name: Arbella Mutual Insurance Company
Date of Loss: 03/01/2020
Insured: KATIE IRVING
Property Location: 9 NORTH PINE ST, SALEM, MA
To Whom 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,
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