11 Roslyn Street 10-6-20 claim RECEIVED
1100 Crown Colony Drive
�,- OCT 102020 P.O.Box 699195
A R B E L L-A. Quincy,MA 02269-9195
.328.2800
CITY OF SALEM 617.328.2800
INSURANCE GROUP arbella.com
BOARD OF HEALTH
October 13, 2020
SALEM HEALTH DEPARTMENT
SALEM CITY HALL
93 WASHINGTON STREET
SALEM, MA 01970
Claim Number: 034138868
Policy Number: 05056400004
Company Name: Arbella Mutual Insurance Company
Date of Loss: 10/06/2020
Insured: John Karedis
Property Location: 11 Roslyn 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 313 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,
Cynthia Holden-Amor
Claim Service Specialist
Property Claim Office
800-272-3552 ext.7549
Fax 617-773-4760