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19 CHANDLER ROAD 12-27-20 CLAIM RECEIVED 1100 Crown Colony Drive MAR 0 8 2021 P.O.Box 699195 Quincy,MA 02269-9195 A ► L L CITY OF SALEM 617.328.2800 BOARD OF HEALTH arbella.com March 2, 2021 SALEM HEALTH DEPARTMENT SALEM CITY HALL 93 WASHINGTON STREET SALEM, MA 01970 Claim Number: 034167130 Policy Number: 96266400004 Company Name: Arbella Mutual Insurance Company Date of Loss: 12/27/2020 Insured: SEAN KELLEHER Property Location: 19 CHANDLER RD, 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, Karen Kimball Claim Service Specialist Property Claim Office 800-272-3552 ext. 7398 Fax 617-773-4760