20 CENTRAL STREET 10-3-20 CLAIM ,.-A RECEIVED 1100 Crown Colony Drive
P.O.Box 699195
O C T 13 2020 Quincy,MA 02269-9195
A� $ � L L � CITY OF SALEM 6 7.32.arbellaco00
INSURANCE GROUP BOARD OF HEALTH
October 6, 2020
SALEM HEALTH DEPARTMENT
SALEM CITY HALL
93 WASHINGTON STREET
SALEM, MA 01970
Claim Number: 034137283
Policy Number: 92178400005
Company Name: Arbella Mutual Insurance Company
Date of Loss: 10/03/2020
Insured: NICHOLAS MCCAULLEY
Property Location: 20 CENTRAL ST#216, 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,
Sarah Monaco
Claim Service Specialist
Property Claim Office
800-272-3552 ext. 7323
Fax 617-773-4760