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21 Settlers Way 7-4-20 claim 1100 Crown Colony Drive P.O. Box 699195 A R B E L L A° Quincy,MA 02269-9195 617.328.2800 INSURANCE GROUP arbella.com July 15, 2020 SALEM HEALTH DEPARTMENT SALEM CITY HALL 93 WASHINGTON STREET SALEM,MA 01970 Claim Number: 034119051 Policy Number: 93491400005 Company Name: Arbella Indemnity Insurance Company Date of Loss: 07/04/2020 Insured: ROBERT PETERSON Property Location: 21 SETTLERS WAY, 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, Cynthia Holden-Amor Claim Service Specialist Property Claim Office 800-272-3552 ext.7549 Fax 617-773-4760