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22 West Avenue 9-1-20 claim 1100 Crown Colony Drive + P.O.Box 699195 �� Quincy,MA 02269-9195 ARBELL617.328.2800 INSURANCE GROUP arbella.com September 24, 2020 RECEIVED SALEM HEALTH DEPARTMENT OCT a 6 2020 SALEM CITY HALL 93 WASHINGTON STREET CITY OF SALEM SALEM, MA 01970 BOARD OF HEALTH Claim Number: 034135096 Policy Number: 88061400005 Company Name: Arbella Mutual Insurance Company Date of Loss: 09/01/2020 Insured: LAUREL GUY Property Location: 22 WEST AVE, 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