33 Walter Street 10-22-20 claim 1100 Crown Colony Drive
�I►� P.O.Box 699195
A R B E L L A Quincy,MA 02269-9195
617.328.2800
INSURANCE GROUP arbella.com
October 28, 2020 RECEIVED
O C T 3 0 2020
SALEM HEALTH DEPARTMENT �;rr"Y OF SALEM
SALEM CITY HALL SC?ARD OF HEALTH
93 WASHINGTON STREET
SALEM,MA 01970
Claim Number: 034143025
Policy Number: 27551400004
Company Name: Arbella Mutual Insurance Company
Date of Loss: 10/22/2020
Insured: PATRICIA MILLBURY
Property Location: 33 WALTER 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,
Douglas McGuirk
Claim Service Specialist
Property Claim Office
800-272-3552 ext. 2454
Fax 617-773-4760