34 BELLEVIEW AVENUE 4-19-21 CLAIM RECEIVED
1100 Crown Colony Drive
MAY 0 3 2021 P.O.Box 699195
T T � Quincy,MA 02269-9195
L L CITY OF SALEM 617.328.2800
INSURANCE GROUP BOARD OF HEALTH arbella.com
April 27, 2021
SALEM HEALTH DEPARTMENT
SALEM CITY HALL
93 WASHINGTON STREET
SALEM, MA 01970
Claim Number: 034178115
Policy Number: 25341400006
Company Name: Arbella Indemnity Insurance Company
Date of Loss: 04/19/2021
Insured: MATTHEW BEANE
Property Location: 34 BELLEVIEW 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 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,
Karen Kimball
Claim Service Specialist
Property Claim Office
800-272-3552 ext. 7398
Fax 617-773-4760