36 Forrester Street 4-10-20 claim y,'w 1100 Crown Colony Drive
P.O.Box 699195
�� Quincy,MA 02269-9195
617.328.2800
INSURANCE GROUP arbella.com
April 16, 2020 RECEIVED
SALEM HEALTH DEPARTMENT APR 212020
SALEM CITY HALL CITY OF SALEM
93 WASHINGTON STREET BOARD OF HEALTH
SALEM, MA 01970
Claim Number: 034105200
Policy Number: 21234400006
Company Name: Arbella Mutual Insurance Company
Date of Loss: 04/10/2020
Insured: LARS HOFFBECK
Property Location: 36 FORRESTER ST UNIT 3, 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
I