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331 Lafayette Street 1-17-20 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 RECEIVED January 24, 2020 JAN 2 8 2020 SALEM BUILDING COMMISSIONER SALEM CITY HALL BCITYOARD O SALEM OF HEALTH 93 WASHINGTON STREET SALEM, MA 01970 Claim Number: 601KI91403 Policy Number: 8500067799 Company Name: Arbella Protection Insurance Company Date of Loss: 01/17/2020 Insured: 331 LAFAYETTE ST LLC Property Location: 331 LAFAYETTE 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 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, Melissa Ross Claim Service Specialist Property Claim Office 800-272-3552 ext. 2489 Fax 617-773-4760 CC: SALEM HEALTH DEPARTMENT SALEM CITY HALL 93 WASHINGTON STREET SALEM, MA 01970 CC: SALEM FIRE DEPARTMENT 48 LAFAYETTE STREET SALEM, MA 01970