399 Lafayette Street 6-11-20 claim e! 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
June 17,2020
RECEIVED
JUN 2 2 2020
SALEM HEALTH DEPARTMENT CITY OF SALEM
SALEM CITY HALL BOARD OF HEALTH
93 WASHINGTON STREET
SALEM, MA 01970
Claim Number: 034114385
Policy Number: 42560400004
Company Name: Arbella Mutual Insurance Company
Date of Loss: 06/11/2020
Insured: S BEHESHTI
Property Location: 399 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 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,
Cynthia Holden-Amor
Claim Service Specialist
Property Claim Office
800-272-3552 ext.7549
Fax 617-773-4760