430 Loring Avenue 10-31-19 claim RECEIVED
>w 1100 Crown Colony Drive
NOV 12 2019 P.O.Box 699195
Quincy,MA 02269-9195
A R B E L L A® CITY OF SALEM 6117.328 2800
INSURANCE GROUP BOARD OF HEALTH arbella.com
November 5, 2019
SALEM BUILDING COMMISSIONER
SALEM CITY HALL
93 WASHINGTON STREET
SALEM, MA 01970
Claim Number: 034069255
Policy Number: 30339400004
Company Name: Arbella Mutual Insurance Company
Date of Loss: 10/31/2019
Insured: SHEILA THEBERGE
Property Location: 430 LORING 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
CC: SALEM HEALTH DEPARTMENT
SALEM CITY HALL
93 WASHINGTON STREET
SALEM, MA 01970
CC: SALEM FIRE DEPARTMENT
48 LAFAYETTE STREET
SALEM, MA 01970