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414.5 Lafayette Street 7-6-21 claim RECEIVE 1100 Crown Colony Drive JUL 15 2021 P.O.Box 699195 Quincy,MA 02269-9952 ARBELLA: 617.328.2800 INSURANCE GROUP CITY OF SALEM arbella.com BOARD OF HEALTH July 12, 2021 SALEM HEALTH DEPARTMENT SALEM CITY HALL 93 WASHINGTON STREET SALEM, MA 01970 Claim Number: 034194594 Policy Number: 29244400004 Company Name: Arbella Mutual Insurance Company Date of Loss: 07/06/2021 Insured: MAURICE MOLONEY Property Location: 414 1/2 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. Best regards, Douglas McGuirk Claim Service Specialist Property Claim Office 800-272-3552 ext. 2454 Fax 617-773-4760