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141 Fort Avenue 8-3-21 claim RECEIVED 1100 Crown Colony Drive 41 AUG Q 9 2021 P.O.Box 699195 2269-9952 A R B E L L.A: CITY OF SALEM Quincy,M 6 07 328 2800 INSURANCE GROUP BOARD OF HEALTH arbella.com August 4, 2021 SALEM HEALTH DEPARTMENT SALEM CITY HALL 93 WASHINGTON STREET SALEM, MA 01970 Claim Number: 034200864 Policy Number: 39049400004 Company Name: Arbella Mutual Insurance Company Date of Loss: 08/03/2021 Insured: ROBIN STEIN Property Location: 141 FORT 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. Best regards, James Handerhan Claim Service Specialist Property Claim Office 800-272-3552 ext. 2329 Fax 617-773-4760