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4 LOWELL STREET 1-17-22 CLAIM RECEIVE® 1100 Crown Colony Drive JAN 2 5 2022 P.O.Box 699195 Quincy,MA 02269-9952 A R B E L LA CITY OF SALEM617.328.2800.2800 INSURANCE GROUP (BOARD OF HEALTH arbella.com January 18, 2022 SALEM HEALTH DEPARTMENT SALEM CITY HALL 93 WASHINGTON STREET SALEM, MA 01970 Claim Number: 034238950 Company Name: Arbella Mutual Insurance Company Date of Loss: 01/17/2022 Insured: ROSEMARY BANE BOGAN Property Location: 4 LOWELL 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, Marc Lindell Claim Service Specialist Property Claim Office 800-272-3552 ext. 6867 Fax 617-773-4760