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13 FIRST STREET 1-2-22 CLAIM RECEIVED 1100 Crown Colony Drive P.O.Box 699195 JAN 10 2022 Quincy,MA 02269-9952 A R B E L L Ag 617.328.2800 INSURANCE GROUP? CITY OF SALEM arbella.com BOARD OF HEALTH January 4, 2022 SALEM HEALTH DEPARTMENT SALEM CITY HALL 93 WASHINGTON STREET SALEM, MA 01970 Claim Number: 034236004 Company Name: Arbella Mutual Insurance Company Date of Loss: 01/02/2022 Insured: MAHADEVA DANIEL Property Location: 13 FIRST ST D-2, 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