10 LOVETT STREET #1 - CLAIMLTR I 1100 Crown Colony Drive
P.O.Box 699195
A R B E L L A° Quincy,MA 02269-9952
617.328.2800
INSURANCE GROUP arbellaxom
August 23,2021
SALEM BUILDING COMMISSIONER
SALEM CITY HALL
93 WASHINGTON STREET
SALEM, MA 01970
Claim Number: 034204567
Policy Number: 09259400006
Company Name: Arbella Indemnity Insurance Company
Date of Loss: 08/19/2021
Insured: MATTHEW MODAFF
Property Location: 10 LOVETT ST#1, 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,
Debra Gellerman
Claim Service Specialist
Property Claim Office
800-272-3552 ext. 7358
Fax 617-773-4760
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