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141 FORT AVE - CLAIM NOTICE 1100 Crown Colony Drive P.O.Box 699195 A g Quincy,MA 02269-9952 ARBELL.C]h 617.328.2800 INSURANCE GROUP arbella.com August 4, 2021 SALEM BUILDING COMMISSIONER 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 313 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 AUG 9 PM4: 88 AUG