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95 Insurance Loss 2019 1103 Crown Colony Drive P.O.Box 699195 Quincy,MA 02269-9195 A R B E L L A 617.328.2800 INSURANCE GROUP arbella.com I September 25, 2019 NORTHAMPTON BUILDING COMMISSIONER CITY GOVERNMENT OFFICE 212 MAIN STREET 4"100' NORTHAMPTON,MA 01060 Claim Number: 034058276 Policy Number: 04917400004 Company Name: Arbella Mutual Insurance Company Date of Loss: 09/18/2019 Insured: CONSTANCE COGGSWELL Property Location: 95 STATE ST,NORTHAMPTON, 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. Sincerely, Marc Lindell Claim Service Specialist Property Claim Office 800-272-3552 ext. 6867 Fax 617-773-4760 CC: NORTHAMPTON HEALTH DEPARTMENT CITY GOVERNMENT OFFICE 212 MAIN STREET#101 NORTHAMPTON, MA 01060 CC:NORTHAMPTON FIRE DEPARTMENT CITY HALL 21OMAN STREET -�:'NORTHAMPTON MA 01060