AVA Insurance Requests 2024/03/04
    IDs: R3231


Insurance AVA RequestID: R3231   Due Date: 04/15/2024   Request Date: 03/02/2024

Event Information
Request #: R3231
Event #: 126814
Event: Walk
Location: Old Tipp Town, IN
Date: 05/25/2024 - 05/25/2024
Club: AVA-0723 Hoosier Hikers
Contact Information
Robert Buzolich
(574) 339-9140
sonofbuzz@prodigy.net
1703 E Howard St, South Bend, IN 46617-1826
Additional Insured: 1
Potawatomi Park, Inc.
Beneficial Administrator of Corporate Properties
16998 State Road 331
Tippecanoe IN, 46570-9786