AVA Insurance Requests 2024/07/17
    IDs: R3270


Insurance AVA RequestID: R3270   Due Date: 07/31/2024   Request Date: 07/15/2024

Event Information
Request #: R3270
Event #: 127203
Event: Seasonal Bike
Location: Middlebury, IN
Date: 04/01/2025 - 10/31/2025
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
ELKHART COUNTY PARKS
211 W Lincoln Ave
Goshen IN, 46526-3280

Beneficial Administrator of Corporate Properties
Additional Insured: 2
TOWN OF MIDDLEBURY
418 North Main Street
Middlebury IN, 46540-9216

Beneficial Administrator of Corporate Properties
Additional Insured: 3
TOWN OF SHIPSHEWANA
PO Box 486
Shipshewana IN, 46565-0486

Beneficial Administrator of Corporate Properties
Additional Insured: 4
FRIENDS OF THE PUMPKINVINE NATURE TRAIL, INC.
PO Box 392
Goshen IN, 46527-0392

Beneficial Administrator of Corporate Properties