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HomeMy WebLinkAbout234327 07/01/2014 .�''`""y CITY OF CARMEL, INDIANA VENDOR: 361521 ® ONE CIVIC SQUARE ANTHONY KEATON CHECK AMOUNT: $ ......75.00" r. CARMEL, INDIANA 46032 7655 MADDEN LANE CHECK NUMBER: 234327 '''�.oN�� FISHERS IN 46038 CHECK DATE: 07/01/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4357004 75.00 EXTERNAL INSTRUCT FEE �\ON ofq CSP' ��'Qsp IAAI-FIT Q FIRE a INVESjTIGAYON;y International Association of Arson Investigators, Inc. o TECHNICIAN Fire Investigation Technician d'�1N1 3 �D National Fire Academy Reciprocity Application Includes IAAI Membership* PAYMENT: Eligible Fire/Arson Origin and Cause Investigations R0206 applicants: $150.00 USD *Current IAAI members will have their membership extended for 1 year. Complete credit card payment page included in the application or Make checks payable to IAAI SUBMISSION: Email t0: IAAI-FIT(aDfirearson.com or Mail to: 2111 Baldwin Avenue, Suite 203, Crofton, MD 21114 IAAI Member No.: l 3(9-5-7'76 Date of Birth: I o-,)-y-7-3 Prefix: First: M.I.: Last: Suffix: Company: Supervisor: 0,11Lv cL x.,-0-7� Title s/fiF7 rNv��s7�6�`r�� Address: �� Y�c s��/ �` Home ❑Work [ Apt. No.: City: State: t Country: u-CA Zip: Work # ( T17 )S-7l eUOO Fax# ( ) Cell # ( 3r7 ) 4T/ Home# ( ) E-mail Address: Occupational Affiliation (Select One) ire Investigator-Fire Department-Local/County ❑ Fire Investigator-Police/Peace Officer-Local/County ❑ Fire Investigator-State/County ❑ Fire Investigator-Federal ❑ Fire Investigator-Private ❑ Firefighter/Officer ❑ Police Officer/Detective ❑ Insurance Claims Adjuster ❑ Insurance SIU ❑ Engineer PE, EE, Etc. ❑ Attorney-Prosecutor ❑ Attorney-Private Sector ❑ Forensic Laboratory ❑ Forensic accountant ❑ Instructor ❑ Retired Type of Fire Department(Select One) Career ❑Volunteer ❑ Combination ❑ N/A Have you ever been convicted a crime, felony or misdemeanor? Note: A yes answer to this question may affect your acceptance as a member of the International Association of Arson Investigators. 2110 ❑ Yes If yes, explain offense and date/location of conviction. Have you ever been denied membership in, or had your membership suspended, or revoked by the IAAI, any affiliate Chapter, or any other fire service/law enforcement or other organization? Note: A yes answer to this question may affect your acceptance as a member of the International Association of Arson Investigators. PNo ❑ Yes If yes, please explain. Are you interested in serving on an IAAI Committee ❑ Yes ©'No Are you interested in delivering IAAI training ❑ Yes [9-No Are you a member of an IAAI Chapter ❑ Yes E'>vo If yes, please list -SON ofq Rso IAAI-FIT Q f- 4RE International Association of Arson Investigators, Inc. Fire Investigation Technician a INVESTIGATION; 9 s TECHNICIAN = National Fire Academy Reciprocity Application o g 6,L .spy Includes IAAI Membership d�1NI -)NQS WORK EXPERIENCE: You must have a minimum of 18 months of general experience in afire investigation related industry. Please provide documentation to support your experience such as a letter from your employer or employment records. Current Employer --/t-&4/er - rrfRc- A/,--r Office Use Only Position: f-" 4- _574-t J117- i V 6rS7-r,e; A� Address: 2 G r Ir1C -5 �A-Zvle � r- ►-/6d 3 1- Phone: Y r 7 t-I 3( o H ys; Supervisor Years of Experience: 3 Dates: From: / To: --7 Letter from Employer attached? Yes No❑ Previous Employer.- Office Use Only Position: Address: Phone: Su ervisor. Years of Ex erience: Dates: From: To: Letter from Employer attached? Yes❑ No❑ TRAINING & EDUCATION: Please provide information regarding the training courses that you are submitting in support of your application for the Fire Investigation Technician Program. Supporting documentation can either be contained in a transcript or on a course certificate.All documentation will be subject to approval. Additional pages may be attached if necessary. Course Title Date Tested Office Use Hours Only Track CFITrainer.net-Ethics and the Fire Investigator /a iZ 3 A CFITrainer.net-NFPA 1033 and Your Career 2 C FI Trainer.net-The Practical Application of the �a�,L 2 Relationship Between NFPA 1033 and NFPA 921 FAOCI-RO206 ° Total Hours (Minimum of 47): 7 By submitting this application to the IAAI, with all required documentation, either via mail or electronic communications, the applicant hereby makes application for membership in the International Association of Arson Investigators in accordance with its Constitution and By-Laws, and agrees to be bound therewith and certifies the information submitted for the IAAI-FIT designation to be true and accurate and certifies that they have read and understand the program requirements. The intentional submission of false information as part of this application will be cause for immediate rejection of the application and potentially subject the applicant to other penalties, including removal of IAAI member benefits. Applicant's signature: Date: "\ON of AR LSP•,4p���' 'y 'sQ FIRE �aIAAI-FIT a INVESTIGATION International Association of Arson Investigators, Inc. zFire Investigation Technician o TECFJNIC9AN�. N �N�S� National Fire Academy Reciprocity Application Applicants Last Name: �-r '`✓y �` ' '�'� PAYMENT: Eligible Fire/Arson Origin and Cause Investigations R0206 applicants: $150.00 USD Pp r-o S U/3 M 11(7 7� Payment method: ❑VISA ❑ MC ❑AMEX Check No.: P.O_ No.: Card Number: Security Code: Name on Card: Expiration Date: Billing Address(if different from firstpage): Prin Signature: ted Name: /r y � Snyder, Denise W From: tony <tkeaton495@hotmail.com> Sent: Friday, June 27, 2014 09:35 To: Snyder, Denise W Subject: FW:IAAI Receipt From: Chris.Burt@firearson.com To:tkeaton495@hotmail.com Subject: RE: IAAI Receipt Date: Wed, 30 Apr 2014 17:03:10+0000 Yes. You had recently paid your membership. Christine Burt Certification and Membership Coordinator International Association of Arson Investigators 2111 Baldwin Avenue, Suite 203 Crofton, Maryland 21114 410-451-FIRE (3473) 800-468-4224 410-451-9049 Fax chris.burtfirearson.com http://www.firearson.com AIMNNoFq "NItF57iLA7MN 4" Jm �S From: tony [mailto:tkeaton495Ca)hotmail.com1 Sent: Wednesday, April 30, 2014 12:04 PM I To: Chris Burt Subject: RE: IAAI Receipt Does this cover the FIT certification only? Then I will pay at my normal time for membership? Thank you Tony From: chris.burt@firearson.com To:tkeaton495@hotmail.com Subject: IAAI Receipt Date: Tue, 29 Apr 2014 18:36:59 -0400 i x International Association of Arson Investigators 2111 Baldwin Avenue, Suite 203 Crofton, Maryland 21114 410-451-3473 410-451-9049 Fax www.firearson.com iaai@firearson.com 4/29/2014 Anthony Keaton 7655 Madden Lane Fishers, IN 46038 Re: Member Number- 1305790 Your payment has been received and processed. Payment Amount: 75.00 Invoice Total: 75.00 Miscellaneous Total: 0.00 Check Number: cc Credit Card: AMER xxxxxxxxxxx1002 Please contact the IAAI Office if you have any questions or need additional information. x 2 Outlook.com-tkeaton495@hotmail.com https://blul72.mail.live.com/default.aspx?id=64855 New Reply Delete Archive Junk Sweep Move to Categories tony A International Association of Arson Investigators Customer Folders Receipt/Purchase Confirmation Inbox From IAAI (iaaimail @firearson.com) 4/29/14 Junk 1 To:Anthony Keaton Drafts 1 From: From IAAI(iaaimail@firearson.com) Sent Sent Tue 4/29/14 526 PM Deleted To: Anthony Keaton(tkeaton495@hotmail.com) POP Be careful!This sender failed our fraud detection checks. New folder Thank you for your order! Order Information Merchant: International Association of Arson Investigators Description: IMPak Cash:011136-CDB-1305790-cc Invoice Number: 1305790 Customer ID: 1305790 Billing Information Shipping Information Anthony Keaton 7655 Madden Lane Fishers,IN 46038 tkeaton495@hotmil.com Total: US$75.00 American Express Date/Time: 29-Apr-2014 17:26:38 EDT Transaction ID: 6133653924 ®2014 Microsoft Terms Privacy&cookies Developers English(United States) 1 of 1 5/30/2014 6:58 PM AMERICAN Blue Cash Everyday° from American Express p.1/7 EGRESS a ANTHONY R KEATON Closing Date 05/02/14 Account Ending 6-21002 Blue Cash Rewards New Balance $625.13 as of Apr 2014 Minimum Payment Due $35.00 155.96 For details,please see your i Reward Dollar Summary Payment Due Date 05/27/14 Account Summary Late Payment Warning: If we do not receive your Minimum Payment Due by Previous Balance $759.74 the Payment Due Date listed above,you may have to pay a late fee of up to Payments/Credits -$1,317.07 $35.00 and your Purchase APR may be increased to the Penalty APR of 27.24°x6. New Charges +$1,182.46 Fees +$0.00 Interest Charged +$0.00 Minimum Payment Warning: If you make only the minimum payment each period, New Balance $625.13 you will pay more in interest and it will take you longer to pay offyour balance. For Minimum Payment Due $35.00 example: Credit Limit $9,100.00 Ifyou make no additional I You will pay offthe balance 1 And you will payan Available Credit $8,474.87 charges and each month you shown on this statement in f estimated total of... PaY••• about... Cash Advance Limit $1,300.00 i —�-- Available Cash $1,300.00 Only the Days Period: 30 Minimum Payment Due ` 21 months I $712 Y 9 If you would like information about credit counseling services,call 1-888-733-4139. Customer Care PSee page 2 for important information about youraccount. Im Pay byComputer amerlcanexpress.com/pbc Customer Care Pay by Phone 1-888-258-3741 1-800-472-9297 RSee Page 2 for additional information + Pleasefold on the perforation below,detach and return with your payment + ®Payment Coupon �PaybyComputer ®Pay by Phone Account Ending 6-21002 Do not staple or use paper clips americanexpress.com/pbc 1-800-472-9297 Enter account number on all documents. Make check payable to American Express. ANTHONY R KEATON 7655 MADDEN LN Payment Due Date FISHERS IN 46038-1303 05/27/14 New Balance $625.13 Minimum Payment Due $35.00 AMERICAN EXPRESS $ ❑ Check here if your address or P.O.BOX 650448 Amount Enclosed phone number has changed. DALLAS TX 75265-0448 Note changes on reverse side. IIIIII�I�I111'IIT���I�I�I�����I��I�I��III�I11'lllll�llll�lll 0000349992017167444 000062513000003500 01 ri ANTHONY R KEATON Account Ending 6-21002 p.4/7 Detail Continued Amount 04/11/14 KFC X314034 140346CARMEL IN $5.45 317-8464107 04/13/14 MARSH#017000000000FISHERS IN $2.38 3175775325 04/13/14 JO-ANN ETC 1910 19101NDIANAPOLIS IN $10.57 SEWING&FABRIC STORE 04/15/14 MCDONALD'S F3258200NOBLESVILLE IN $4.89 3175770815 04/20/14 SEARS HHO INC 05340 FISHERS IN $8.54 Description Price LAWN,GARDEN,PATIO $4.99 LAWN,GARDEN,PATIO $2.99 04/20/14 KROGER#944000000943175798309 $7.01 3175798309 GROCERY STORES 04/21/14 SPEEDWAY 08041 723 5FISHERS IN $29.40 2175788092 Description Price AUTOMATED FUEL DISP $29.40 04/21/14 PENN STATION#10650INDIANAPOLIS IN $8.11 3172437366 04/22/14 TACO BELL#28921 OOOCARMEL IN $5.98 317-8444124 Description FAST FOOD RESTAURAN 04/23/14 WHICH WICH CARMEL CARMEL IN $8.34 FAST FOOD RESTAURANT 04/26/14 TARGETT13501350 FISHERS IN $26.62 DISCOUNT STORE 04/26/14 LITTLE CAESARS 3072-FISHERS IN $19.42 7656402409 Description RESTAURANT CHARGES 04/26/14 PUCCINI'S 5429298044FISHERS IN $14.74 3175790572 FOOD/BEVERAGE $14.74 04/26/14 SPEEDWAY 08041 723 5FISHERS IN $48.86 2175788092 Description Price AUTOMATED FUEL DISP $48.86 04/26/14 KROGER#944 000000943175798309 $54.01 3175798309 GROCERY STORES 04/27/14 KROGER#944000000941NDIANAPOLIS IN $11.98 98309 Description Price GROCERY STORES $11.98 0"%29/14 INTERNATIONAL ASSOC CROFTON MD $75.00 410-451-5105 Description TUITION/FEES Continued on ne e Prescribed by State Board of Accounts City Form No.201 (Rev.1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service,where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) $75.00 1 hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 20 Clerk-Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 Tony Keaton IN SUM OF $ $75.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1120 43-570.04 $75.00 1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except F Af Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund