HomeMy WebLinkAbout234933 07/16/14 ♦y W.G!7N,yR
CITY OF CARMEL, INDIANA VENDOR: 368220
ONE CIVIC SQUARE OHIO ASSOC OF EMERGENCY VEHICLECHECK AMOUNT: $.....**770.00*
CARMEL, INDIANA 46032 TECHNICIANS CHECK NUMBER: 234933
'MiTON-�o: PO BOX 303 CHECK DATE: 07/16/14
AVON OH 44011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4357004 770.00 EXTERNAL INSTRUCT FEE
TUITION INFORMATION
REGISTRATION CLOSES SEPTEMBER 12, 2014
Late registration rate will be required. $20 per day/class.
FULL PACKAGE
Includes the 5 day symposium, daily lunch, and the Wednesday night Banquet:
$385.00 X
Daily Rate - Any Class................................................. $130.00
The Wednesday Night Banquet-
ADDITIONAL TICKETS ...................... $25.00
TOTAL ENCLOSED-
Late Registration after 9-12-14 Full Week.................. $100.00
Per Day/Class...................................... $20.00
TOTAL INCLUDING LATE REGISTRATION
Send registration form along with full tuition or payment verification:
(for example, purchase order number from your employer)
Registration: Monday 7:30 AM Welcome & General Assembly: Monday 8:30 AM to 5:30 PM
Class Times: Classes are Tuesday thru Thursday from 9 AM to 4 PM, with one hour for
lunch and two 15 minute breaks. Friday 9 AM - 12 PM
Lunch will be in the Ohio Fire Academy cafeteria. Meal tickets will be issued to each student.
Some classes are limited in size due to hands-on training. Register early, classes will be filled on
a first come, first served basis.
Class registrations must be postmarked by September 12, 2014.
Certificates of attendance will be awarded upon payment of all fees and verification of
attendance.
Students are responsible for providing suitable personal protective equipment, i.e., eye
protection, hearing protection, as may be needed for the hands-on portion of any class.
O.A.E.V.T. reserves the right to cancel or substitute classes due to conditions beyond our control.
Reasonable efforts have been made to confirm the classes and instructors scheduled.
Please call Pat Guhde (440) 476-8707 or E-mail at pguhde@AOL.com
4
ATTENDEE REGISTRATION FORM
2014 OHIO ASSOCIATION OF EMERGENCY VEHICLE TECHNICIANS
EMERGENCY APPARATUS MAINTENANCE SYMPOSIUM
NOTE: PLEASE PRINT or TYPE all information. This form must be filled out completely or it will
be returned to you. DEADLINE for registration is September 12, 2014. All late registrations after
9-12-14 will be required to pay a fee of$20 per day/class or $100 total for the week.
Full registration refund prior to 8-31-14. 50% refund prior to 9-5-14. No refund after 9-5-14.
Name &)SCRT 00y0®?,S
Preferred Address of 3 VO a MME BA l id R D
City S14'FrZ1DAIJ State Gil Zip
Cell Phone (°3i7) l �/- 09,5-5 Work Phone (W) s'7/- o? a O
E-mail R UAAR)cyakSi AR-m .7,AJ o 4 o I�
Fire Dept./ Agency / Company Cly or CARM F& --/eel= .DSP I
Address CiOIC SELAAc 6,421nFL .1�►J Zip
Do you plan to attend Wednesday night Banquet? (x ) Yes ( ) No
How did you hear about this training symposium Amp-ozo CASTy ARL
REGISTRATION
Carefully fill out the registration form and send it along with full tuition or payment
verification: (for example purchase order number from your employer)
Ohio Association of Emergency Vehicle Technicians, Inc.
P.O. Box 303 • Avon, Ohio 44011
Use class selection number— PLEASE indicate second choice!-
Monday Tuesday Wednesday Thursday Friday
First rte/
Choice I® v
Second 1
Choice Q� 0
Form may be photocopied as needed.
3
ATTENDEE REGISTRATION FORM
2014 OHIO ASSOCIATION OF EMERGENCY VEHICLE TECHNICIANS
EMERGENCY APPARATUS MAINTENANCE SYMPOSIUM
NOTE. PLEASE PRINT or TYPE all information. This form must be filled out completely or it will
be returned to you. DEADLINE for registration is September 12, 2014. All late registrations after
9-12-14 will be required to pay a fee of$20 per day/class or $100 total for the week.
Full registration refund prior to 8-31-14. 50% refund prior to 9-5-14. No refund after 9-5-14.
Name ..1 ft�ifOfJQC�
Preferred Address 2.) 5 a�( �qgm C>R� /Z
City / )O L F.S 1)i L L F_' State Zip
Cell Phone 713) (,v 0 -- q2 o:l Work Phone 9-4 1 - 2&OD
ILI
E-mail J
Fire De ./ Agency / Company Ate- 4F-i
Address �o �P✓t. C Se L) ` � C`9 2M L, �� Zip
Do you plan to attend Wednesday night Banquet? ( ) Yes ( ) No
How did.you hear about this training symposium
REGISTRATION
Carefully fill out the registration form and send it along with full tuition or payment
verification: (for example purchase order number from your employer)
Ohio Association of Emergency Vehicle Technicians, Inc.
P.O. Box 303 • Avon, Ohio 44011
Use class selection number— PLEASE indicate second choice!
Monday Tuesday Wednesday Thursday Friday
F
L '
10'-
Form may be photocopied as needed.
3
VOUCHER NO. WARRANT NO.
ALLOWED 20
Ohio Assoc. of Emergency Vehicle Technicians
IN SUM OF$
P.O. Box 303
Avon, OH 44011
$770.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#ITITLE AMOUNT Board Members
1120 43-570.04 $770.00 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
JUL 14 gnu
B
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
I
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))
$770.00
I 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