247345 07'/15/15 i
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tF. CITY OF CARMEL, INDIANA VENDOR: 362436
ONE CIVIC SQUARE INTERNTL ASSOC OF ARSON INVEST. CHECK AMOUNT: $*j******600.00*
'•S9\ ,_�. CARMEL, INDIANA 46032 2111 BALDWIN AVENUE,STE 203 CHECK NUMBER: 24;7345
Mi-—w�. CROFTON MD 21114 CHECK DATE: 07/15/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4355300 600.00 ORGANIZATION &j MEMBER
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In emationa Association of Arson Investigators, Inco
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I application for Membership
T hereby mala application•for Active($loo),.❑,Associate($i:oo),Q Student('$25),or []Retired($25
membership in the Intexnati.dnaXAssociation of Arson Investigators'n accordance:with its Constitution and.
By--Laws;and agree to be bound therewith..I am transmitting annualmembership dues(USD)with this:
application.I affirm that all information given by me is true and,accurate. (Descriptions,of membership,
types caii be found at;www.flrearson com.)
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Prefix: Firs�"1V a.: � Last: � Suffix: Date of Birth,
Home Address,
1 ` :v
city 1 ��,3)012-S�X, StA- /,Pi:ovince 4- lQ zip/Postal Code HL-9-Z " _Couutry_1�2�h
`Home#(a77 ) el6b - 035E-mail Address: p o/ W)
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"Employer rW-",\ S
'title e � 2
Business Address v c
City��( rc\C1 .State/Province � Zip/Postal Code Gauntry a
N?ork; (` l-1 )S^l ``a.L° Fax#(. ) Cell
Oe upational Affiliation(Select One)
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Fire Investigator Fn a Department,Local/County ❑Fire Investigator Police/Peace officer toeal/Couinty
Fire Investigator State/County ❑'Fire Investigtitor:Federal, ❑Firp Investigatoi�P�ivate
❑Fhrefighter/Of cer ❑Police officer/Detective D Insurance..Claims ALdjuster ❑Insurance SIU
❑Engineer PA,:EE,Other. ❑AttoYneymProsecutor ❑Attorney Private Sector ❑Forensic Laboratory
t ❑Forensic Accountant ❑Instructor ❑Retired
Type of FYre:D.epartiiient: .Career❑Volunteer ❑Combination [I I'�iot:Applicable
u-evei;,been_canvieted:a crime;feloi>y gi finis.demeanor?Note.Ayes answer to this question may affect
Have yo.-
your acceptance as a member of the IAAI, o ❑Yes if yes,explain offense and date/location of conviction.
Have you:ever been denied membershipin,or b.ail.yoiir.membership suspended,car revoked by the IgA1,any
affiliate Chaptier,or any`other fire service/law enforcement or er organization?Note:A yes answer to this
question.may i ffect.your,acceptance as a member ofthe 1tiTo ❑Yes 'Ifyes,please e�lam.
���
i
;Are you interested in ser%ing on,an IAAI Committee? []'yes o f
Are you interested 2n delivering IAEM-training. ❑Yes o s
Are you a�meinUer of an W Chapter? ❑Yes o
If yes,please list p.
ai
Charge mymeiiiJbei:sltip dues ❑:Amex []Visa. ❑ MasterCard Account#.
Expiration elate.
Name an,card l
Billing Address
.' Applicant's signature Dafee,
s
• i r.
mail corresp i dence'to: ❑ Home 0 Business
Mail to:; '
UM 9111 Baldwin Avenue,Siiite 203,Crofton,Maryland'22114 or,Membership(a�firearson:com
10/2014
64 vyft.firears0lom Fire&Arson Investigator Janciary2015
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A International Association of Arson Investigators, Inc.
Application for Membership r
I
I hereby make application for®Active,($ioo), ❑Associate($ioo), ❑Student($25),or ❑Retired.($.25).
membership inf the International Association of Arson Investig'atvrs in a ccord'ance.with its"Constitution and, ;
By-Laws,and agree to.bebound therewith.I"am transmitting annual membership dues(USD)with this
application.I a firm that all information given by me is true and accurate: (Descriptions of membership
types can be found at www:firearson'.com.) I�
Prefix: First: M.I.: Last; A .fin Suffix:; Date of,Birth` / 1-�9- /S-76
Home Address
M; 11
city C-c r-m el State/Province :A/ Zip/Postal,Code L/n O �t,Country C.J 54
Homer('31 7 ) 7/0 -1/34 E-mail Address: 6 c./l fei
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Employer. G a I Pr � i R D T T Supervisor' 1'
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Title.
Susiness.Address �_ C
O�1_171 P 1 1. /L Pl �/6 o 3 vL �' (/SQ t
City G State Province Zi Postal.Code Counts K
Work#(3 / 7 ) S 21 - 2, O o Fax'#{ ) Cell#:(3/ -7 ) 75 OG 9,g 9<?,
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Occupational Affiliation(Select One) t
r 3 laYireInvestigator=Fire Department-Local/County ❑Fu a Investigator-Police/Peace Officer-Local/County
❑Firefi vter Officertate/County ❑Fire Investigator-Federal ❑Fire Investigator Private
❑_ _ gh _ / ❑PoIice.Officer/Detective Insurance Claims.Adjuster ❑Insurance SN
❑Engineer'PE,'EE,Other ❑Attorney-Prosecutor ❑Attorney-Private Sector ❑Forensic Laboratory
❑Forensic Accountant ❑Instructor ❑Retired
: s
Type of Fire Depart hent: OCareer ❑volunteer -]Combination ❑Not Applicable. ,
f
Have you:ever been convieted.a crime,felony or misdemeanor:?Note:A.yes.answer to this question may affect
❑Yes fYes,expIYour acceptance amember of �10 oense and daten
ochof conviction.
i E
i
Have you:everb'een denied membershig:in,or had your membership suspended,or reuoked bylhe IAI L any'
affiliate Chapter,or any other fire service/law enforeement.or other organization?Note:Ayes answer'to this
"! question may affect your acceptance as a member of the IAAI. 9No ElYes If yes,please explain.
Ar eyou interested in servitng:on an IAAI.Committee? El Yes QNo
Are you interested in delivering IAAI training? ❑Yes ®:No
Are.you a member of an IAAI Chapter? ❑Yes ONO
If yes,please list w
y Charge mymembersliip dues El Amex ❑visa ❑ Master Card Account#
Name on card Expiration date x
Billing Address
Applicant's signature Date:'-
Mail
ate:Marl correspondence to: ® Home ❑ Business
Mail.to:
IAAI 2111 Baldwin Avenue,Suite 203,Crofton,Maryland 21114 or Membership@firearson.com r
IN2oi4
Vis. '64 wmfirearsonxo Fire&Arson Investigator January2015
Ya A International Association of Arson Investigators, Ince
Application for Membership
I hereby make application for Active($1oo), ElAssociate($ioo), E] Student($25),or L] Retired($25)
membership in the Internationa Association of Arson Investigators in accordance with its Constitution and
By-Laws,and agree to be bound therewith. I am transmitting annual membership dues(USD)with this
application.I affirm that all information given by me is true and accurate. (Descriptions of'membership
types can be found at www.firearson.com.)
Prefix: Fust: /`�%}.✓ M.I.: L� Last: Swt �"!T Suffix: Date of Birth:
Home Address !G g l q k,e•v7"-L.w1) y r
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City 'Noet-s state/Province ✓_�__ Zip/Postal Code Country �Ly��.�
Home#( 3 o; ) qV L— j G ?3 E-mail Address: S' a �� �G !-✓
Employer G l kk d iC Supervisor �--r-
Title
Business Address
City CA y.94�L State/Province „�v Zip/Postal Code 6 0.3 3 Country
work#(3 171 ) S 7/ 9_600 Fax#( ) Cell#
Occupational Affiliation(Select One
i
Fire Investigl for-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,I EE,Other ❑Attorney-Prosecutor ❑Attorney-Private Sector El Forensic Laboratory
❑Forensic Accountant ❑Instructor ❑Retired
Type of Fire Department: PSCareer ElVolunteer ❑Combination ElNot Applicable
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 IAAI. Po ❑Yes If yes,explain offense and date/location of conviction.
y i i 4
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 orother organization?Note:A yes answer to this
question may affect your acceptance as a member of the IAAI JTo ❑Yes If yes,please explain.
Are you interested in serving on an IAAI Committee? ❑Yes No
I Are you interested in delivering IAAI training? ❑Yes No
Are you a member of an IAAI Chapter? ❑Yes No
G If yes,please list
i Charge my membership dues ❑Amex ❑Visa ❑ Master Card Account#
Name on card Expiration date
Billing Addres
Applicant's signature Date:
Mail correspondence to: ❑ Home ❑ Business
1( Mail to:
it LAAI,2111 Baldwin Avenue,Suite tog,Crofton,Maryland 21114 or Membership@firearson.com
i' 10/2014
64 www.firearsonxom Fire&Arson Investigator January2015
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T"7 a
International Associati®n of Arson Investigators, One.
Application for Membership
I
I hereby male application for Active(Wo),❑Associate($ioo), ❑ Student($25),or ❑ Retired($25)
membership in the InternatiokAssociation of Arson Investigators in accordance with its Constitution and
By-Laws,and agree to be bound therewith. I am transmitting annual membership dues (USD)with this
application.I affirm.that all information given by me is true and accurate. (Descriptions of membership .
types can be fund at www.firearson.com.)
Prefix: First: C►4K M.I.: f� Last: J__)r-C k a Suffix: Date ofBirth: 1� r7 4
Home Address 7 Z6-- 70
City J%�,� (C� State/Province `-Al Zip/Postal Code 021/Country�_
Home.#( 3 l j ) 7(a - 2��! E-mail Address: C ra 1« Ca e ,TN• G oy
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Employer &r n,7 e. Fi•2e f�P- Pt Supervisor gg
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Title L, e s_-t-e n st
Business Address 2 C i 0 `c Se: "u r&
City Com.r.t e- State/Province '-T y✓ Zip/Postal Code LI&03 Z Country
Work#('31-71 )5 7/-2600 Fax#( 317 ) 571-26-2 Cell#(
L:I
I
Occ ationaII Affiliation(Select One)
Fire 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 El Insurance Claims Adjuster El Insurance;SIU
El Engineer PE,EE,Other [I Attorney-Prosecutor El Attorney-Private Sector E]Forensic Laboratory
❑Forensic Accountant ❑Instructor ❑Retired
Type of Fire Department: Career ❑Volunteer ❑Combination ❑Not Applicable
Have you.ever been convicted.a crime,felonyoar misdemeanor?Note:A yes answer to this question may affect
your acceptance as a member of the IAAL o ❑Yes If yes,explain offense and date/location of conviction. j
,i
Have you ever been denied membership in,or had your membership suspended,or revolted by the IAAI,any
affiliate Chapter,or any other fire service/law enforcement or otherprganization?Note:Ayes answer to this }
question may,affct your acceptance as a member of the LAAI. o ❑Yes If yes,please explain.
Are you interested in serving on an IAAI Committee? ❑Yes L I X10
Are you interested in delivering IAAI training? ❑Yes [ N0
Are you a member of an IAAI Chapter? ❑Yes E3 No
j If yes,please list I
Charge my nimbership dues ❑Amex ❑Visa ❑ Master Card Account#
Name on card Expiration date
} Billing Address
Applicant's signature Date:
J
M
Mail correspi ndence to: ❑ Home ❑ Business
Al
Mail to:
l; IAAI,2111 Baldwin Avenue,Suite 203,Crofton,Maryland 21114 or Membership
1.0/2014
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64 ww4v.firearson.com Fire&Arson Investigator January20�5
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ontevne onN Ass®caaftn of Armon Wastigat®mq On.
it Application for Membership
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I hereby make application forActive($ioo), ❑Associate($ioo), El Student($25), or El Retired($25) `
membership'inl the Internationa Association of Arson Investigators in accordance with its Constitution and
By-Laws, and agree to be bound therewith. I am transmitting annual.membership dues(USI))with this
application..I,affirm that all information given by me is true and accurate. (Descriptions of membership i
I types can befound at www.-firearson.com.)
'i Prefix: . First: Nic Ci M.I.: Last: rlseo Suffix.: Date of Birth: 4-(6-f9q
,)
S Home Address cl4c�evS gv Ra�
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City No e syl i+c State/Province Zip/Postal Code 4060 Country U s,& j
Home#( 31-11 ) 3-70 - 5095 E-mail Address: M O Bri sco 2 D gr ai I•co n
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Employer Ci4y 09 Ccky rn, Supervisor capl. 7J;�n M"I"",-/y ;
Title 19V-!lajneer I
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Business, dress SD32 E ("Gin c'
I City Cay4-1a 1 State/Province 1N Zip/Postal Code 46092 Country V S,& 4
Work#( 3V7 ) 5-11-2044 Fax#( ) Cell#( 3i'7 ) S-70 -3055 i
Occupational(Affiliation(Select One)
Fire Investigator-Fire Department-Local/County ❑Fire Investigator-Police/Peace Officer-Local/County
1 ❑Fire Investigator-State/County ❑Fire Investigator-Federal ❑Fire Investigator-Private I
OFirefighter/Officer ❑Police Officer/Detective ❑Insurance Claims Adjuster ❑Insurance SIU
❑Engineer PE;EE,Other ❑Attorney-Prosecutor ❑Attorney-Private.Sector ❑Forensic Laboratory
i ❑Forensic Accountant ❑Instructor ❑Retired
Type of Fire Department: Xcareer ❑Volunteer ❑Combination ❑Not Applicable
i
Have you eves:been convicted:a crime,felony-or misdemeanor?Note:A yes answer to this question nyay affect i
your acceptance as'a member of the IAAL $No ❑Yes If yes;explain offense and date/location of conviction.
i
Have you ever been denied niembership;in,or had your membership suspended,or revoked by the IAIAI,any
affiliate Chapter,or any other fire service/law enforcement or otligr organization?Note:A yes answei•to this
r. question may affect your acceptance as a member of the IAAL. XNo ❑Yes If.yes,please explain.
5
Are you interested in.serving on.an IAA(Committee? El Yes $No 1
Are,you interested in delivering(AAI training? ❑Yes _X No
Are you a member of an IAAI.Chapter? El Yes ,9 No f
If yes,please list
Charge my meibership dues ❑Amex ❑Visa ❑ Master Card Account# j
Name:on card I Expiration date
!� Billing Address
i! Applicant's signature Date:
i•
Mail correspo deuce to: home ❑ Business
Mail to:
s, IAM,ziii Baldwin Avenue,Suite tog,Crofton,Maryland 21114 or Membership@firearson.com
io/2014
64 www.firearson.com Fire&Arson Investigator January2915 !
T Wavnatlon 10 ASSGC� 0®B1 01 Anson Di vesUuat®rs9 On. I
" Application for Membership j
I hereby make application for Active($too), ❑Associate($ioo), ❑ Student($25), or ❑Retired($25)
membership in the Internatio Association of Arson Investigators in accordance with its Constitution and
By-Laws,and agree to be bound therewith.I am transmitting annual membership dues (USD)with this
I application.I affirm that all information given by me is true and accurate. (Descriptions of-membership
types can be:faund at wwv.filearson.con
Prefix: First: M.L: Last: Suffix: Date of Birth: ® a
Home Address
City 21 m.,4y a Lur— State/Province Zip/Postal Code d Country.
Home#( j 7 ) •7 - y E-mail Address: N66E..i"ACA /0 eA![s1,ta'L, yW, 4,o
Employer Supervisor ` �
Title
Business Address
City C �ct_ State/Province Zip/Postal Code Country
Work#( , ) < f 1 Fax#( ) Cell#
1
O
ccupational Affiliation(Select Que) j
Fire:Investigator-Fire Department-Local/County ❑Hire Investigator-Police/Peace Officer-Local/County I
❑Fire Investigator-State/County ❑Fire Investigator-Federal ❑Fire Investigator-Private !
,J ❑Firefighter/Officer ❑Police Officer/Detective ❑Insurance Claims Adjuster ❑Insurance SIU
❑Engineer PE,EE,Other ❑Attorney-Prosecutor ❑Attorney-Private Sector ❑Forensic Laboratory
❑Forensic Ac ountant ❑Instructor ❑Retired
i
' Type of Fire Department: 216areer ❑Volunteer ❑Combination ❑Not Applicable
Have you ever been convicted a crime,felony o�r misdemeanor?Note:Ayes answer to this question may affect
your acceptance asa member of the UAL CV o ❑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 LAM,any i
N affiliate Chapter,or any other fire service/law enforcement or othier�rganization?Note:A yes answer to this
question may affect your acceptance as a member of the IA AI. 1�To ❑Yes If yes,please explain.
i
f
Are you interested in serving on an 1AAI Committee? ❑Yes El No
Are you interested in delivering IAAI training? ❑Yes ❑No
Are you a member of an IAAI Chapter? ❑Yes ❑No }
If yes,please list '
I
Charge my membership dues Amex ❑Visa ❑ faster Card Account# '
Name on card Expiration date j
Billing Address
'! Applicant's signature Date: }
±� I
j . Mail correspondence to: ❑ Home Business
Mail to:
IAM,2111 Baldwin Avenue,Suite tog,Crofton,Maryland 21114 or Membership@firearson.com
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64 www.firearson.com Fire&Arson Investigator January20'15
i
VOUCHER NO. WARRANT NO.
ALLOWED 20
IAAI
IN SUM OF $
2111 Baldwin Avenue, #203 n
Crofton, MD 21114 V
i
$600.-00--- ----
ON
-- ----ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 43-553.00 $600.00 1 hereby certify that the attached invoice(s), or
bill(s) is (are)true and correct and that the
I
materials or services itemized thereon for
which charge is made were ordered and
received except
jut 1
I
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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))
Reynolds,Allen, Smith, Drake, Brisco, Gehlbach $600.00
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