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Home My WebLink About250217 10/07/15 Q CITY OF CARMEL, INDIANA VENDOR: 363862 ONE CIVIC SQUARE JASON FORCE CHECK AMOUNT: $ ..."577.69" CARMEL, INDIANA 46032 21589 OVERDORF ROAD CHECK NUMBER: 250217 NOBLESVILLE IN 46062 CHECK DATE: 10/07/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4343002 577.69 EXTERNAL TRAINING TRA CA �1VOF- �TFW.vYk�q! CITY OF CARMEL Expense Report (required for all travel expenses) 111111199W - NOIANa EMPLOYEE NAME: Jason Force DEPARTURE DATE: TIME: (AJOPM DEPARTMENT: FIRE RETURN DATE: TIME: \O AM/ M REASON FOR TRAVEL: EVT Class DESTINATION CITY: Reynoldsburg, OH EXPENSES ARE FOR (check all that apply): TRAVEL ADVANCE TRAVEL REIMBURSEMENT TRAVEL PER DIEM Transportation Gas/Tolls/ Meals Date Lodging Misc. Total Air-fare Car Rental Other Parking Breakfast Lunch Dinner Snacks Per Diem $0.00 $0.00 9/21/15 65.00 $65.00 9/22/15 65.00 $65.00 9/23/15 65.00 $65.00 9/24/15 $50.00 267.69 65.00 $382.69 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0.00 Total $0.00 $0.00 $50.00 $0.00 $267.69 $0.00 $0.00 $0.00 $0.00 $260.00 $0.00 DIRECTOR'S STATEMENT: I reby affirm that all exp nses listed conform to the City's travel policy and are,�itt;�n Wr3d ment's appropriated budget. Director Signature: Date: ��JJII,, yw City of Carmel Form#ER06 Revision Date 9/30/2015 Page 1 Emergency Vehicle Technician EVTCertification Commission, Inc. P. O. Box 894 Dundee, IL 60118 847-426-4075 Fax 847-426-4076 web address: www.evtcc.org September 10, 2015 Jason Force jforce@carmel.in.gov 21589 Overdorf Rd Noblesville, IN 46062 You must bring this confirmation letter, along with photo ID to gain admittance to the upcoming Emergency Vehicle Technician Certification examination that will be held on: Thursday, 09/24/2015 4:00 p.m. Ohio Fire Academy Main Building - OAEVT Maini 8895 E. Main St. Reynoldsburg, OH Proctor name and phone: Alan Conkle 419-351-8050 Please note, the proctors generously donate their time to EVT to host the exam: You have registered for: F2 Design& Performance Standards of Fire Apparatus EVT Certification Commission, Inc. actively supports and encourages emergency vehicle training classes. They are of enormous benefit to the industry and we applaud the organizations offering these training seminars. Even if you are attending a training class to prepare for the EVT exams, we recommend that you also study on your own prior to attending the class. Technicians and/or instructors are encouraged to use the EVT learning objectives as a basis for preparing for the EVT exams. All training seminars are done completely independent of the EVT Certification Commission. As a certification agency, EVT is not involved the the development of the training. Preparation is very important to the successful completion of the EVT exams. To prepare for the exam, review the Learning Objectives and study the references listed which can be downloaded by going to www.evtcc.org, then "exams and preparation" button, then scroll down the list for the exam(s) for which you have registered. If you wish to change or cancel your test date- --- no charge if it is at least 15 business days before the test date. ---between 2-14 business days before the test date, an administration charge of$25 will apply. --- less than 1 business day or if you do not show up, a penalty of$50 will apply. Please contact the EVT office at 847-426-4075. Force, Jason S From: shannon <shannonw@evtcc.org> Sent: Friday, September 11, 2015 10:41 AM To: Force, Jason S Subject: RE: EVT Confirmation Letter Attached TRANSACTION RECORD EVT CERTIFICATION COMM 640 S. 2ND ST W. DUNDEE, IL 60118 United States WWW.EVTCC.ORG TYPE: Purchase ACCT: Visa $ 50.00 USD CARDHOLDER NAME Jason Force CARD NUMBER ############ DATE/TIME 10 Sep 15 15:49: 54 REFERENCE # 001 0780044 M AUTHOR. # 933542 TRANS. REF. Force Approved - Thank You 100 Please retain this copy for your records. Cardholder will pay above amount to card issuer pursuant to cardholder agreement. ---------- Above is your EVT Certification credit card receipt. Thank you for your support of the EVT Certification program. Shannon Wilde Assistant Manager EVT Certification Commission P.O. Box 894 West Dundee, IL 60118 847-426-407 fax:847-426-4076 shannonw n,evtcc.ore w\vw.evtcc.org From: Force, Jason S [mailtoJforce(d)carmel.in.gov] Sent: Thursday, September 10, 2015 7:59 PM i Credit Card Transaction History Page 1 of 1 Contact/Business: JASON S FORCE Type: CONTACT TIN: 290626442 DOB: 03/09/1973 Account#: Product: IL/IN/NKY/MO/WI Features: VAR CHIP Transactions Posted Since Last 0 Statemented Transactions (5 Pending Transactions (Includes Authorized and Statement Declined) Transactions Posted Since Last Statement Card Posting Date Purchase Date Amount Transaction Description Type 09/25/2015 09/25/2015 C-267.69 f MAG ,FARIFIEED-INN&SUITES REYNOLDBURG OH https://www.cct.pncbank.com/eaimsg/pp/EaiMessageServlet 9/29/2015 Fairfield Inn&Suites by Marriott 2826 Taylor Road Ext FAIRFIELD Columbus East Reynoldsburg Oh 43068 INN&SUITES° 614.864.4555 0 karnott. o e J. Force Room: 129 Room Type: EXKS Number of Guests: 1 Rate: $83.00 Clerk: Arrive:21Sep15 Time: 09:53PM Depart: 24Sep15 Time: Folio Number: 88375 Date Description, Charges Credits 21Sep15 Room Charge 83.00 21Sep15 Occupancy Sales Tax 4.98 21Sep15 County Tax 1.25 22Sep15 Room Charge 83.00 22Sep15 Occupancy Sales Tax 4,98 22Sep15 County Tax 1.25 23Sep15 Room Charge 83.00 23Sep15 Occupancy Sales Tax 4.98 23Sep15 County Tax 1.25 24Sep15 Amount: 267.69 Auth:021454 Signature on File This card was electronically swiped on 21Sep15 Balance: 0.00 As a Rewards Member, you could have earned points toward your free dream vacation today. Start earning points and elite status, plus enjoy exclusive member offers. Enroll today at the front desk. Thank you for choosing our hotel for your stay! Knowing the many options available,we sincerely appreciate your business. If this receipt of your bill is correct, you may take advantage of express check-out by dialing zero, informing the Guest Service Representative of your departure, and leaving the keys in the room. We wish for safe travels and that you may return home soon. On your next visit to the area, we hope you will choose the Fairfield Inn & Suites Columbus East as your destination hotel! As requested, a final copy of your bill will be emailed to you at:jforce@carmel.in.gov. See"Internet Privacy Statement' on Marriott.com. Operated under license from Marriott International,Inc.or one of its affiliates Account Transaction Detail Report Page 3 of 4 Post Date Effect Date Amount Balance DCN Pin Seq/Ref# Description 09%14/2015 09/14/2015 $50.00 $ =EVT CERTIFICATION-COMM VIS 0911 847-4264075 IL7211845002368877 2256 https://www.cct.pncbank.com/eaimsg/pp/EaiMessageS ervlet?SOURCE-CHANNEL=UNK... 9/29/2015 `0 P9SOCIATION EMEgOF 0� .N°< Ohio Association of Emergency Vehicle Technicians a ' P.O. Box 303 Avon, OH 44011 Fy�OLF TECHNICIANS'� NOTICE OF REGISTRATION CONFIRMATION To: Jason Force You have been registered for the following classes to be held during our 23rd Annual Maintenance Sympositim on September 21-25, 2015, at the Ohio Fire Academy in Reynoldsburg, Ohio. Date . Class No. Class Name 9-21 105 Cummins 9-22 107 EVT Prep F-2 9-23 115 EVT Prep F-6 9-24 125 Code Reading 9-25 You have XX have not registered for the O.A.E.V.T. banquet at Tall Timbers Banquet Center 13831 St Rt. 40 on Wednesday, September 23, at 5:30 p.m. If you have an questions, lease contact Patrick Guhde 440-476-8707 or Y Y q � p � pguhde@aol.com) Please bring this form with you. -vvww.oaevt.org ATTENDEE REGISTRATION FORM 2015 OHIO ASSOCIATION OF EMERGENCY VEHICLE TECHNICIANS EMERGENCY & MUNICIPAL 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 11, 2015. All late registrations after 9-11-15 will be required to pay a fee of$25 per day/class or $125 total for the week. Full registration refund prior to 8-30-15. 50% refund prior to 9-4-15. No refund after 9-4-15. Name �ia$p if ►'0 2CJ� Preferre Address �Wo l tul C SC'Z0Ae1= City 2 F' State Zip q6 3 Z Cell Phone (3q) 6 ! o Work Phone ( ,3a) 17/ - 2 G Od E-mail tot^ C e Fire Dept. Agency / Company �,gQ,vt I'L_ w�i7� G�� M2 i 7` Address Zip Do you plan to attend Wednesday night Banquet? ( x ) Yes ( ) No How did you hear about this training symposium Tee-shirt size L r9R C 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 o Avon, Ohio 44011 Use class selection number — PLEASE indicate second choice! Monday Tuesday Wednesday Thursday Friday First Choice I 0 5 I D + Second O Choice Form may be photocopied as needed. 3 TUITION INFORMATION REGISTRATION CLOSES SEPTEMBER 11, 2015 Late registration rate will be required. $25 per day/class. FULL PACKAGE Includes the 5 day symposium, daily lunch, and the Wednesday night Banquet: $425.00 Daily Rate - Any Class................................................ $150.00 The Wednesday Night Banquet- ADDITIONAL TICKETS ...................... $30.00 TOTAL ENCLOSED Late Registration after 9-11-15 Full Week.................. $125.00 Per Day/Class...................................... $25.00 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 to 9:00 AM Welcome & Opening Remarks Class Times: Classes are Monday 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 11, 2015. 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 OATION No i G• � � TECHP�►GIR► �9 \# presents the 'm?SCG c4?I/!%iGGaG September 21 thru 25, 2015 at the OHIO FIRE ACADEMY 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)) $577.69 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 Jason Force IN SUM OF $ $577.69 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1120 43-430.02 $577.69 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 OCT - 5 2095 Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund