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Home My WebLink About255252 02/09/16 y ut.4AgM �( k( CITY OF CARMEL, INDIANA VENDOR: 00351400 ONE CIVIC SQUARE IFCA MEMBERSHIP APPLICATION CHECK AMOUNT: $********25.00* �'� CARMEL, INDIANA 46032 Po Box 305 CHECK NUMBER: 255252 9M,��oN: r CAMBY IN 46113-0305 CHECK DATE: 02/09/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4355300 020216 25.00 ORGANIZATION & MEMBER VOUCHER NO. WARRANT NO. ALLOWED 20 I FCA IN SUM OF$ PO Box 305 Camby, IN 46113 $25.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1120 43-553.00 $25.00 I 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 FEB - 3 2016 141 k Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund Snyder, Denise W From: Haboush, David G Sent: Monday,January 18,201614-01 To: Dale Henson;Snyder., Denise W Cc: jroberts@greenfieldin.org Subject: Re: Membership Chief Henson, Thank you for the email.We will.Take care of this and send irin the near future. Dave Haboush Sent from my iPhone On Jan 18,2016,at 1:44 PM,'Dale Henson<dheniongiridfke-chiefs.or >wrote: rote: Chief Haboush I received your membership information on Saturday and we thank you for your continued,support. Oprocessing y0r'C ,J trssegtop - Thanks Dale Z)4& Executive Director Indiana Fire.Chief s Association P.O Box 305 Camby, In 46113-0305 317-856-1850 office -IN 877-7334850 toll free 317-856-5949 fax 317-339-2473 cell dhensorigindfirechigfs.org Z016 IFC1 Membership Invoice Summary INDIANA FIRE CHIEFS ASSOCIATION t ro: Carmel fire Department { 2 Civic Square Carmel, IN 46032 hone: 317-571-2600 Fax: 317-571-261521)16 , DUES STRUCTURE opulation Served: Dept Type wind Size (Career/Vol/Combin)L )YlemberType Dues tate Senate District: US Congress District: Department Budget: Active(ist two chiefs,any rank)' $75 each Late Rep District: IDiHS District 5 Active(Addt'I Chiefs,any rank) $50 each Departmental(<30 In Dept,all ranks) $100 total 2015, the individuals listed below with your department were members of the Indiana Fire Chiefs Associate(>30,Non Chief or Other) $50 each ssociation. We certainly hope those of you who were 2015 members will renew and encourage others in Section Dues(EMS,Aviation,Public $25 each zur department too join as well in 20% Please call with any questions concerning membership rates. Safety Educators,Technical Rescue) ate: We request that you review and eormct this su'mma'ry(especially Wanks above). Mutual Aid Section-no charge tease change online or fax,ema8 or mail to Dale Hanson,Executive Director WCA. SECTIONTITLE NAME WAIL MEMBERSHIP f i. Fire Chief -Matt ew�o —an 4a 'n@carmel.in.gov Active $0.00 $75.00 4ction(s): v'(A +' k � HS��►�one.� �h 2. Assistant Fire Chief Orbie Bowles obowies@carmel.in.gov Active $0.00 $75.08 fectlon(s): t To Add A New Member: To Remove A Member: To Change Data: Please add on this form the new memtters name,rank and Please robe on the summary which member will not be Please change or add information to emall address and determine any additional dues that may be rm wIng and adjust the amours due by referring to the the data Melds on this form. Attach awed. membership dues structure. Sheet if several changes IFCA Membership Application 1 P.O. 80)i 305 1 Camby, IN x46113-0305 1 dhenson@ir dfirechiefs.org TEL: 1-(677) 733 =1850 I FAX - ( 317 ) 856-5949 1 www.indflreiltifefs-ora 1016 IFC1 Membership Invoice Summary � INDIANA FIRE CHIEFS ASSOCIATION � •o: Carmel Fire Department 2 Civic Square i, Carmel, IN 46032 3. Assistant Fre Chief Robert Hensley bhensley@carmel.in.gov Active $0.00 $50.00 ection(s): 4. EMS Chief Tom Small 1 tsmall@carmel.In.gov Active $0.00 $50.00 ection(sy S. Battalion Chief Jeff Steele jsteele@carmel.in.gov Active $0.00 $50.00 ectlon�-$): f f f f f f e i 6. Safety Chief Mark Cromich mcromlich@carmel.in.gov Active $0.00 $50.00 ection(s): 7. Public Education Keith Freer kfreer@carmel.in.gov Active $25.06 $50•00 Director eetlon(s): Pubr(cSafety Education ro Add A New Member: To Remwe A Member. To Change Data: Mease add on this form the new members name,rank and Please note on the summary which member will not be Please change or add information to ,mail address and determine any additional dues that may be renevving and adJust the amount due by referring to the the data fields on this form. Attach weed. membership dues structure. sheet if several changes IFCA Membership Application I P.O. box 305. ( Camlry, IN 46113-03135 dhenson@i df3rechiefs.org TEL : 1-(877) 733 - 1850 1 FAX : ( 3 17 ) 856-5949 ) www.indfirecNefs.org' !016 iFCA Membership 1n oice summary ,. •• INDIANA FIRE CHIEFS ASSO IATIQN t : Carmel Fire Department 2 Civic Square Carmel,IN 46032 8. fire Marshal Bruce Knott s' bknott@carmeLin.gov Active $0.00 $50.00 lctlon(s): ease Send Receipt: ❑ Check(payabie to,IFCA) Renewal Total: .$4,50.00 Section Dues: $25.00 sa Mastercard Card Number: New Members: ame on Card: Exp Date: Total Due: gnature: Online Payment Option-Visit:www3ndiUechlekorg under the membership tab 6W Members(write name,rank, ernall and any;ect ro changes below or submit changes onli e): `. � Y To Add A New Member: To,Remove,A Member To Change Data: Please add on this form the new members name,rank and' Please note on the summary wNc h member will not be Please change or add information to email address and determine any additional dues that may be renewing and adjust tate amount due by referring to the the data fields on this form. Attach owed. mernbershipdues structure. sheep If several changes IFCA Membership Application, ( P.B.Box 305 Camby, IN 45113-0305.) dhensor@iridfirechiefs.org, TEL 1-(877 ) 133 M,1850 1 FAX :. ( 317 ) 856-5949 I www.indfirechkfs.org 2016 IFCA Membership fnv Ace Summarymom— �,.� �•• .� INDIANA FIRE CHIEFS ASSOCIATION g To: Carmel Fire,Department 4 .,,,,�1 2 Civic Square $, Carmel, IN 46032 fE Phone: 317-571-2600 Fax: 317-571-2615 2016 . DUES STRUCTURE Population Served: Dept Type fund Size (Career/Vol/Combin): liember Type Dues ate Senate District: US Congress District: 4. Department Budget: Active(1st:two Chiefs,any rank) $75 each hate Rep District: IDHS District 5 S Active(A440 Chiefs,any rank) $50 each Departmental(<30 in Dept,all ranks) $100 total n 2015, the individuals listed below with your department`were members of the Indiana Fire ChiefsAssociate(>3o,Non Chief or Other) $50 each Association. We certainly hope those of you who were 2015 members will renew and encourage others in Section Dues(EMS,Aviation,Public $25 each four department to join as well in 2016. Please call with any questions concerning membership rates. Safety Educators;Technical Rescue) Note: We request that you review and correct this summary(especialiy blanks above). Mutual Aid Section-no charge Please change online or fax,email or mail to Date Henson,Executive Director iFCA. SECTIONTITLE NAME EMAIL MEMBERSHIP DUES AMT. DUE i. Fire Chief .`.Matt ew Ho an .fin@carmel.in.gov Active ;' $0.00 $75.00 Section(s): a, Assistant Fire Chief Orbie Bowles obowles@carmebri.gov Active $0.00 $75.00 i Section(s):. i. At "i `Zt To Add A New Member: To Remove A Member: To Change Data,: Please add on this form the new members name,rank and Please note on the summary which member will not be Please change or add information to email address and determine any.additional dues that may be renewing and adjust the amount due.by referring to the ; the data fields on this form. Attach owed. membership dues structure.. '` sheet if several changes IFCA Membership Application I P.O. Box 305 1 Camby, IN46113-0305 ( dhensori txlftred�iefs.org �'. TEL.: 1-(877) 733 - 1850 I F A X : ( 3 17 ) 856-5949I www.indfir"' efs.org '�n 2016 IFCA Membership Invoice Summary .,A ..• y INDIANA FIRE CHIEFS ASSOCIATION y � � To: Carmel Fire Department 2 Civic Square Carmel, IN 46032 4' � 3, Assistant Fire Chief Robert Hensley ( bhensley@carmel.in.gov Active $0.00 $50.00 Section(s): t. 4. EMS Chief Tom Small tsmall@carmel.in.gov Active $0.00 $50.00 i i ' Section(s): { i 5. Battalion Chief Jeff Steele isteele@carmel.in.gov Active ! $0.00 $50.00 i Secti'on(s): f f ti f 6. Safety Chief Mark Cromich mcromllch@carmel.in.gov Active I $0.00 $50.00 Section(s): { 1 7. Public Education Keith Freer kfreer@carmel.in.gov Active $25.00 $50.00 Director Section(s): Public Safety Education To Add A New Member: To Remove A Member: i' To Change Data: Please add on this form the new members name,rank and Please note on the summary which member will not be '' Please change or add information to email address and determine any additional dues that may be renewing and adjust the amount due by referring to the the data fields on this form. Attach owed. membership dues structure. �� sheet if several changes IFCA Membership Application I P.O. Box 305 I Camby, IN 46113-0305 ( dhenson@indfirechiefs.org TEL : 1=(877) 753 - 1850 I FAX : ( 3 17) 856-5949 I www.lndfirecfiiefs:org 2016 IFCA Membership Inice Summary { INDIANA FIRE CHIEFS ASSOCIATION To: Carmel Fire Department 2 Civic Square Carmel, IN 46032 �.r g, Fire Marshal Bruce Knott i bknott@carmel.in.gov Active $0.00 $50.00 Section(s): 1 4 Tease Send Receipt: ElCheck(payable to IFCA)# Renewal Total: $450.00 Section Dues: $25.00 Asa Mastercard Card Number. + New Members: Jame on Card: Exp Date: Total Due: , ')ignature: f jOnline Payment Option-Virtit:www.indtirecolefs}org under toe membership b Vew Members(write name, rank, email and any`lection changes below or submit changes online): I . r !A i l To Add A New Member: ; To Remove A Member: To Change Data: Please add on this form the new members name,rank and Please note on the summary which member will not be Please change or add information to email address and determine any additional dues that may be renewing and adjust the amount due by referring to the the data fields on this form. Attach owed, membership dues structure. sheet if several changes IFCA Membership Applicatio 1 I P.O. Box 305 Camby, IN 46113-0305 dhenson@Wdfirechiefs.org TEL: 1-(877 ) 73 - 1850 FAX : ( 3 17) 856-5949 1 www.indfirecHiefs.org