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320624 01/11/18
(9, CITY OF CARMEL, INDIANA VENDOR: 366556 ONE CIVIC SQUARE TIM FAGIN CHECK AMOUNT: $*******370.90*CARMEL, INDIANA 46032 C/O CFD CHECK NUMBER: 320624 CHECK DATE: 01/11/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4343002 370.90 EXTERNAL TRAINING TRA VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.-201(Rev.1995) ALLOWED 2C ACCOUNTS PAYABLE VOUCHER Vendor# 366556 TIM FAIN IN SUM OF$ CITY OF CARMEL C/O CFD 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 $370.90 Purchase Order# ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Terms Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 0 43-430.02 $370.90 1 hereby certify that the attached invoice(s),or 1/2/18 0 Reimburse AirFare $370.90 1120 101 1120 101 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 Friday,January 05,2018 David Haboush Fire Chief 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 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Snyder, Denise W From: Tim Fagin <timfagin@gmail.com> Sent: Tuesday, December 19, 2017 13:44 To: Snyder, Denise W Subject: Fwd:Your trip confirmation-EOTFAS 19FEB .Begin forwarded message: From: American Airlines<no-reply¬ify.email.aa.com> Date: December 19, 2017 at 13:24:49 EST To: "TIMFAGIN&GMAIL.COM" <TIMFAGIN&GMAIL.COM> Subject: Your trip confirmation-EOTFAS 19FEB Hello Timothy Fagin! Issued: Dec 19, 2017 - X Your • confirmation . • receipt Record locator: EOTFAS View your trip Monday, February 19, 2018 IND CLT Seats:-- Class: Economy(N) 1 :46 PM N' 3:25 PM Meals: Indianapolis Charlotte American Airlines 2379 i Friday, February 23, 2018 CLT IND Seats:-- X Class: Economy(N) 7:45 PM 9:23 PM Meals: Charlotte Indianapolis American Airlines 1151 Timothy Fag i n Earn miles-with this trip. Join AAdvantage » Ticket# 0012163253733 Your trip receipt Visa XXXXXXXXXXXXX5685 Timothy Fagin FARE-USD $320.00 TAXES AND,CARRIER-IMPOSED FEES $ 50.90 TICKET TOTAL $370.90 Book a car Book a hotel Buy trip insurance SuperShuttle 0 = 0 _ 2 Ems,\ r . FDRW RD TODAFEP � ,+ PY 21-23; 20181 CHARLOTTE,NC tt dt t'CF6ARLCTTTE CCNVEl1lTIO119 CEIIITER_!t llt. .. "WW f EMSTODAY.COM ttt #EMSTQCAY 4 WAYS TOR First Name I ! /"�: Last Name �� i 1.Online: Job Title�I(QCT I o( _ r- : I In �4r C, =: Organization 2.Email: Add ss: r C I J i G U '_'t�L . Address 2 . (US Only)888-299-8057 +1-918-831-9161 City ` CQ rtiti State/Province I Postal Code Country . . 0 PO Box 973059, Telephone(+)"'31.` S1 L .a;�.aa Fax.(+) Dallas, Email Questions? Call us at: +1.918.831.9160.(direct)or Your individual email address is required=confirmation is sent via'email and is needed for CEH certificate login +1.888:299.801.6 U.S.( only)or . Jf you hive multiple licenses or an NRE10T#,please contact registration via phone or email: +441992 65671.7(or 01992 656717 from.UK).. .Certification/License#:` License State: Date of.Birth: License Type(E.G.;EMT-B,EMT-P) License Category'.(BLS,ALS,or Other) License Expiration Date: FOLLOWINGPLEASE ANSWER THE 1.000UPATION/POSITION(CHOOSE ONLY-1) 2.EMPLOYER/AFFILIATION(CHOOSE ONLY 1) 4.WITHIN THE NEXT,24 MONTHS, 01.Paramedic(EMT-I,EMT-D) 1.Hospital or Health System/District. I WILL RECOMMEND;SPECIFY,OR .02.EMT(Basic,First Responder) f.2.Private Ambulance/EMS PURCHASE PRODUCTS/SERVICES ff 04:Instructor/Co6rdinator/Trainer 4.Municipal EMS agency/Third,Service IN THE FOLLOWING CATEGORIES " 05.Administrator/Supervisor �,5.Industrial/Commercial 01 Airway Equipment . 06.EMS Chief 6.Education/Institutional [3'02 Ambulances/Vehicles 07.Fire Chief f.7.Military/Federal Government 03 Bags,Cases,Kits ff,09.Pres,Dir CEO,VP,.Mgr ff 8.Law EnforcementIPolic'e 04 Basic Life Saving.Equipment J 10.Student r(]�x 11,Volunteer Fire Dept./Rescue Squad 05 Billing Systems"&Software ff 11.Emergency/Public Safety Manager. 12.Paid Fire Dept./Rescue Squad [06 Computers/Computer Systems/Software ff 12.Medical Director 13.Combination Fire Dept./Rescue Squad 07 Education and Training . 13.Physician 98.,Other(Specify) 13 08 First Responder Equipment. 14.Registered Nurse. 09 Medical Equipment ff 15:OtherChief .- 3.PURCHASING ROLE 10 Rescue Equipment ff 16.Captain/Lt/Commander/Other Officer. (CHOOSE ALL THAT APPLY) - ©11 Simulators/Manikins, f 9.8.Other(Specify) ©12 Other ©A Purchase B Approve 131 am not an authorized buyer C Recommend D D Specify E Influence Penn ell ❑SILVER PASSPORT(2-Day) ; ❑INTERNATIONAL CONFERENCE ATTENDEE(3-day) ❑EXHIBIT HALL I Paid by 1119118:$325.: I. *Use promo code EMSTINTLI8 to'register online. VISITOR ONLY. s' € Paid.after 1119118.:$425- r • ' , I ,. Paid by 1119118:$325 Paid by 11_ 19118:.$25 Choose One: Wed.IThurs. Paid after 1119118:.$425 r Paid after_1119/1,8:$45 . r`, • 0 7hurs./Fri. . , PRE-CONFERENCE ■ , ■ , ■ , ■ Please select the Pre-Conference.Workshop you;would like to attend and add the price to your registration total.All are at a'first come,first-served basis.Lunch;is included with all 8-hour (full day),workshops_and two;4-hour(half day)workshops.. FULL-DAY Workshops:, -HALF-DAY Workshops:. [].-EMS Supervisor Leadership Aiademy(#19882) -❑ 12-Lead ECG Acquisition and Interpretation Made Easy(#19892) 8:00 AM 5:00 PM 11 Before 1/19/18:$2251 After 1119/18:$250 8:00 AM-12:00 PM Il. Before 1/19/18:$1251 After 1119/18:$,150 ❑ Essentials of Advanced Airway Management(#19880) ❑Tactical Tips and Treatment Techniques for EMS.Providers(#20559) 8:00 AM-5:00 PM 7/.Before-1/19/18:$225-1 After 1119/18:$250- 8:00 AM-12:00 PM" /1 Before 1/19/18:$125 1 After 1119/18:'$1 50, , ❑ Stimulating Simulation-A Deep Dive Into EMS Best Practice Simulation Techniques-. ❑.Proper Post Exposure'Medical Fallow Up-The Latest and Greatest(#19868) (#19881)-OFFSITE - 8:00 AM=12:00 PM 11 Before 1119/18:$125 1 After 1119/18:$150 8:00 AM-5:00 PM 11 Before 1119118:$2501 After 1/19/18:.$275 ❑:Ultrasound Use in Prehospital Care&Resuscitations(#20531) ❑The National Conference on Law&Policy(#20086) 8:00 AM-12:00 PM-//:Before 1/19118:$125 After.1/19/18:.$150 8:00 AM-5:00 PM:// Bef6re.//19118:$225 1 After.1119/18:$250 . ❑ Emerging Challenges in EMS(#19878)) ❑The Entrepreneurial EMSAgency-How.EMS Service Leaders Can Take Advantage of 1:00 PM r5:00 PM /1 Before 1119/18:$125,After.l/19/18:$150 the EMS 3.0 Transformation(#20087) ❑Advanced Concepts in 12-Lead Interpretation(#19895) 8:00 AM-5:00 PM /I Before 1119/18:$225 1 After 1/1,9/18:$250. 1:00 PM 5:00 PM // Before 1/19/18:$125 1 After 1/19118:$150 ❑"Essentials of Wilderness Medicine for EMTs and Paramedics(#19869)*OFFSITE ❑ Classrooms that Engage(#19866) 8:00AM-5:60:PM /I Before 1/19/18:$250 1 After 1/19/18:$275 1:00 PM-5:00 PM Il Before 1/108:$125 After 1719118:$150 " ❑-Drones&Artificial Intelligence as Tools for Public Safety(#20088)' ! ! Tactical Tips and Treatment Techniques for EMS Providers 8:00 AM-5:00 PM //.Before 1/19118:$250 After 1119/18:$275 1:00 PM-5:00 PM 11 Before 1119118:$125 1 After 1/19118:$150 ❑ Ultrasound Use in Prehospital Care&Resuscitations(#20058) 1:00 PM,-,5:00 PM: I( Before 1/19/18:$1-25 After 1119198:$150.' MILITARY PRICING ,Military ID will be required. CREW PRICING Early Bird_Rate- Regular Rate Send Rd NOOFe'and"SAVEI before 11191.18 after 1/1 9/i 8 . s. $275 $375 . Amount of.people Price Name of r6g.type. ` 3-5, $1;000 CODE ALPHA. 6—10 $2,000 CODE BRAVO BREAKFAST 1 1 11 -19 $3,000 CODE CHARLIE February 22,20.18//8:00 AM:=9:30 AM H.COST:$40 SPACE IS LIMITED 20—'29' $4,000 CODE DELTA: 0Rural&Wilderness EMS ❑Identifying&Diverting Stroke Patents 30 OR MORE $.5,;000 CODE ECHO ❑I'm a New Manager,NowWhat? ❑Epinephrine:To Use or Not to Use? . CLICK HERE to learn more and get-your crew registered I ❑Best Practices in Peer.Support ❑Benefits of Prehospital ECMO ❑Provider Stress&Resiliency. (extracorporeal membrane oxygenation) ❑Sepsis Screening&Alerting' _ 17 Issues in Mobile Integrated Healthcare(MIH) *Use promo code EMSTMIL19to register online. ❑Ameiica's Opioid Crisis . 7EM • •• • • Yourregistration fee includes a.l-year di' ••. • • � cription•,• •• .• ' • • to JEMS magazine.First • ❑Check here if you do not wishto receiv TOTALPAYMENT r METHOD OF PAYMENT Payment must be received prior to the conference Please add all selections' ; f S I �� S—� ❑Check Enclosed(U.S.funds only.Checks payable to PennWell/EMS Today 2018) and total here: `1 . ❑Wire Transfer(wiring info provided upon confirmation) PROMO/SOURCE CODE: Credit Card: - Payment must be received by published date to receive early registration discounts. ❑Amex ❑Visa ❑MasterCard [3 Discover [3 Diners Club Cancellations must be received in writing by February 9,.2018 to receive a refund minus Card Number a$100.00,administrative fee.NO REFUNDS will be permitted after February 9,2018. Exp.Date Substitutions may be made at any time by written notification to the registration office. Name on Card Signature - PE `