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Home My WebLink About191242 10/27/2010 CITY OF CARMEL, INDIANA VENDOR: 00351400 Page 1 of 1 0 ONE CIVIC SQUARE INDIANA FIRE CHIEFS ASSN. CARMEL, INDIANA 46032 P 0 BOX 364 CHECK AMOUNT: $500.00 ZIONSVILLE IN 46077 ar CHECK NUMBER: 191242 CHECK DATE: 10/27/2010 DEPARTMENT ACCOUNT PO NUMBER I NUMBER AMOUNT DESCRIPTION 1120 4355300 500.00 ORGANIZATION MEMBER I o' 2011 IFCA Membership Invoice Summary ,PE OW" t e� IND IANA FIRE CHIEFS ASSOCIATION a To: Carmel Fire Department "�fo SEF1�6p 2 Civic Square Carmel, IN 46032 Phone: 317- 571 -2600 Fax: 317- 571 -2615 i e Population Served: Dept. Type and Size (Career /Vol /Combin) Member Type Dues State Senate District: US Congress District: Department Budget Active (1st two Chiefs, any rank) $75 each State Rep District: IDHS District: 5 Active (Addt'I Chiefs, any rank) $50 each all ranks) $100 total (�30 in Dept, t In 2010, the individuals listed below with your department were members of the Indiana Fire Chiefs Association. Departmental ntal Non Chief t, Other) $50 each We certainly hope those of you who were 2010 members will renew and encourage others in your department to Section Dues (EMS, Aviation, Public $25 each join as well in 2011. Please call with any questions concerning membership rates. Safety Educators, Technical Rescue) Note: We request that you review and correct this summary (especially blanks above). Please change online or fax, email or mail to Terry Rake, Executive Director IFCA. NAME SECTI TLE'� 1. Fire Chief Keith Smith ksmith @carmel.in.gov Active $0.00 $75.00 Section (s): 2. Assistant Fire Chief David Haboush dhaboush @carmel.in.gov Active $0.00 $75.00 Section (sl: 3. Assistant Fire Chief Jeff Steele jsteele @carmel.in.gov Active $0.00 $50.00 Section (s): 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 renewing and adjust the amount due by referring to the the data fields on this form. Attach be owed. membership dues structure. sheet if several changes IFCA Membership Application I P.O. Box 364 1 Zionsville, IN 46077 1 rake @indfirechiefs.org TEL: 1-(877) 733 -1850 1 FAX; (3 1 7) 733-4212 1 www.indfirechiefs.org s>, 2011 IFCA Membership Invoice Summary F4ECMEF4 �d INDIAN FIRE CHI ASS a o 90 S' To: Carmel Fire Department EP'sM' 2 Civic Square Carmel, IN 46032 4. Fire Marshal Bruce Knott bknott @carmel.in.gov Active $25.00 $50.00 Section (s): Public Safety Education Section 5. Public Education Keith Freer kfreer @carmei.in.gov Associate $25.00 $50.00 Director Section (s): Public Safety Education Section 6. Frag-Chief Matt Hoffman mhoffman @carmel.in.gov Active $25.00 $50.00 Section (s): Technical Rescue Section 7. EMS Chief Mark Hulett mhulett @carmel.in.gov Active $25.00 $50.00 Section (S): EMS Section 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 renewing and adjust the amount due by referring to the the data fields on this form. Attach be owed. membership dues structure. sheet if several changes IFCA Membership Application I P.O. Box 364 1 Zionsville, IN 46077 k rake @indfirechiefs.org T E L 1- (877 733 1850 1 F A X 3 17 733 4212 1 www.indfirechiefs.org 2011 IFCA Mem bership Invoice Su m mary F,pE CN EFg INDIA FIRE CHIEFS ASSOCIATION o To: Carmel Fire Department y ~4E BEPTEN Z Civic Square Carmel, IN 46032 Please Send Receipt: Check(payable to IFCA) Renewal Total: $400.00 Section Dues: $100.00 Visa Mastercard Card Number: New Members: Name on Card: Exp Date: Total Due: Signature: New Online Payment Option Visit: www.indfirechiefs.org under the membership tab New Members (write name, rank, email and any section changes below or submit changes online): 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 renewing and adjust the amount due by referring to the the data fields on this form. Attach be owed. membership dues structure. sheet if several changes IFCA Membership Application I P.O. Box 364 1 Zionsville, IN 46077 1 rake @indfirechiefs.org T E L 1- (877 733 1850 1 F A X 3 17 733 4212 1 www.indfiirechiefs.org VOUCHER NO. WARRANT NO. ALLOWED 20 I FCA Indiana Fire Chiefs Association IN SUM OF P.O. Box 364 Zionsville, IN 46077 $500.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 1120 43- 553.00 $500.00 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 OCT 2 5 Me TILT�TUTi�i t r 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)) $500.00 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