157108 03/05/2008 CITY OF CARMEL, INDIANA VENDOR: 00351400 Page 1 of 1
47I ONE CIVIC SQUARE INDIANA FIRE CHIEFS ASSN. CHECK AMOUNT: $65.00
CARMEL, INDIANA 46032 P 0 BOX 364
ZIONSVILLE IN 46.077 CHECK NUMBER: 157108
CHECK DATE: 3/5/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT D ESCRIPTION
1120 4355300 65.00 ORGANIZATION MEMBER
y
y xA� *e, i� f'�+T' o .o' t:' ,7 r ttA f. 3 I G -Y
Name: Bruce Knott Title: Fire Marshal
Department: Carmel Fire Department County: Hamilton
Department Address: 2 Civic Square
City: Carmel State: IN ZIP Code: 46032
Phone: (317) 571 -2619 E -Mail: bknott @carmel.in.gov Fax: (317) 571 -2674
State Rep State Senate US Congressional IN Homeland Security
District: District: District:. District:
MEMBERSHIP CATEGORIES (C HECKAPPROPRIATELINE
Active Memberships shall tie,coinprised of the Chief of Department and any Chief Officer' Rank of a regularly organized
Fire Department and the StatikrAMarshal's Office. Active members shall be entitled to vote ob all matters requiring a vote
unless otherwise prohibited by and _By -Laws and be entitled to hold elective office �A Fire Department may
authorize and pay for=the.continual membership of its =chief officers. a i, p 1
_X_ Associate,Aembership shalLirtclude, individuals interested in the protection of life' and property from'fire. Associate
members shall be`erititled to participate fully" n the affairs of the Association, with the exception „of holding elective office and
votin
�f
Life Membership is ava`ilable4o Active'rnembers who have "retired fromlthe Fir6 Service after 'O N consecutive,,years as
members Qf IFCA. Life memr bers entitled to participate fully in the affairs of the Asso'dation,`with the exception'ofrholding
elective office. Membership, basedonBoardapproval'.,L ife memtiers are exemptfroma %paymentofdues.
MEMBER SECTIONS (CHECKAPPROPRIATELINE)
EMSr X_� Public Safety Educator
FireiInspector F� Technical Rescuer l
PAYMENT METHODS DUDES TOTAL DUES:
First Member 75 _X— Third-t�lember from the same department- $)65
'Second Member from the same department-$65 Each additional member. -from the same department 55;1
Check (payable to IFCA) ,a visa MasterCard,
Card Number Expiration Date:.
tt f
Name Onll and i Signature.
TO HELP US SERVE YOUIBETTER, PLEASE ANSWER FOLLOWING QUESTIONS
Population Served by FD 65.000 twp. a (number in city I r r
Type of Org'anization
Career Fire Departmentl r'' \Combination Fire Department Volunteer Fire Department.__ r t
Equip. Manufacturer, Distributert�" Federal /State /Local Government Industrial Fire Brigade Municipal'Agency
Rescue Squad, Trade or Professional Org. Educational- Institution /Library Other r
Job Function r
Assistan De u Chief Chief
t/ p ty .Company Officer _EMT /Paramedic Fire Chief f` Fire Commissioner
Firefighter X 117 rst•Respcnder Inspector: i Instructor/Training Officer 4.- 'Military _X State /Local Fire Marshall
Student Supen+isor Other.
am interested in the following committees:
Communication _C3nf6rerke- Constitution /By -Laws _X_ Education EMS X� Inspectors
Legislation Membership` Memorial Team _Xr Public Education _Tech Rescue
Please check all topics of interest
Apparatus Maintenance Budget Management Career /Volunteers Combination Issues
_Community Relations/ Marketing Conflict Mana ~,.:._.D' €sasterManagement —Diversity/Recruitment
EMS Firefighter Safety Fire Prevention Fitness /Wellness Govt. Relations Grants /Fundraising
Hazmat Human resources Industrial Fire and Safety Labor /Management. Relations Military
_Officer Development Risk Management _Technology Terrorism /Homeland Security _X_ Training/Education
Wildland Fire Other
Easy Ways To Join. Return application and payment to Terry Rake, IFCA Executive Director.
By Mail: IFCA Membership Application, P.O. Box 364, Zionsville, IN 46077
By Fax: 317- 733 -4212 Toll Free: 1- 877 733 -1850 or 317 -733 -1850
Online: www.indfirechiefs.org E -Mail: rake @indfirechiefs.org
Sponsorship Opportunities Available Contact our office or website.
111607khw
VOUCHER NO. WARRANT NO.
i•FCA. ALLOWED 20
Indiana Fire Chiefs Association
IN SUM OF
P.O. Box 364
Zionsville, IN 46077
$65.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept.# INVOICE NO. ACCT /TITLE AMOUNT Board Members
43- 553.00 $65.00 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
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 property 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))
Membership Dues Knott $65.00
f 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