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Home My WebLink About176231 08/19/2009 CITY OF CARMEL, INDIANA VENDOR: 096000 Page 1 of 1 ONE CIVIC SQUARE FIRE DEPT SAFETY OFFICERS ASSOC IyT 0 j CHECK AMOUNT: $2,160.00 CARMEL, INDIANA 46032 Po aox 149 ASHLAND MA 01721 -0149 CHECK NUMBER: 176231 CHECK DATE: 8/19/2009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4357004 585.00 EXTERNAL INSTRUCT FEE 1120 4357004 12674 1,575.00 REGIS. FEES Annual,Conference Online Receipt Page 1 of 1 U Al r s Y'qa Ail 7,\ Thank you for submitting your information for the Annual Conference. Confirmation of your registration will come to you through U.S. Mail. Please call the FDSOA office at 508- 881 -3114 with any questions. Here is a summary of your submission: Name: James Toney Position: Lt/BC Aide Agency: Carmel Fire Department Address: 2 Civic Square City: Carmel State: IN Zipcode: 46032 Country: USA Work Phone: 317 -571 -2600 Fax: 317 -571 -2615 Email: dsnyder @carmel.in.gov Safety Forum Registration Fee: Safety Forum ISO Academy Non Member $525.00 PO Number: 12674 Submit: Submit https: /www.fdsoa.org /annconf receipt.htm 8/11/2009 Annual.Conference Online Receipt Page 1 of 1 yt f ;N c ij a &p D Z o m Thank you for submitting your information for the Annual Conference. Confirmation of your registration will come to you through U.S. Mail. Please call the FDSOA office at 508- 881 -3114 with any questions. Here is a summary of your submission: Name: Orbie Bowles Position: Lt/BC Aide Agency: Carmel Fire Department Address: 2 Civic Square City: Carmel State: IN Zipcode: 46032 Country: USA Work Phone: 317 -571 -2600 Fax: 317 -571 -2615 Email: dsnyder @carmel.in.gov Safety Forum Registration Fee: Safety Forum ISO Academy Non Member $525.00 PO Number: 12674 Submit: Submit https: /www.fdsoa.org /annconf receipt.htm 8/11/2009 Annual.Conference Online Receipt Page 1 of 1 i y 1 ff1 ti. X 44 "�G °i Pik s a r d k I �dx "N�x k .YgF.i.'YR :!W77ft25 Thank you for submitting your information for the Annual Conference. Confirmation of your registration will come to you through U.S. Mail. Please call the FDSOA office at 508- 881 -3114 with any questions. Here is a summary of your submission: Name: Timothy L. Conner Position: Lt /BC Aide Agency: Carmel Fire Department Address: 2 Civic Square City: Carmel State: IN Zipcode: 46032 Country: USA Work Phone: 317 -571 -2600 Fax: 317 -571 -2615 Email: dsnyder @carmel.in.gov Safety Forum Registration Fee: Safety Forum ISO Academy Non Member $525.00 PO Number: 12674 Submit: Submit https: /www.fdsoa.org /annconf receipt.htm 8/11/2009 Please type or print all information Exam Location IZZ_'�N ��o Exam Date: Deadline: Completed application, with payment, must be received 15 days prior to exam date. Payment must accompany registration form $195.00 Non Member (US Funds) $95.00 FDSOA Member (US Funds) A refund will be given the applicant (or sponsoring organization) provided written notification is received by FDSOA at least one (1) week prior to exam. A 25% processing fee will be applied. Save $15.00 Join FDSOA today (with the submission of the application) and pay member rate. Membership: $85.00 Individual (US Funds) $385.00 Department (US Funds) Payment Information: (U.S. Funds, drawn on U.S. Bank) Enclosed is a check payable to FDSOA L'JEnclosed is an official Purchase Order MasterCard Visa Card Number: Expiration Date: Card Holder Signature: Date: Card Holder Name: (Please Print) If all information requested is not provided, application will be returned. By signing and submitting my credentials, registration form and payment, I accept the conditions for FDSOA Certification concerning the offering of the examination, the reporting of scores, the release of information and the certification and /or re- certification processes and policies. I certify that the information in this application is true, complete and current to the best of my knowledge and is made in good faith. I understand that if any information is later determined to be false, the FDSOA Certification Committee reserves the right to revoke any certification granted because of that false information. I understand that the evaluator(s) at any, assigned exam center are authorized to take all action they deem necessary and o er to admini ter the test securely, fairly and efficiently. I acknowledge that the evaluator(s) may eloc t me ng or before the examination Applicants Signature: Applicants Printed Name: 19Z) N\ Date: Pl ease type or print all information Exam Location Exam Date: Deadline: Completed application, with payment, must be received 15 days prior to exam date. Payment must accompany registration form $195.00 Non Member (US Funds) $95.00 FDSOA Member (US Funds) A refund will be given the applicant (or sponsoring organization) provided written notification is received by FDSOA at least one (1) week prior to exam. A 25% processing fee will be applied. Save $15.00 Join FDSOA today (with the submission of the application) and pay member rate. Membership: $85.00 Individual (US Funds) $385.00 Department (US Funds) Payment Information: (U.S. Funds, drawn on U.S. Bank) Enclosed is a check payable to FDSOA N*— nclosed is an official Purchase Order ae� MasterCard Visa Card Number: Expiration Date: Card Holder Signature: Date: Card Holder Name: (Please Print) If all information requested is not provided, application will be returned. By signing and submitting my credentials, registration form and payment, I accept the conditions for FDSOA Certification concerning the offering of the examination, the reporting of scores, the release of information and the certification and /or re- certification processes and policies. I certify that the information in this application is true, complete and current to the best of my knowledge and is made in good faith. I understand that if any information is later determined to be false, the FDSOA Certification Committee reserves the right to revoke any certification granted because of that false information. I understand that the evaluator(s) at any assigned exam center are authorized to take all action they deem necessary and proper to administer the test securely, fairly and efficiently. I acknowledge that the evaluator(s) may relocate e during or before the examination Applicants Signature. Applicants Printed Name: Date: Pl ease type or print all information Exam Location 0.�4Q �L Exam Date: Deadline: Completed application, with payment, must be received 15 days prior to exam date. Payment must accompany registration form V $195.00 Non Member (US Funds) $95.00 FDSOA Member (US Funds) A refund will be given the applicant (or sponsoring organization) provided written notification is received by FDSOA at least one (1) week prior to exam. A 25% processing fee will be applied. Save $15.00 Join FDSOA today (with the submission of the application) and pay member rate. Membership: $85.00 Individual (US Funds) $385.00 Department (US Funds) Payment Information: (U.S. Funds, drawn on U.S. Bank) Enclosed is a check payable to FDSOA VEnclosed is an official Purchase Order MasterCard Visa Card Number: Expiration Date: Card Holder Signature: Date: Card Holder Name: (Please Print) If all information requested is not provided, application will be returned. By signing and submitting my credentials, registration form and payment, I accept the conditions for FDSOA Certification concerning the offering of the examination, the reporting of scores, the release of information and the certification and /or re- certification processes and policies. I certify that the information in this application is true, complete and current to the best of my knowledge and is made in good faith. I understand that if any information is later determined to be false, the FDSOA Certification Committee reserves the right to revoke any certification granted because of that false information. I understand that the evalu r s t any assigned exam center are authorized to take all action they deem necessary and proper administer the test securely, fairly and efficiently. I acknowledge that the evaluator(s) may relo ate m wring or before the examination Applicants Signature: Applicants Printed Name: Date: a Z�-' VOUCHER NO. `WARRANT NO. FDSOA ALLOWED 20 IN SUM OF P.O. Box 149 Ashland, MA 01721 $2,160.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 12681 pj JZ 43- 570.04 $585.00 I hereby certify that the attached invoice(s), or 12674 43- 570.04 $1,575.00 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 n AUG 17 2009 c 1 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)) $585.00 $1,575.00 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