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HomeMy WebLinkAbout179255 11/11/2009 a CITY OF CARMEL, INDIANA VENDOR: 00351400 Page 1 of 1 ONE CIVIC SQUARE INDIANA FIRE CHIEFS ASSN. i. CARMEL, INDIANA 46032 P 0 BOX 364 CHECK AMOUNT: $425.00 ZIONSVILLE IN 46077 CHECK NUMBER: 179255 CHECK DATE: 11/11/2009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4355300 425.00 ORGANIZATION MEMBER 2010 IFCA Membership Invoice Summary p E CNiEFe INDIA CHIEFS A SSOC IAT ION To: Carmel Fire Department U SEPT�M�Q 2 Civic Square Carmel, IN 46032 Phone: 317 -571 -2622 Fax: 317 -571 -2615 Mimi I N MR o Population Served: Dept. Type and Size (Career /Vol /Combin) Member Type Dues State Senate District: US Congress District: Department Budget: Departmental (<30 in Dept, pay once) $100 State Rep District: IDHS District: 5 Active >30 in Dept /Chief- Assist -Dep) $75 Active >30 in Dept/ Other Chief) $50 In 2009, the individuals listed below with your department were members of the Indiana Fire Chiefs Association, Associate(> in Non Chief or Other) $50 We certainly hope those of you who were 2009 members will renew and encourage others in your department to Section Dues $25 join as well in 2010. Please see cover letter /application for complete 2010 membership type descriptions. Note: We request that you review and correct this summary (especially blanks above). Please fax, email or mail to Terry Rake, Executive Director IFCA. i 1. Public Education Dire Keith Freer kfreer @carmel.in.gov Associate Public Safety Education Section as 2. Assistant Fire Chief David Haboush dhaboush @carmel.in.gov Active 3. Training Chief Matt Hoffman mhoffman @carmel.in.gov Active Technical Rescue Section `J Q To Add A New Member: To Remove A Member: To Change Data: Please complete the new membership form included with Please note on the summary which member will not be Please change or add information to this summary and adjust the amount due by referring to the renewing and adjust the amount due by referring to the the data fields on this form. Attach membership dues structure, 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 2 01 IFCA Membership Invoice Summary IND IANA FIRE CHIEFS ASSOCIATION -p To: Carmel Fire Department BEPTfN 2 Civic Square Carmel, IN 46032 4. EMS Chief Mark Hulett mhulett @carmel.in.gov Active p EMS Section 5. Fire Marshal Bruce Knott bknott @carmel.in.gov Active Public Safety Education Section 5 Q 6. Fire Chief Keith Smith ksmith @carmel.in.gov Active S 7. Assistant Fire Chief Jeff Steele jsteele @carmel.in.gov Active Please Send Receipt: Check(payable to IFCA) Renewal Total: �S Section Dues: Visa Mastercard Card Number: New Members: Name on Card: Total Due: Signature: To Add A New Member: To Remove A Member: To Change Data: Please complete the new membership form included with Please note on the summary which member will not be Please change or add information to this summary and adjust the amount due by referring to the renewing and adjust the amount due by referring to the the data fields on this form. Attach membership dues structure. 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 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)) $425.00 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 VOUCHER NO. WARRA NO. ALLOWED 20 I FC_A Indiana Fire Chiefs Association IN SUM OF P.O. Box 364 Zionsville, IN 46077 $425.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1120 43- 553.00 $425.00 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 NOV m 9 2009 d Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund