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HomeMy WebLinkAbout169014 02/17/2009 CITY OF CARMEL, INDIANA VENDOR: 00351400 Page 1 of 1 ONE CIVIC SQUARE INDIANA FIRE CHIEFS ASSN. CARMEL, INDIANA 46032 P o BOX 364 CHECK AMOUNT: $475.00 ZiONSViLLE IN 46077 CHECK NUMBER: 169014 CHECK DATE: 2/17/2009 DEPART ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4355300 475.00 ORGANIZATION MEMBER I INDIANA FIRE CHIEFS ASSOCIATION a F' 2009 MEMBERSHIP APPLICATION Name: Keith Smith Title: Fire Chief Department Name: Carmel Fire Department Department Address: 2 Civic Square City: Carmel State: IN ZIP Code: 46032 Phone: 317 571 -2600 E -Mail: Ksmith@carmel.in.gov Fax: 317 -571 -2615 State Senate District: US Congressional District: IN Homeland Security District: State Representative District: MEMBERSNIP,CATEGORIES ACTIVE MEMBERSHIP Active Membership shall be comprised of the Chief of Department and any Chief Officer Rank of a regularly organized Fire Department officially recognized by the State Fire Marshal's Office. Active members shall be entitled to vote on all matters requiring a vote unless otherwise prohibited by the Constitution and By -Laws and shall be entitled to hold elective office. For departments with less than 30 emergency responders, the Fire Chief and one (1) Assistant Deputy Chief will be identified as active members who will have voting rights, all others of that department will be considered to have Departmental Membership. DEPARTMENTAL MEMBERSHIP Departmental Membership shall be comprised of each additional member beyond the Fire Chief and one (1) Assistant Deputy Chief of a department with less than 30 emergency responders. Departmental Members shall be entitled to participate fully in the affairs of the Association, with the exceptions of holding elective office and voting privileges. attach roster list of member names. ASSOCIATE MEMBERSHIP Associate Membership shall include individuals interested in the protection of life and property from fire. This also includes all members of a department with 30 or more emergency responders who are not the Fire Chief or a Chief Officer. Associate Members shall be entitled to participate fully in the affairs of the Association, with the exception of holding elected office and voting privileges. RETIRED ACTIVE MEMBERSHIP Retired Active Membership shall include only Active Members who have retired from the Fire Service after ten (10) consecutive years, as members of the I. F.C.A. Retired Active Members shall be entitled to participate fully in the affairs of the Association, with exception of holding elective office. Retired Active Membership may be obtained by application to and certification from the Board of Directors. MEMBER SECTIONS DUES (CHECK- JOINANYORALL) EMS 25.00 Public Safety Educator 25.00 Technical Rescue 25.00 MEMBER DUES STRUCTURE. AND PAYMENT METHODS Active Chief Assistant/Deputy Chief (30 or more in Dept.) 75.00 each Active Other Chief Rank (30 or more in Dept.) 50.00 each Member Dues Departmental Combo /Vol Dept. less than 30 $100.00 (please provide Dept. Roster) attach roster list of members names Section Dues Associate Non Chief Rank (more than 30) or Interested Individuals 50.00 Retired Active (by approval) Free TOTAL DUES: nS If an invoice is needed please complete application and indicate here with your initials Check (payable to mca) Visa MasterCard Card Number: Expiration Date: Name On Card: Signature: Easy Ways To Join. Return application and payment: By Mail: IFCA Membership Application, P.O. Box 364, Zionsville, IN 46077 By Fax: 317 -733 -4212 Toll Free: 1- 877 733 -1850 Online: www.indfirechiefs.org E -Mail: rake @indfirechiefs.org Sponsorship Opportunities Available Please see otir website'at www.indfrechiefs.org or contact Terry Rake, IFCA Executive Director at 3171 733 -1850 or 'rake @indfirechiefs,org. INDIANA FIRE CHIEFS ASSOCIATION a Y 2009 MEMBERSHIP APPLICATION %�a n Name: Mark Hulett Title: EMS Chief Department Name: Carmel Fire Department Department Address: 2 Civic Square City: Carmel State: IN ZIP Code: 46032 Phone: 317 571 -2600 E -Mail: mhulett @carmel.in.gov Fax: 317- 571 -2615 1 State Senate District: US Congressional District: IN Homeland Security District: State Representative District: MEMBERSHIP CATEGORIES ACTIVE MEMBERSHIP Active Membership shall be comprised of the Chief of Department and any Chief Officer Rank of a regularly organized Fire Department officially recognized by the State Fire Marshal's Office. Active members shall be entitled to vote on all matters requiring a vote unless otherwise prohibited by the Constitution and By -Laws and shall be entitled to hold elective office. For departments with less than 30 emergency responders, the Fire Chief and one (1) Assistant Deputy Chief will be identified as active members who will have voting rights, all others of that department will be considered to have D epartmental Membership. DEPARTMENTAL MEMBERSHIP— Departmental Membership shall be comprised of each additional member beyond the Fire Chief and one (1) Assistant Deputy Chief of a department with less than 30 emergency responders. Departmental Members shall be entitled to participate fully in the affairs of the Association, with the exceptions of holding elective office and voting privileges. attach roster list of member names. ASSOCIATE MEMBERSHIP Associate Membership shall include individuals interested in the protection of life and property from fire. This also includes all members of a department with 30 or more emergency responders who are not the Fire Chief or a Chief Officer. Associate Members shall be entitled to participate fully in the affairs of the Association, with the exception of holding elected office and voting privileges. RETIRED ACTIVE MEMBERSHIP Retired Active Membership shall include only Active Members who have retired from the Fire Service after ten (10) consecutive years, as members of the I.F.C.A. Retired Active Members shall be entitled to participate fully in the affairs of the Association, with exception of holding elective office. Retired Active Membership may be obtained by application to and certification f rom the B oard of Directors. MEMBER SECTIONS DUES (CHECX —JOIN ANY OR ALL) EMS 25.00 Public Safety Educator 25.00 Technical Rescue 25.00 MEMBER DUES STRUCTURE AND PAYMENT METHODS Active Chief Assistant/Deputy Chief (30 or more in Dept.) 75.00 each f( Active Other Chief Rank (30 or more in Dept.) 50.00 each Member Dues �Q Departmental Combo /Vol Dept. less than 30 $100.00 (please provide Dept. Roster) attach roster list of members names Section Dues a Associate Non Chief Rank (more than 30) or Interested Individuals 50.00 Retired Active (by approval) Free TOTAL DUES: h� If an invoice is needed please complete application and indicate here with your initials Check (payable to rFrA) Visa MasterCard Card Number: Expiration Date: N a m e O Card: Signature: Easy Ways To Join. Return application and payment: By Mail: IFCA Membership Application, P.O. Box 364, Zionsville, IN 46077 By Fax: 317- 733 -4212 Toll Free: 1- 877 733 -1850 Online: www.indfirechiefs.org E -Mail: rake @indfirechiefs.org Sponsorship 'Opportunities Available Please'see our website at www.indfirechiefs.org or contact Terry Rake, ,IFCA 'Executive Director at 317 -733 -1850 or rake @indfirechiefs.org. .......y INDIANA FIRE CHIEFS ASSOCIATION G 2003 MEMBERSHIP APPLICATION Name: David Haboush Title: Assistant Chief Department Name: Carmel Fire Department Department Address: 2 Civic Square City: Carmel State: IN ZIP Code: 46032 Phone: 317 -571 -2600 E -Mail: dhaboush @carmel.in.gov Fax: 317 -571 -2615 State Senate District: US Congressional District: IN Homeland Security District: State Representative District: MEMBERSHIP CATEGORIES., ACTIVE MEMBERSHIP Active Membership shall be comprised of the Chief of Department and any Chief Officer Rank of a regularly organized Fire Department officially recognized by the State Fire Marshal's Office. Active members shall be entitled to vote on all matters requiring a vote unless otherwise prohibited by the Constitution and By -Laws and shall be entitled to hold elective office. For departments with less than 30 emergency responders, the Fire Chief and one (1) Assistant Deputy Chief will be identified as active members who will have voting rights, all others of that department will be considered to have Departmental Membership. DEPARTMENTAL MEMBERSHIP Departmental Membership shall be comprised of each additional member beyond the Fire Chief and one (1) Assistant Deputy Chief of a department with less than 30 emergency responders. Departmental Members shall be entitled to participate fully in the affairs of the Association, with the exceptions of holding elective office and voting privileges. attach roster list of member names. ASSOCIATE MEMBERSHIP Associate Membership shall include individuals interested in the protection of life and property from fire. This also includes all members of a department with 30 or more emergency responders who are not the Fire Chief or a Chief Officer. Associate Members shall be entitled to participate fully in the affairs of the Association, with the exception of holding elected office and voting privileg RETIRED ACTIVE MEMBERSHIP Retired Active Membership shall include only Active Members who have retired from the Fire Service after ten (10) consecutive years, as members of the I.F.C.A. Retired Active Members shall be entitled to participate fully in the affairs of the Association, with exception of holding elective office. Retired Active Membership may be obtained by application to and certification from the Board of Directors. MEMBER SECTIONS DUES (04CK- Jorro.nrvrortaL4) EMS 25.00 Public Safety Educator 25.00 Technical Rescue 25.00 MEMBER DUES STRUCTURE AND PAYMENT METHODS Active Chief Assistant/Deputy Chief (30 or more in Dept.) 75.00 each V Active Other Chief Rank (30 or more in Dept.) 50.00 each Member Dues S Departmental Combo /Vol Dept. less than 30 $100.00 (please provide Dept. Roster) attach roster list of members names Section Dues Associate Non Chief Rank (more than 30) or Interested Individuals 50.00 Retired Active {by approval} Free TOTAL DUES: SQ If an invoice is needed please complete application and indicate here with your initials Check (payable to iFca) Visa MasterCard Card Number: Expiration Date: Name O Ca Signature: Easy Ways To Join. Return application and payment: By Mail: IFCA Membership Application, P.O. Box 364, Zionsville, IN 46077 By Fax: 317 733 -4212 Toll Free: 1- 877- 733 -1850 Online: www.indfirechiefs.o E M a il: ra Sponsorship Opportunities Available Please see our website at www.indfirechiefs.org or, contact Terry Rake, IFCA Executive, Director at 317 -733 -1850 or rake @indfirechiefs.org. INDIANA FIRE CHIEFS A r. a 2009 MEMBERSHIP APPLICATION Name: Jeff Steele Title: Assistant Chief Department Name: Carmel Fire Department Department Address: 2 Civic Square City: Carmel State: IN ZIP Code: 46032 Phone: 317 571 -2600 E -Mail: jsteele @carmel.in.gov Fax: 317 571 -2615 State Senate District: US Congressional District: IN Homeland Security District: State Representative District: i MEMBERSHIP CATEGORIES ACTIVE MEMBERSHIP Active Membership shall be comprised of the Chief of Department and any Chief Officer Rank of a regularly organized Fire Department officially recognized by the State Fire Marshal's Office. Active members shall be entitled to vote on all matters requiring a vote unless otherwise prohibited by the Constitution and By -Laws and shall be entitled to hold elective office. For departments with less than 30 emergency responders, the Fire Chief and one (1) Assistant Deputy Chief will be identified as active members who will have voting rights, all others of that department will be considered to have Departmental Membership. DEPARTMENTAL MEMBERSHIP Departmental Membership shall be comprised of each additional member beyond the Fire Chief and one (1) Assistant Deputy Chief of a department with less than 30 emergency responders. Departmental Members shall be entitled to participate fully in the affairs of the Association, with the exceptions of holding elective office and voting privileges. attach roster list of member names. ASSOCIATE MEMBERSHIP Associate Membership shall include individuals interested in the protection of life and property from fire. This also includes all members of a department with 30 or more emergency responders who are not the Fire Chief or a Chief Officer. Associate Members shall be entitled to participate fully in the affairs of the Association, with the exception of holding elected office and voting privileges. RETIRED ACTIVE MEMBERSHIP Retired Active Membership shall include only Active Members who have retired from the Fire Service after ten (10) consecutive years, as members of the I.F.C.A. Retired Active Members shall be entitled to participate fully in the affairs of the Association, with exception of holding elective office. Retired Active Membership may be obtained by application to and certification from the Board of Directors. MEMBER SECTIONS DUES (cM cK- JXNaNroa, LL) EMS 25.00 Public Safety Educator 25.00 Technical Rescue 25.00 MEM BER DUES STRUCTURE AND PAYMENT METHODS Active Chief Assistant /Deputy Chief (30 or more in Dept.) 75.00 each Active Other Chief Rank (30 or more in Dept.) 50.00 each Member Dues Sd Departmental Combo /Vol Dept. less than 30 $100.00 (please provide Dept. Roster) attach roster list of members names Section Dues Associate Non Chief Rank (more than 30) or Interested Individuals 50.00 Retired Active (by approval) Free TOTAL DUES: S Q If an invoice is needed please complete application and indicate here with your initials Check (paraare Visa MasterCard Card Number: Expiration Date: Name On Card: Signature: Easy Ways To Join. Return application and payment: By Mail: IFCA Membership Application, P.O. Box 364, Zionsville, IN 46077 By Fax: 317 733 -4212 Toll Free: 1- 877 733 -1850 Online: www.indfirechiefs.org E -Mail: rake @indfirechiefs.org Sponsorship Opportunities Available Please see our'website at vuww.indfirechiefs.org or contact Terry, Rake; IFCA Executive Director at 317- 733- 1850,o:r rake @indfirechiefs.org. °•..4 INDIANA FIRE CHIEFS ASSOCIATION bo o ry f 2009 MEMBERSHIP APPLICATION Name: Matt Hoffman Title: Training Chief Department Name: Carmel Fire Department Department Address: 2 Civic Square City: Carmel State: IN ZIP Code: 46032 Phone: 317 571 -2600 E -Mail: mhoffman @carmel.in.gov Fax: 317- 571 -2615 State Senate District: US Congressional District: IN Homeland Security District: State Representative District: MEMBERSHIP CATEGORIES ACTIVE MEMBERSHIP Active Membership shall be comprised of the Chief of Department and any Chief Officer Rank of a regularly organized Fire Department officially recognized by the State Fire Marshal's Office. Active members shall be entitled to vote on all matters requiring a vote unless otherwise prohibited by the Constitution and By -Laws and shall be entitled to hold elective office. For departments with less than 30 emergency responders, the Fire Chief and one (1) Assistant Deputy Chief will be identified as active members who will have voting rights, all others of that department will be considered to have Departmental Membership. DEPARTMENTAL MEMBERSHIP Departmental Membership shall be comprised of each additional member beyond the Fire Chief and one (1) Assistant Deputy Chief of a department with less than 30 emergency responders. Departmental Members shall be entitled to participate fully in the affairs of the Association, with the exceptions of holding elective office and voting privileges. attach roster list of member names. ASSOCIATE MEMBERSHIP Associate Membership shall include individuals interested in the protection of life and property from fire. This also includes all members of a department with 30 or more emergency responders who are not the Fire Chief or a Chief Officer. Associate Members shall be entitled to participate fully in the affairs of the Association, with the exception of hol ding elected office and voting pr ivileges. RETIRED ACTIVE MEMBERSHIP Retired Active Membership shall include only Active Members who have retired from the Fire Service after ten (10) consecutive years, as members of the I.F.C.A. Retired Active Members shall be entitled to participate fully in the affairs of the Association, with exception of holding elective office. Retired Active Membership may be obtained by application to and certification from the Board of Directors. MEMBER SECTIONS DUES (CHECK JOINANYOR ALL) EMS 25.00 Public Safety Educator 25.00 Technical Rescue 25.00 MEMBER DUES STRUCTURE AND PAYMENT METHODS 11 Active Chief A5sista n t/ Deputy Chief (30 or more in Dept.) 75.00 each [a Active Other Chief Rank (30 or more in Dept.) 50.00 each Member Dues S Departmental Combo /Vol Dept. less than 30 $100.00 (please provide Dept. Roster) attach roster list of members names Section Dues a� Associate Non Chief Rank (more than 30) or Interested Individuals 50.00 Retired Active (by approval) Free TOTAL DUES: n5 If an invoice is needed please complete application and indicate here with your initials Check (payable to7Fc4) Visa MasterCard Card Number: Expiration Date: Name On Card: Signature: Easy Ways To Join. Return application and payment: By Mail: IFCA Membership Application, P.O. Box 364, Zionsville, IN 46077 By Fax: 317 733 -4212 Toll Free: 1 -877- 733 -1850 Online: www.indfirechiefs.org E -Mail: rake @indfirechiefs.org Sponsorship Opportunities Available —Please see our website at www.indfirechiefs.org or contact Terry Rake, IFCA Executive Director at 317 733 =1850 or rake @indfirechiefs.org, INDIANA FIRE CHIEFS ASSOCIATION 2009 MEMBERSHIP APPLICATION Name: Keith Freer Title: Public Education Director Department Name: Carmel Fire Dept. Department Address: 2 Civic Square City: Carmel State:IN ZIP Code: 46032 Phone: 317- 571 -2600 E -Mail: kfreer @carmel.in.gov Fax: 317 571 -2674 State Senate District: US Congressional Distrct: IN Homeland Security District: State Representative District: MEMBERSHIP CATEGORIES ACTIVE MEMBERSHIP Active Membership shall be comprised of the Chief of Department and any Chief Officer Rank of a regularly organized Fire Department officially recognized by the State Fire Marshal's Office. Active members shall be entitled to vote on all matters requiring a vote unless otherwise prohibited by the Constitution and By -Laws and shall be entitled to hold elective office. For departments with less than 30 emergency responders, the Fire Chief and one (1) Assistant Deputy Chief will be identified as active members who will have voting rights, all others of that department will be considered to have Departmental Membership. DEPARTMENTAL MEMBERSHIP Departmental Membership shall be comprised of each additional member beyond the Fire Chief and one (1) Assistant Deputy Chief of a department with less than 30 emergency responders. Departmental Members shall be entitled to participate fully in the affairs of the Association, with the exceptions of holding elective office and voting privileges. attach roster list of member names. ASSOCIATE MEMBERSHIP Associate Membership shall include individuals interested in the protection of life and property from fire. This also includes all members of a department with 30 or more emergency responders who are not the Fire Chief or a Chief Officer. Associate Members shall be entitled to participate fully in the affairs of the Association, with the exception of holding elected office and voting privileges. RETIRED ACTIVE MEMBERSHIP Retired Active Membership shall include only Active Members who have retired from the Fire Service after ten (10) consecutive years, as members of the I.F.C.A. Retired Active Members shall be entitled to participate fully in the affairs of the Association, with exception of holding elective office. Retired Active Membership may be obtained by application to and certification from the Board of Directors. MEMBER SECTIONS DUES {CHECK- 70INANYORALO EMS 25.00 _X— Public Safety Educator 25.00 Technical Rescue 25.00 MEMBER DUES STRUCTURE AND PAYMENT METHODS Active Chief Assistant/Deputy Chief (30 or more in Dept.) 75.00 each Active Other Chief Rank (30 or more in Dept.) 50.00 each �0 Member Dues Departmental Combo/Vol Dept. less than 30 $100.00 �1 (please provide Dept. Roster) attach roster list of members names Section Dues 11 Associate Non Chief Rank (more than 30) or Interested Individuals 50.00 �7 TOTAL DUES: Retired Active (by approval) Free If an invoice is needed please complete application and indicate here with your initials Check (payame to zFca) Visa MasterCard Card Number: Expiration Date: Name On Card: Signature: Easy Ways To Join. Return application and payment: By Mail: IFCA Membership Application, P.O. Box 364, Zionsville, IN 46077 By Fax: 317- 733 -4212 Toll Free: 1- 877 -733 -1850 Online: www.indfirechiefs.org E -Mail: rake @indfirechiefs.org Sponsorship Opportunities Available Please see our website at www.indfirechiefs.org or contact Terry Rake, IFCA Executive Director at 317- 733 -1850 or rake @indfirechiefs.org. INDIANA FIRE CHIEFS ASSOCIATION 2009 MEMBERSHIP APPLICATION oa^r Name: Bruce Knott Title: Fire Marshal Department Name: Carmel Fire Dept. Department Address: 2 Civic Square City: Carmel State:IN ZIP Code: 46032 E Phone: 317- 571 -2600 E -Mail: bknott@carmel.in.gov Fax: 317- 571 -2674 State Senate District: US Congressional District: IN Homeland Security District: State Representative District: MEMBERSHIP CATEGORIES ACTIVE MEMBERSHIP Active Membership shall be comprised of the Chief of Department and any Chief Officer Rank of a regularly organized Fire Department officially recognized by the State Fire Marshal's Office. Active members shall be entitled to vote on all matters requiring a vote unless otherwise prohibited by the Constitution and By -Laws and shall be entitled to hold elective office. For departments with less than 30 emergency responders, the Fire Chief and one (1) Assistant Deputy Chief will be identified as active members who will have voting rights, all others of that department will be considered to have Departmental Membership. DEPARTMENTAL MEMBERSHIP Departmental Membership shall be comprised of each additional member beyond the Fire Chief and one (1) Assistant Deputy Chief of a department with less than 30 emergency responders. Departmental Members shall be entitled to participate fully in the affairs of the Association, with the exceptions of holding elective office and voting privileges. attach roster list of member names. ASSOCIATE MEMBERSHIP Associate Membership shall include individuals interested in the protection of life and property from fire. This also includes all members of a department with 30 or more emergency responders who are not the Fire Chief or a Chief Officer. Associate Members shall be entitled to participate fully in the affairs of the Association, with the exception of holding elected office and voting privileges. RETIRED ACTIVE MEMBERSHIP Retired Active Membership shall include only Active Members who have retired from the Fire Service after ten (10) consecutive years, as members of the I.F.C.A. Retired Active Members shall be entitled to participate fully in the affairs of the Association, with exception of holding elective office. Retired Active Membership may be obtained by application to and certification from the Board of Directors. MEMBER SECTIONS DUES (CHECK- JOr NANroRAll) EMS 25.00 X— Public Safety Educator 25.00 Technical Rescue 25.00 MEMBER DUES STRUCTURE AND PAYMENT METHODS Active Chief Assistant/Deputy Chief (30 or more in Dept.) 75.00 each Active Other Chief Rank (30 or more in Dept.) 50.00 each Member Dues Departmental Combo /Vol Dept. less than 30 $100.00 (please provide Dept. Roster) attach roster list of members names S Section Dues Associate Non Chief Rank (more than 30) or Interested Individuals 50.00 Retired Active (by approval) Free TOTAL DUES: If an invoice is needed please complete application and indicate here with your initials Check (payable m r c4) Visa MasterCard Card Number: Expiration Date: Name On Card: Signature: Easy Ways To Join. Return application and payment: By Mail: IFCA Membership Application, P.Q. Box 364, Zionsville, IN 46077 By Fax: 317 733 -4212 Toll Free: 1- 877 -733 -1850 Online: www.indfirechiefs.org E -Mail: rake @indfirechiefs.org Sponsorship Opportunities Available Please see our website at www.indfirechiefs.org or contact Terry Rake, IFCA Executive Director at 317- 733 -1850 or rake @indfirechiefs.org. VOU CHER NO. WARRANT NO. ALLOWED 20 I FCA Indiana Fire Chiefs Association IN SUM OF P.O. Box 364 Zionsville, IN 46077 $475.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1120 43- 553.00 $475.00 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 FEB 13 2009 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)) Dues Smith, Steele, Haboush, Hulett, Hoffman, Knott, Freer $475.00 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