The URL can be used to link to this page

Home My WebLink About221639 07/02/2013 CITY OF CARMEL, INDIANA VENDOR: 367237 Page 1 of 1 ONE CIVIC SQUARE OH ASSOC OF EMERG VEHICLE TECH'CHECK AMOUNT: $770.00 CARMEL, INDIANA 46032 Po eox 303 AVON OH 44011 CHECK NUMBER: 221639 CHECK DATE: 7/2/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4357004 770 . 00 EXTERNAL INSTRUCT FEE ATTENDEE REGISTRATION FORM 2013 OHIO ASSOCIATION OF EMERGENCY VEHICLE TECHNICIANS EMERGENCY APPARATUS MAINTENANCE SYMPOSIUM NOTE. PLEASE PRINT or TYPE all information. This form must be filled out completely or it will be returned to you. DEADLINE for registration is September 13, 2013. All late registrations after 9-13-13 will be required to pay a fee of$20 per day/class or $100 total for the week. Full registration refund prior to 8-31-13. 50% refund prior to 9-6-13. No refund after 9-6-13. Name d►J VA W �O a/ZS T Preferred Address l_ City 64P-m y L State ZP2 . zip 1/6(:D 32 Cell Phone (317) l 4 5/- o �!S® Work Phone (317) S 7/ 6 o 0 E-mail R VAA)Vor P_S7-0 CAQmCL :j?0 , 60 Fire Dept./ Agency / Company Address C o/C JD zip Do you plan to attend Wednesday night Banquet? Yes ( ) No T-shirt size 1Ae6-t REGISTRATION Carefully fill out the registration form and send it along with full tuition or payment verification: (for example purchase order number from your employer) Ohio Association of Emergency Vehicle Technicians, Inc. P.O. Box 303 • Avon, Ohio 44011 Use class selection number — PLEASE indicate second choice! Monday Tuesday Wednesday Thursday Friday [Second 900 h� Pon to rv� 'rvT GP �% J'/'P I f��" P ICJ / 0� �! ��` i0 1� Form may be photocopied as needed. 3 TUITION INFORMATION REGISTRATION CLOSES SEPTEMBER 13, 2013 Late registration rate will be required. $20 per day/class. FULL PACKAGE Includes the 5 day symposium, daily lunch, and the Wednesday night Banquet: � o $385.00 O.J• o Daily Rate - Any Class................................................ $130.00 The Wednesday Night Banquet- ADDITIONAL TICKETS $25.00 TOTAL ENCLOSED Late Registration after 9-13-13 Full Week.................. $100.00 Per Day/Class...................................... $20.00 TOTAL INCLUDING LATE REGISTRATION S • o d Send registration form along with full tuition or payment verification: (for example, purchase order number from your employer) Registration: Monday 7:30 AM Welcome & General Assembly: Monday 8:30 AM Class Times: Classes are Tuesday thru Thursday from 9 AM to 4 PM, with one hour for lunch and two 15 minute breaks. Friday 9 AM - 12 PM Lunch will be in the Ohio Fire Academy cafeteria. Meal tickets will be issued to each student. Some classes are limited in size due to hands-on training. Register early, classes will be filled on a first come, first served basis. Class registrations must be postmarked by September 13, 2013. Certificates of attendance will be awarded upon payment of all fees and verification of attendance. Students are responsible for providing suitable personal protective equipment, i.e., eye protection, hearing protection, as may be needed for the hands-on portion of any class. O.A.E.V.T. reserves the right to cancel or substitute classes due to conditions beyond our control. Reasonable efforts have been made to confirm the classes and instructors scheduled. Please call Pat Guhde (440) 476-8707 or E-mail at pguhde @AOL.com 4 ATTENDEE REGISTRATION FORD 2013 OHIO ASSOCIATION OF EMERGENCY VEHICLE TECHNICIANS EMERGENCY APPARATUS MAINTENANCE SYMPOSIUM NOTE. PLEASE PRINT or TYPE all information. This form must be filled out completely or it will be returned to you. DEADLINE for registration is September 13, 2013. All late registrations after 9-13-13 will be required to pay a fee of$20 per day/class or $100 total for the week. Full registration refund prior to 8-31-13. 50% refund prior to 9-6-13. No refund after 9-6-13. Name .J ►9�S�n/ o,e C E Preferred Address 30 61, EEfy /40LLoLI-3 CT City JA)E.ST rI EL,6 //Y' State A/ Zip Cell Phone((3i'�) cpgo – y2g / Work Phone 07) �� 2 Coo �jo^ C E C Cv/-`/l e / i 0✓ Fire Dept./ Agency / Company r'gR10E L F' i78: 6EP'glL�"Tw'1 LIW T Address ID n rl j 1 r r -C-)Q U A!?E 64/?MFG , �i\,/. Zip Do you plan to attend Wednesday night Banquet? ( ) Yes ( ) No T-shirt size L,�2 REGISTRATION Carefully fill out the registration form and send it along with full tuition or payment verification: (for example purchase order number from your employer) Ohio Association of Emergency Vehicle Technicians, Inc. P.O. Box 303 • Avon, Ohio 44011 Use class selection number — PLEASE indicate second choice! Monday Tuesday Wednesday Thursday Friday First j7t ZVE PV/op V A7E7P. 1-2 DOLT F-1 RE Choice moliv1ou'quL T I ELECTRICITY FAMILIAR 7-CO 1 G> Second Ku55,w1�vG- Fr7E l�0�f� Fj;ZE P7v�► Choice X11 EN&)(C '� 10 S 9,e0 1 1 ' 3 1� Form may be photocopied as needed. 3 TUITION INFORMATION REGISTRATION CLOSES SEPTEMBER 13, 2013 Late registration rate will be required. $20 per day/class. FULL PACKAGE Includes the 5 day symposium, daily lunch, and the Wednesday night Banquet: $385.00 Daily Rate - Any Class................................................ $130.00 The Wednesday Night Banquet- ADDITIONAL TICKETS ...................... $25.00 TOTAL ENCLOSED Late Registration after 9-13-13 Full Week.................. $100.00 Per Day/Class...................................... $20.00 TOTAL INCLUDING LATE REGISTRATION 3 �� Send registration form along with full tuition or payment verification: (for example, purchase order number from your employer) Registration: Monday 7:30 AM Welcome & General Assembly: Monday 8:30 AM Class Times: Classes are Tuesday thru Thursday from 9 AM to 4 PM, with one hour for lunch and two 15 minute breaks. Friday 9 AM - 12 PM Lunch will be in the Ohio Fire Academy cafeteria. Meal tickets will be issued to each student. Some classes are limited in size due to hands-on training. Register early, classes will be filled on a first come, first served basis. I Class registrations must be postmarked by September 13, 2013. Certificates of attendance will be awarded upon payment of all fees and verification of attendance. Students are responsible for providing suitable personal protective equipment, i.e., eye protection, hearing protection, as may be needed for the hands-on portion of any class. O.A.E.V.T. reserves the right to cancel or substitute classes due to conditions beyond our control. Reasonable efforts have been made to confirm the classes and instructors scheduled. Please call Pat Guhde (440) 476-8707 or E-mail at pguhde @AOL.com 4 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)) $770.00 1 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. WARRANT NO. ALLOWED 20 Ohio Assoc. of Emergency Vehicle Technicians IN SUM OF $ P.O. Box 303 Avon, OH 44011 $770.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT Board Members 3 43-570.04 $770.00 1 hereby certify that the attached invoice(s), or 7 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 Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund