Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
222024 07/17/2013
CITY OF CARMEL, INDIANA VENDOR: 360684 Page 1 of 1 ONE CIVIC SQUARE HILTON GARDEN INN DENVER DOWNTp�N CARMEL, INDIANA 46032 1400 WELTON ST L'HECK AMOUNT: $2,561.22 DENVER CO 80202 CHECK NUMBER: 222024 CHECK DATE: 7/17/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4343002 2 , 561 . 22 EXTERNAL TRAINING TRA Reservation Confirmation - 3525762876 Page 1 of 2 Hilton Garden Inn Denver Downtown MHiltolft 1400 Welton Street,Denver,Colorado,80202,USA p-+ar en Innr 1-303-603-8000 Reservation Confirmation # 3525762876 Hotel Stay Information Hilton Garden Inn Denver Downtown Arrival: Wednesday,21 Aug 2013 1400 Welton Street Departure: Sunday,25 Aug 2013 Denver,Colorado 80202 2 rooms for 4 nights USA Phone: 1-303-603-8000 Early check-in cannot be guaranteed.Contact the hotel to inquire about early check-in or late check-out. Hotel check-in time is 3:00 pm and check-out is at 12:00 pm. Room and Plan Selection Guest Information Room 1: Guest name: Dave Haboush 2 adults Address type: Work 2 QUEEN BEDS Address: On file Price(4 nights x 279.00) 1,116.00 Email: On file Taxes 164.61 Phone: On file Room Subtotal 1,280.60 Best Available Rate Room preferences: 2 Beds. Your preferences have been submitted with your reservation and are subject to Room 2: hotel availability. 2 adults Payment Information IQ 2 QUEEN BEDS Price(4 nights x 279.00) 1,116.00 Card type: Card number: Taxes 164.61 Expiration: Nov 2015 Room Subtotal 11280.60 Best Available Rate Total for stay all rooms: $2,561.22 USD https://secure3.hilton.com/en_US/gi/reservation/view/confirmation.htm 7/2/2013 Reservation Confirmation - 3525762876 Page 2 of 2 Driving directions To our hotel:Directions from Colorado Springs:Merge onto 1-25 N toward Denver. Merge onto W.Colfax Ave/1-70 BL E/US 287 S exit#210A. Turn slight left onto Welton Street. Proceed to Welton and 14th Street. Directions from Boulder: US-36 East toward Denver.Merge 1-25S/US 87S.Take Speer Boulevard exit 2128,merge onto Speer Blvd.Turn left onto Lawrence Street.Turn right onto 14th Street to Welton Street. From Denver,CO[Denver International Airport: North on Pena Blvd,merge onto 1-70 West,Take 1-25 South exit#274 toward Colorado Springs, Merge onto 1-25 South/US 87 S,Take Speer Blvd South exit#212B,Merge onto Speer Blvd,Turn left onto Lawrence St,Turn right onto 14th St. Rules&Restrictions Taxes • 14.75%per room per night Guarantee Policy There is a credit card required for this reservation If you use a debit/credit card to check in,a hold may be placed on your card account for the full anticipated amount to be owed to the hotel,including estimated incidentals, through your date of check-out and such hold may not be released for 72 hours from the date of check-out or longer at the discretion of your card issuer. Cancellation Policy If you wish to cancel,please do so 1 day prior to arrival to avoid cancellation penalties At check in,the front desk will verify your check-out date.Rates quoted are based on check-in date and length of stay.Should you choose to depart early,price is subject to change. We reserve the right to cancel or modify reservations where it appears that a customer has engaged in fraudulent or inappropriate activity or under other circumstances where it appears that the reservations contain or resulted from a mistake or error. Totals listed here are estimated based on current taxes and exchange rates(if applicable)and do not include additional fees/charges that may be incurred during your stay. Services provided for an additional charge Parking charges:Valet parking-$31.00 In-Room Wireless Internet:Complimentary In-Room Wired Internet:Complimentary https:Hsecure3.hilton.com/en_US/gi/reservation/view/confirmation.htm 7/2/2013 t is way uccess - i 2013 JohnzP. Redmond Symposium oh-the Occupational Health'Hazarcls-of tFie'Fire Service .:." ' in,conjunctiori'with the,Dominick F. Barbera Emergency Me'didal Services Gonfererice Hyatt Regency Denver at Colorado Convention Centeri;Denver, Colorado August 21-24; 2013 Only.orie registrant per form. Each registrant must check off one Information'Session for Thursday°,- PRE-CONFERENCE EVENTS::,,,', two workshops and one Information Session for Friday and four workshops for.Saturday.. TUESDAY -WEDNESDAY(SELECT ONE) EXCEPTION:Registrants selecting the two-part Functional Fitness workshop which is considered two, ❑Fire Ops 101 ❑Fire Ground Survival workshops,registrants selecting the Fire Behavior Research workshop which is considered two (Bring your own"equipment) workshops and/or the registrants selecting the Medical Directors Course part 1'and 2 is considered two ❑NIST Radio Comm`Lab Tour workshops and the Medical Directors Course part 3 and Interactive Session is considered two workshops. ` Attendance at all workshops is limited and Will be determined on a first-dome basis. THURSDAY INFORMATION SESSIONS(SELEC71) FRIDAY INFORMATION SESSIONS(SELECT 1) ❑.The World Trade Center Health Program ` `❑National.Partners with EMS Interests-DHS,HHS, ❑National Partners with:EMS Interests-DHS,HHS, ❑Ask the Doc:The Physicians'Discussion on Fire M1NHTSA('NREMT;NEMS15,CoAEMSP NHT.SA,NREMT,NEMSIS,CoAEMSP and EMS Issues ❑Carbon Monoxide:EMS Response to Fireground, ❑National Fire Service Data Project-NFORS ❑Writing Winning Grants:Fire Act,AFG,SAFER and Incidents ❑NFPA EMS Standards(Standards 450 and 1917) Beyond CJ National Fire Service Data Project-NFORS O.W.E.R.:Performance,Optimization,Well-being, ❑Ask the Trainer-WFI,CPAT PFT,FGS NFPA Standards for the Fire Service, enhancement&Regeneration ❑NIST High-Rise Toolkit:Using the study at home - ❑The World Trade Center Health Program': ❑Ask.the Doc:The"Physicians'Discussion on Fire and SATURDAY MORNING WORKSHOPS(SELECT 2) ❑Behavioral Wellness - -: EMS Issues ' ❑EMS Medical,Director Course(Part 1'and 2) ❑Burn Injuries-It Happened in Seconds ❑Writing Winning Grants:Fire Act,AFG,SAFER and. ❑Fire-Based EMS:Explaining the Benefits to Policy ❑Emergency.Vehicle Safety-How to Protect Beyond Makers&Tax Payers Yourself While Serving Others ❑Ask the General:Meet Geneal McCaffreymlb close' CI Fire Fighter Safe ty and Deployment:EMS A Sleep and The Truth About.Shift Schedules and.' :FRIDAY.WORKSHOPS.(SELECT 2) Integration Models Performance,- O Consultants and EMS System Design ` X Functional Fitness-Balancing the Physical ❑NIOSH Fire Fighter Cancer Study , ❑Fire-Based EMS-Case Scenarios Demands with Human Capacity(Part 1 and 2) ❑Wildland Urban Interface(WUI)-Safety and Tactics ,O Fire Based EMS Operations in Canada. ❑NIST and UL Research:Studying Fire Behavior (Part 1 and 2): O.NIST and UL Research:Studying Fire Behavior and and Fireground Tactics(Part 1 and 2). Fireground Tactics Part 1 and 2 SATURDAY AFTERNOON WORKSHOPS(SELECT 2) ❑Wildland Urban Interface(WUI) Safety and Tactics ❑Building,Codes:Your Work Environment Needs the Proper Protection—Your Life Depends On It El EMS Medical Director Course(Part 3 and (Part 1 and 2) , Fire Service Communications:Why They Are Not Interactive Session) ❑Personal Protective Clothing Working= 13 EMS Delivery and the Affordable Care Act ❑Infectious Diseases-Common Exposures-New Functional Fitness-Balancing the Physical ❑Community Paramedics Threats-Biological Warfare .Demands with Human Capacity Part 1 and 2 ❑Suicide Prevention WFI Implementation Strategies ❑Respiratory Protection ' ❑Burn Injuries-Taking Care of Our Own AWorking to Death-Occupational Diseases- ❑PSO-Public Safety Officers:Knowing the Facts ❑The Toxic Fire Environment-Giving the"All Clear" Heart Disease,Respiratory Disease and Cancer METHOD;OF PAYMENT:F113EPAC OPTIONS-IAFF MEMBERS ONLY: METHOD OF PAYMENT:NON-FIREPAC OPTIONS: `):'Chairman's Council=US and-Canada FIREPAC Leadership Trust=US and Canada 0 500 I will attend the Symposium/Conference Chairman's Council•members will receive a Leadership TrusCmembers will receive a°Leadership and li;61 join the FIREPAC Leadership Trust. Chairman's Council pin,a specially designed wind Trust pin and recognition on the IAFF website.. shirt and recognition on the IAFF website. ❑CHECK(Payable in U.S.Dollars to ❑$500 1 would like to join the FIREPAC Leadership John;P.Redmond Foundation) ❑$750,•:I would like to join the FIREPAC Trust and register for the Symposium/ Chairman's Council and register for.the Conference at the same time. D V1SA1MA,STERCARD"(complete credit Symposium/Conference at the saine time. card information below). = ❑PERSONAL CHECK/MONEY ORDER ❑I would like to make a separate voluntary contribution ❑'PERSONAL CHECK/MONEY ORDER: (Payable to IAFF FIREPAC.Canadian to FIREPAC in the amount of but not have (Payable to IAFF FIREPAC.Canadian members please make check payable to it credited towards my conference registration. = '"'members please niake.check"payable IAFF FIREPAC Canada) to IAFF'FIREPAC Canada) -, El PERSONAL VIS.AlA4AS"I"ERCARD Please cam fete this registration farm" 'Cl PERSONAL VISA/MASTERCARD (complete credit card information and„mail to the address below: (complctceredit card information below) heltiw) -:.John R Redmond'Foundation.,', :'':Chairman's Council members U.S.members only:FI REPAC can only accept personal Dominick F.Barbera Conference Wind shirt size checks,money orders or personal credit cards.Federal •`International Association of Fire Fighters'. ” ❑S'❑'M .❑L ❑XL ❑2XL O 3XL ❑4XL electiondaws prohibit FIREPAC from accepting business :Attention: Beverly Lewis or union dues(treasury)account checks.(;onti ibutions 1750 New York Avenue,NW<: to,FIREPAC do not qualify as;diaritable contributions Washington;_DC 20006-5395, 'PAC. income tax purposes._ Phone:(202}824-1:594(1571 VISA/MASTERCARD Name l nn (3 ............... Credit Card Number: L �1�LIL\ C!F aF CA'2 u�t( F-� IAFF Local/Con an Name Address 3 4 Z U C_p (N w ��___...._._..__.____ _ Name as it appears on the card: City C-A q, State/Province Zip Code PhAe —in U_-TEsgs'L--- ( ( K- IFF I plJ (L TN, coUv Signature Email Address -T �-L.._t"----- Exp.date Pathways to Success I 2013 John P. Redmond Symposium on the Occupational Health Hazards of the Fire Service in conjunction with the Dominick F. Barbera Emergency Medical Services Conference s Hyatt Regency Denver at Colorado Convention Center, Denver, Colorado -August 21-24, 2013 Only one registrant per form. Each registrant must check off one Information Session for Thursday, PRE-CONFERENCE EVENTS two workshops and one Information Session for Friday and four workshops for Saturday. TUESDAY WEDNESDAY(SELECT ONE) EXCEPTION:Registrants selecting the two-part Functional Fitness workshop which is considered two ❑Fire Ops 101 ❑Fire Ground Survival workshops,registrants selecting the Fire Behavior Research workshop which is considered two (Bring your own equipment) workshops and/or the registrants selecting the Medical Directors Course part 1 and 2 is considered two ❑NIST Radio Comm Lab Tour workshops and the Medical Directors Course part 3 and Interactive Session is considered two workshops. Attendance at all workshops is limited and will be determined on a first-come basis. THURSDAY INFORMATION SESSIONS(SELECT 1) FRIDAY INFORMATION SESSIONS(SELECT 1) ❑The World Trade Center Health Program ❑National Partners with EMS Interests-DHS,HHS, ❑National Partners with EMS Interests-DHS,HHS, ❑Ask the Doc:The Physicians'Discussion on Fire NHTSA,NREMT,NEMSIS,CoAEMSP NHTSA,NREMT,NEMSIS,CoAEMSP and EMS Issues ❑Carbon Monoxide:EMS Response to Fireground ❑National Fire Service Data Project-NFORS ❑Writing Winning Grants:Fire Act,AFG,SAFER and Incidents ❑�1FPA EMS Standards(Standards 450 and 1917) Beyond ❑National Fire Service Data Project-NFORS 4P.O.W.E.R.:Performance,Optimization,Well-being, ❑Ask the Trainer-WFI,CPAT PFT FGS ❑NFPA Standards for the Fire Service Enhancement&Regeneration ❑NIST High-Rise Toolkit:Using the study at home •The World Trade Center Health Program •Ask the Doc:The Physicians'Discussion on Fire and SATURDAY MORNING WORKSHOPS(SELECT 2) Behavioral Wellness EMS Issues ❑EMS Medical Director Course(Part 1 and 2) ❑Burn Injuries-It Happened in Seconds ❑Writing Winning Grants:Fire Act,AFG,SAFER and ❑Fire-Based EMS:Explaining the Benefits to Policy ❑Emergency Vehicle Safety-How to Protect Beyond Makers&Tax Payers ourself While Serving Others ❑Ask the General:Mee eneral Mc ffrey up close`a ❑Fire Fighter Safe and Deployment:EMS f lee and The Truth About Shift Schedules and 9 Safety p FRIDAY WORKSHOPS(SELECT 2) Integration Models Performance El and EMS System Design 11 Functional Fitness-Balancing the Physical El NIOSH Fire Fighter Cancer Study ❑Fire-Based EMS Case Scenarios Demands with Human Capacity(Part 1 and 2) ❑Wildland Urban Interface(WUI)-Safety and Tactics ❑Fire-Based EMS Operations in Canada ❑NIST and UL Research:Studying Fire Behavior (Part 1 and 2) ❑NIST and UL Research:Studying Fire Behavior and and Fireground Tactics(Part 1 and 2) Fireground Tactics Part 1 and 2 SATURDAY AFTERNOON WORKSHOPS(SELECT 2) ❑Wildland Urban Interface(WUI)-Safety and Tactics ❑Building Codes:Your Work Environment Needs the Proper Protection -Your Life Depends On It ❑EMS Medical Director Course(Part 3 and (Part 1 and 2) ❑Fire Service Communications:Why They Are Not Interactive Session) ❑Personal Protective Clothing orking ❑EMS Delivery and the Affordable Care Act ❑Infectious Diseases—Common Exposures—New functional Fitness—Balancing the Physical ❑Community Paramedics Threats—Biological Warfare Demands with Human Capacity Part 1 and 2 ❑Suicide Prevention JpJFI Implementation Strategies El Respiratory Protection ❑Bum Injuries—Taking Care of Our Own Working to Death—Occupational Diseases— El PSO—Public Safety Officers:Knowing the Facts ❑The Toxic Fire Environment-Giving the"All Clear" Heart Disease,Respiratory Disease and Cancer METHOD OF PAYMENT:FIREPAC OPTIONS—IAFF MEMBERS ONLY: METHOD OF PAYMENT"NON-FIREPAC OPTIONS: Chairman's Council—US and Canada FIREPAC Leadership Trust—US and Canada 500 I will attend the Symposium/Conference Chairman's Council members will receive a Leadership Trust members will receive a Leadership and not join the FIREPAC Leadership Trust. Chairman's Council pin,a specially designed wind Trust pin and recognition on the IAFF website. shirt and recognition on the IAFF website. ❑CHECK(Payable in U.S.Dollars to ❑$500 I would like to join the FIREPAC Leadership John P.Redmond Foundation) ❑$750 I would like to join the FIREPAC Trust and register for the Symposium/ Chairman's Council and register for the Conference at the same time. ❑VISA/ (complete credit Symposium/Conference at the same time. card infformatormat VISA/MASTERCARD ion below) ❑PERSONAL CHECK/MONEY ORDER ❑I would like to make a separate voluntary contribution •PERSONAL CHECK/MONEY ORDER (Payable to IAFF FIREPAC.Canadian to FIREPAC in the amount of but not have (Payable to IAFF FIREPAC.Canadian members please make check payable to it credited towards my conference registration. members please make check payable IAFF FIREPAC Canada) to IAFF FIREPAC Canada) ❑PERSONAL VISA/MASTERCARD Please complete this registration form •PERSONAL VISA/MASTERCARD (complete credit card information and mail to the address below. (complete credit card information below) below) John P.Redmond Foundation Chairman's Council members U.S.members only:FIREPAC can only accept personal Dominick F.Barbera Conference Wind shirt size checks,money orders or personal credit cards.Federal International Association of Fire Fighters ❑S ❑M ❑L ❑XL ❑2XL ❑3XL ❑4XL election laws prohibit FIREPAC from accepting business Attention: Beverly Lewis or union dues(treasury)account checks.Contributions 1750 New York Avenue,NW to FIREPAC do not qualify as charitable contributions Washington,DC 20006-5395 for federal income tax purposes. Phone:(202)824-1594/1571 VISA/MASTERCARD Name �—��o ����� Credit Card Number: IAFF Local/Company Name Address Name as it appears on the card: City—�Ra��'' State/Province Zip Code ���+�S�o Phone Email Address Signature ` �`c�na-�-� �_ C--©—c c�.n�1 . c� �.� Exp.date fathwa S , 0 su", CBS& 2013 John.R Redmond Symposium on the Occupational Health Hazards of the Fire,Service, ° iri conjunction-with the•Dominick F. Barbera-Emergency Medical Services.Conference 5 Hyatt Regency Denver at Colorado Convention Center, Denver;Colorado �August_21-24,•2013 - -- Only one registrant per form. Each registrant must check off one Information Session for Thursday, PRE-CONFERENCE EVENTS two workshops and one Information Session for Friday and four workshops for Saturday. TUESDAY WEDNESDAY(SELECT ONE) EXCEPTION:Registrants selecting the two-part Functional Fitness workshop which is considered two ❑Fire Ops 101 ❑Fire Ground Survival workshops,registrants selecting the Fire Behavior Research workshop which is considered two " (Bring your own equipment) workshops and/or the registrants selecting the Medical Directors Course part 1 and 2 iss considered;two U NIST Radio Comm Lab Tour workshops and the Medical Directors Course part 3 and Interactive Session is considered two workshops. [- Attendance at all workshops is limited and will be determined on a first-come basis. THURSDAY INFORMATION SESSIONS(SELECT 1) FRIDAY INFORMATION SESSIONS(SELECT 1) ❑The World Trade Center Health Program O National Partners with EMS Interests-DHS,HHS, ❑National Partners'with EMS Interests-DHS,HHS, 0 Ask the Doc:The Physicians'Discussion on.Fire NHTSA,-NREMT,NEMSIS,CoAEMSP NHTSA,NREMT,NEMSIS,CoAEMSP and EMS Issues ._ ❑Carbon Monoxide-`EMS Response to Fireground- El National Fire Service Data Project-NFORS ❑Writing Winning Grants:Fire Act,AFG,SAFER and Incidents. ❑NFPA EMS Standards(Standards 450 and 1917) eyond Li-National Fire Service Data Project-NFORS ❑P,O.W.E.R.:Performance,Optimization,Well-being, Zsk the Trainer-WFI,CPAT PFT,FGS ❑NF�A Standards for the Fire Service - Enhancement&Regeneration ❑NIST High-Rise Toolkit:Using the study at home El The World Trade Center Health Program Ask the Doc:The Physicians'_Discussion on.Fire and SATURDAY MORNING WORKSHOPS(SELECT 2) ❑Behavioral Wellness EMS Issues . ' ❑EMS Medical Director Course(Part 1°and 2) El urn Injuries,-It Happened in Seconds" ❑Writing Winning Grants:Fire Act,AFG,SAFER and ❑Fire-Based EMS:Explaining the Benefits to Policy. 0? mergency.Vehicle Safety-How to Protect Beyond.. :.; ❑Ask the General:Meet General McCaffrey up close Makers&.Tax Payers urself While Serving Others ❑Fire Fighter Safety and Deployment:EMS Sleep and The Truth About Shift Schedules,and FRIDAY,WORKSHOPS(SELECT,2) Integration Models Performance ❑Consultants and EMS System Design ❑Functional Fitness-Balancing the Physical 0 NIOSH Fire,Fighter Cancer Study O Fire-Based EMS Case Scenarios. Demands with Human Capacity(Part 1 and 2) El Wildland Urban Interface(WUI)-Safety and Tactics ❑Fire Based EMS Operations in Canada ❑NIST and UL Research:Studying Fire Behavior (Part 1 and 2)' ❑NIST and UL Research:Studying Fire Behavior and and Fireground Tactics(Part 1 and'2) Fireground Tactics Part 1 and 2'- SATURDAY. WORKSHOPS(SELECT 2) O Wildland Urban Interface(WUI)-Safety and Tactics ❑Building Codes:,Your Work Environment Needs the Prope(Protection Your Life Depends On It ❑EMS Medical Director Course(Part 3 and (Part 1 and 2)- _ L3 Fire Service Communications:Why TheyAre Not Interactive Session) ❑Personal Protective Clothing Workin ❑EMS Delivery and the Affordable Care Act LTlnfectious Diseases-Common Exposures-New g ❑Community Paramedics �reats-Biological Warfare 6�Functional Fitness,-Balancing the Physical Demands with Human Capacity Part 1 and 2 ❑Suicide Prevention WFI Implementation Strategies ❑Respiratory Protection. ❑Burn Injuries-Taking Care of Our Own ❑Working to Death-Occupational Diseases-. -❑PSO=Public Safety Officers:knowing the Facts ❑The Toxic Fire Environment-Giving the"All Clear" Heart Disease,Respiratory Disease and Cancer- METHOD OF PAYMENT FIREPAC OPTIONS—IAFF MEMBERS ONLY: METHOD OF PAYMENT NON-FIREPAC OPTIONS: -;Chairman'sCouncil—USandCanada FIREPACLeadershipTrust—US and Canada x'$500 Iwill;attendtheSvmpositim/Conference- d;hairman's Council niembersiyill receive a Leadership Trust members will receive a Leadership and not join the FIREPAC Leadership Trust. Chairman's Council pin,a specially designed wind Trust pin and recognition on the IAFF website. 11-shirt and'r•ecognition on the IAFF website. ❑Cl IECK(Payable in U.S.Dollars to ❑$500 1 would like to join the FIREPAC Leadership John P.Redmond Foundation) ❑$750 I would like to join the FIREPAC Trust and register for the Symposium/ Chairman's Council and register for the Conference at the same time. ❑VISA/MASTERCARD(complete credit .. ._S}mtposimad Conference at the-same time. card information below), ❑PERSONAL CHECK/MONEY ORDER ❑I would like to make a separate voluntary contribution "❑.PERSONAL CHECK/MONEY ORDER (Payable to IAFF FIREPAC.Canadian to FIREPAC in the amount of but not have (Payable to IAFF FIREPAC.Canadian members please make check payable to it credited towards my conference registration. members[))ease make check payable- IAFF FIREPAC Canada)' to TAFF FIREPAC Canada) ❑PERSONAL VISA/MAS"f1.RCARD Please complete this registration form , ❑PERSONAL VISA/MASTERCARD (complete credit card information and mail to the address below.-`: (complete credit card inf6rmatirin below) below) John P.Redmond Foundation Chairman's Council members U.S.members only:FIREPAC can only accept personal Dominick F.Barbera'Conference International Association of' Fighters Wind shirt size- checks,innney orders or personal credit cards.Federal g. ❑S El N1 E]L ❑-XL El 2XL C3 3XL- C3 4XL election laws prohibit FIREPAC:from accepting business. Attention:"Beverly Lewis ;. or union dues(treasury)account checks.Conu ibutions 1750 New Yol k Avenue,'NW": to FI REPAC do not qualify as diaritable contributions Washington,DC 20006 5395 for federal income tax purposes. Phone:(202)824-1594(1571• '' - -::Y VISA/MASTERCARD x,. Name j E1 C- c> �1 Credit Card Number: IAFF Local/C�o7mpany Name `7 _ � _r____�".��-�._............ _ Address , &t I Ja. _-....------ Name as it appears the ears on card: .c City r, Nzir-%VL _State/Province Zip Code Lrt) I Z _..Phone Signature ? Email Address Exp,date - 4� .5, -Al 1,N -'7 L"A succe t 2bh't Occ-Lioatioh'al�Hdiilth'�Hiiiaidi;,-bf,,t e-4 R,re"S6iiii e, A N4.201'3J6hn h h -V- �0, in,conjunction WithAKe DdibinICK,,F.A3arbera ErnergencyJm' di'ci�('si rvices$�qpifSr 7� Y� --Center,,,%Denver-,1�Qd H atvRegehcy%l9Mat C616rAd&'06 veiifiibi`h t 21' 4;p2i]l Only one registrant per form..�,Each.registrant must'check off one Information Session for Thursday, -fftE-CONFE ENCE EVENTS.� two Workshops and one Informa'tion.SessioP for._Friclay�ancl four workshops for Saturday.- WE6N `EXCEPTION:Registrants selecting the two�partfunctional Fitness workshop which is considered two TUESDAY . .ESDAY(SELECT 6NE) LI Fire Ops.10'1'- C3 Fire Ground'Sdrvival, Workshops,registrants selecting the Fire Behayior.Re§earch workshop Which is considered two, ;Biiri6 Y�i c�vr equipment) workshcps�ancllor.the,registrants selecting,the Medical Direct&s,Course part I and 2"is considered two WN I�T Radio Corn Lab four ,,workshops and the Medical Directors Course part 3 and int6ractiv',b Session is considered two Workshops. Attendafnce at all workshops ii limited and Will beAk6rimined L on a first-come,basis. THURSDAY,INFORMATION SESSIONg'(SELECT 1) 'FRIDAY INFORMATION SESSl9l4S(SELECT.1) LIThe World Tradi Ith'Program'r 6 Center H6a a National Partners with EMS interests-'DHS,HHS, IJ Natioral Partners with EMS Interests-DHS,HHS,' 11 Ask the Doc:The PhVsicians'Discu'ssion on Fi�e NHTSA,NREMT,NEMSIS,CoAEMSP NHTSA,NREMT,I NEMSIS,CoAEMSP 'and.EMS Issues LI,Carbon Monoxide:EMS Re�ponse to Fireground ata P -6ct" NFORS. V�ffiting,Winning Gra nts:Fire Act AFG,SAFER and Ll National Fire Servic�,D 1`01 Incidents d 0 NFPA EMS Standards(Standards 450 and 1917) Elpyon U'National Fire'Service Data ProjectNFORS- Q NFPA Standards for the Fire Service 0 ROME.R.:Performance,Optimization,Well-being, E)Ask the TraJner7 WFI;CPAT,Pff,FGS Enhancement&Regeneration 0 NIST Hi h-Rise Toolkit:Using the study at home 131he World Trade Center Health Program Wsk the Doc:The Ph�sidians'Discu§sion on Fire and SATURDAY MORNI T 2). h EMS Issues NG WORKSHOPS(SELEC e avior�al Wellness' WER and S vleclical Director Course(Part 1 and 2) Bum Injuries-It Happened in Seconds riting Winning Grants:'Fire Act,AFG,S1 ire-Based EMS:Explaining the Benefits to Policy Ll Emergency Vehicle Safety-How to Protect Beyond,. r faers,&Tax Payers D Ask the General:Meet General McCaffrey Up'ci6se yourself While Serving Others,. , L3 Fire Fighter Safety and Deoloymbrit:EMS ::��*VSleep and3he Trutl�'About Shift Schedules and S FRIDAY WORKSHOPS(SELECT 2) Integration,.Model" Performance D Functional Fitness Balancing the Physical-' El NIOSH Fire Fighter Cancer Study, D Consultants and EMS System Desig'm Human Capacity�(Part 1 and 2) LI Fire-Based EMS Case'Scenarios,,` Demands With .,U Wildland Urban Interface OUI)-Safety and Tactics U Fire-BasedLEMS Operations in Can I ad L3 NIST and UL Research:Studyin I g Fire Be.havior. a (Part 1 and 2) and Fireground Tactics(Part,1 and 2)' . 13 NIST and UL�Reseai6:Studying Fire Behavior:and fireground"Yabfics Part)and 2 SATURDAY AFTERNOON WORKSHOPS(SELECT 2), UWildlancl Urban Interface(WU 1) Safety and Tactics Q Building Codes:Your Work Environment Needs the D EMS Medical Director Course(Part 3 and (Part I and 2), Yoper Protection -Your Life Depends On It Interac.tive Session) SrFire Service�Communibations:Why�They Are Not d Personal Protective Clothing Working MS Delivery and the Afforclable'Care Act Ll Infectious'Diseases-'Common ExposuresNew Cl Functional Fitness-Balancing the Physical �Pcommunity Paramedics Threats-13iological Warfare Demands With Human'Capacity Part tand 2 i4goicide Prevention LI WFI Implementation Strategies DIJIespiratory P.rotection 13 Bum Injuries-Taking Care of Our Own Ll Working to Death Occupational Dis eases- F WSOPublic Safety Officers:Knowing!he acts P The Toxic Fire Environment-Givingfhe"All Clear' Heart Disease,Respiratory Disease and Cancer, METHOD OF PAYMENT.FIR'EPXb OPTIONS IAFF MEMBERS ONLY, METHOD OF PAYMENT.NON-FIREPAC OFTIONS: Chairman's Council—US and Canada iiREPM�Leadeirship Trust—US and Canad Ll$500 1 will attend the Symposium�Conference Chairinian's Council members will receive a LeadershipTrust members will rece:ive'a Leadership ` and not join the.FIREPAC L�raclership Trust. 'ouncil pin,a'specially designed.wind 'Trust pin and recognition on the 1AFF website. Chairman'iC shirt and reco r gnition on the 1AFF website. LI CHECK(Payable in,U.S:DollaTs to- John,R,R6droond Fou I n6tion J'$500 1would like to join the FIREPAC Leadership LI$750 1 would like to join the FIREPAC Trust and register for the Symposium/: Chairman's Co ncit and fi�gistier for the Conference at the same time. 0 YTSA/MASTERCARD-(complete credit Syrnp9sium/Conference at the same,time. card inforniation below). Ll PERSONAL CHECK/MONEY ORDER tary co Ll I would iike tomake a sepr�te'y6hm nriibutioin Ll PERSONAL CHFCK/MO�EY.ORDER (Payable to 1AFF FIREPAC.Canadian to FTREOAC in the a 6unt of bui not have in ..,(Payable to[AFF FIREPAC.Canadian members please mak"check to it credited towards my conference registration.' rhembers please make check payable 1AFF FTREPAC Canada,) toLAYFFIREPACCaniida) LI PERSONAL VISA/M.ASTERCARD �Fil6asiii�6;�ol�telIthi�;�re§is6�ition form Cl PERSONAL VISA/MASTERCARD (compl e te credi t card i,n forma ti on ma i t o,th e�bd d'r e s.s be o w.-, (compl ete credit card information be] w) :below) 0 ;,,,�.--.John'P.�R6dmon oun a ton Chairman's Counci rhemben b.S�imernbers ordy:FIREPAC can only accept personal Wind shirt si�e checks,money orders or per I I� �iatiic� f'Fire�Fi s6nal credit cards.Federal internationa Asgo ght"ers' ewi§F,'q, LIS CIM 01' Q XL:.Ll 2XL J 3XL C34XL eleetion laws ttention: ever y Prohibit FIREPAC from accepting business N' or union clues,(ireasury)account checks.Contributions' _to.FTREPAC do not quality as charitable conthbu' �-��\/V�s6i�'6idn�-'bc�,20,0-06-5395,� tions Pho n 6 (2b 2j,8�41,i 5 94,, 7.14,;, for federal income tax purposes. �tg MASTERCARD."' VISA/ Name in redit Card Nu b4r:�� IAFF Local/Company Name Address 1 �N ame as,it aIipe ars on'the c6fd:, city State/Province Zip Code Phone 3 �Signature Email Address -A-A& xp. ate, �cl, VOUCHER NO. WARRANT NO. ALLOWED 20 Hilton Garden Inn Denver Downtown IN SUM OF $ 1400 Welton Street Denver, CO 80202 $2,561.22 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1120 43-430.02 j $1,280.61 1 hereby certify that the attached invoice(s), or 1120 43-430.02 1 $1,280.61 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 114 i i 29B 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)) Lodging WPE $1,280.61 Lodging WPE $1,280.61 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