225414 10/23/2013 CITY OF CARMEL, INDIANA VENDOR: 00351400 Page 1 of 1
f, ONE CIVIC SQUARE INDIANA FIRE CHIEFS ASSN. CHECK AMOUNT: $525.00
CARMEL, INDIANA 46032 P O BOX 364
ZIONSVILLE IN 46077 CHECK NUMBER: 225414
CHECK DATE: 10/23/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4355300 525 . 00 ORGANIZATION & MEMBER
2014 IFCA Membership Invoice Summary ``PE pH,EEg
INDIANA FIRE CHIEFS ASSOCIATION x� 4
To: Carmel Fire Department
ZF� BE VTEJO
2 Civic Square
Carmel, IN 46032
Phone: 317-571-2600 Fax: 317-571-2615
Population Served: � Dept. T ype and Size (Career/Vol/Combin)C'��--.-;3-�
Member Type Dues
State Senate District: US Congress District: Department Budget: Active(1st two Chiefs, any rank) $75 each
State Rep District: IDHS District 5 Active (Addt'I Chiefs, any rank) $50 each
In 2013, the individuals listed below with your department were members of the Indiana Fire Chiefs Departmental (<30 in Dept, all ranks) $100 total Associate(>30, Non Chief or Other) $50 each
Association. We certainly hope those of you who were 2013 members will renew and encourage others in Section Dues(EMS, Aviation, Public $50 each
your department to join as well in 2014. Please call with any questions concerning membership rates.
Safety Educators,Technical Rescue)
Note: We request that you review and correct this summary (especially blanks above). Mutual Aid Section -no charge
Please change online or fax, email or mail to Terry Rake, Executive Director IFCA.
1. Fire Chief -Keith-Smith— Active $0.00 $75.00
Section(s):
2. Assistant Fire Chief David Haboush dhaboush @carmel.in.gov Active $0.00 $8-0A-
Section(s):
To Add A New Member: To Remove A Member: To Change Data:
Please add on this form the new members name, rank and Please note on the summary which member will not be Please change or add information to
email address and determine any additional dues that may be renewing and adjust the amount due by referring to the the data fields on this form. Attach
owed. 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
2014 IFCA Membership Invoice Summary
INDIANA FIRE CHIEFS ASSOCIATION
To: Carmel Fire Department
P eE VEJO
2 Civic Square
Carmel, IN 46032
3. Assistant Fire Chief @ carmel.in.gov Active $0.00 $50.00
Section(s):
4. EMS Chief Mark Hulett mhulett @carmel.in.gov Active $25.00 $50.00
Section(s): EMS
S. Fire Marshal Bruce Knott bknott @carmel.in.gov Active $25.00 $50.00
Section(s): Public Safety Education
6. Battalion Chief Jeff Steele jsteele @carmel.in.gov Active $0.00 $50.00
Section(s):
7. Safety Chief �@carmel.in.gov Active
$0.00 $50.00
Section(s): C�
To Add A New Member: To Remove A Member: To Change Data:
Please add on this form the new members name, rank and Please note on the summary which member will not be Please change or add information to
email address and determine any additional dues that may be renewing and adjust the amount due by referring to the the data fields on this form. Attach
owed. 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.indfiirechiefs.org
2014 IFCA Membership Invoice Summary PE �H EFe
,s
�o
INDIANA FIRE CHIEFS ASSOCIATION o
To: Carmel Fire Department �P
�f0 8E ViEW'8
2 Civic Square
Carmel, IN 46032
8. Public Education Keith Freer kfreer @carmel.in.gov Active $25.00 $50.00
Director
Section(s): Public Safety Education
Please Send Receipt: ❑ Check(payable to IFCA) #: Renewal Total: �'f"`�� l�❑
Section Dues: �S _
Visa Mastercard Card Number: + New Members:
Name on Card: Exp Date:
Total Due:
Signature: V
Online Payment Option -Visit: www.indfirechiefs.org under the membership tab
New Members (write name, rank, email and any section changes below or submit changes online):
To Add A New Member: To Remove A Member: To Change Data:
Please add on this form the new members name, rank and Please note on the summary which member will not be Please change or add information to
email address and determine any additional dues that may be renewing and adjust the amount due by referring to the the data fields on this form. Attach
owed. 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))
$475.00
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
I FCA
Indiana Fire Chiefs Association IN SUM OF $
P.O. Box 364
Zionsville, IN 46077
$45-00—
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 I I 43-553.00 I $495-00 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
OCT 2,1 2013
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund