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2004 Ambulance License Renewal
CITY OF -ASHLAND Council Communication TITLE: DEPT: DATE: SUBMITTED BY: APPROVED BY: APPROVED BY: Ambulance License Renewal Ashland Fire & Rescue June 1,2004 ~(~ Keith E. Woodley, Fire Chief Gino Grimaldi, City Administrator,S' Paul Nolte, City Attorney Synopsis: Ashland Municipal Code (AMC) Chapter 6.40.110 requires ambulance service providers operating within the City of Ashland to apply annually for an ambulance operator's license. Fiscal Impact: None. Recommendation: Staff recommends approval of the request by Ashland Fire & Rescue for renewal of their ambulance operator's license. Background Information: AMC Chapter 6.40.110 requires ambulance service providers operating within the city limits to apply annually for an operator's license. The issued license shall be valid from the date of issuance to the next following thirtieth day of June, commencing on the first day of July by ordinance. AMC Chapter 6.40.100 sets forth license requirements, all of which have been met by the applicant. CITY OF -? SHLAND Memo TO: FROM: DEPT: RE: Gino Grimaldi, City Administrator Keith E. Woodley, Fire Chief,~ Ashland Fire & Rescue Annual Ambulance Service License Renewal DATE: June 1,2004 In compliance with AMC 6.40.120, an inspection and test of all ambulance service vehicles, equipment and fixed facilities has been completed incident to the renewal of thE; ambulance service operator's license of Ashland Fire & Rescue. All vehicles, equipment and facilities associated with the provision of ambulance services to the City of Ashland have been found to be in compliance with ordinance requirements. Ashland Fire & Rescue Tel: 541-482-2770 \455 Siskiyou Blvd Fax: 541-488-5318 Ashland, Oregon 97520 TTY: 800-735-2900 www.ashland.or, us CITY OF ASHLAND APPLICATION FOR AMBULANCE OPERATOR LICENSE AMC Ch. 6.6.40 Applicant's Name: CITY OF ASHLAND Trade Name, if any: ASHLAND FIRE & RESCUE Address: 455 Siskiyou Boulevard Ashland OR 97520 Telephone number: (541) 482-2770 Ambulance descriptions Manufacturer Vin # L. icense # 1. 1985 BRAUN BRAUN 1FDJE3OLSFHA49888 EXEMPT 2. 1992 FORD WHEELED 1FDJS34M4NHA34394 EXEMPT COACH 3. 1992 FORD LIFELINE 1FDKE30M7PHAO5945 EXEMPT 4. 1996 FORD LIFELINE 1FDKE30FSTHA48282 E:XEMPT 5. 1999 FORD LIFELINE 1FDXE40F2XHA00469 E-'XEMPT 6. 2002 FORD LIFELINE 1FDXF47F63EA10341 E-'XEMPT Attach information showing that every proposed driver, attendant and driver- attendant is qualified as required in Ashland Municipal Code Chapter 6.40 and as required by the laws of the State of Oregon. [] Enclose with the application, the initial license fee of $300 plus $100 per ambulance. [] Enclose a performance bond in the amount of $500,000. [] Enclose an insurance policy meeting the requirements of AMC §6.40.110.7. Attach additional pages as necessary. Explain any box not checked. Submit your application and required enclosures to Barbara Christensen, City Recorder, City Hall, 20 East Main Street, Ashland, Oregon 97520. I certify that each ambulance listed above is adequate and safe for the purposes for which it is to be used and that it is equipped as required by Ashland Municipal Code Chapter 6.40 and the laws of the State of Oregon. ¢_ ' Signature: Print name: Title: ~~ Date: / H :W,m b u lan ce~AP P L I CA. F L E\2003~,M BAPP.doc May 16, 2003 AMBULANCE SERVICE PERSONNEL ROSTER Service: ASHLAND FIRE AND RESCUE (1501) Last Name First Name MI 'Level Cert # IExpires' DL # Empl Stat Anders, Walt L. EMT-Basic 112485 06/30/2005 1955034 PFT Beck ,Todd E. EMT-Paramedic 124333 06/30/2005 5837326 PFT Borosund ~Lars F. EMT-Paramedic 127032 06/30/2005 8716517 PFT Boyersmith Steven P. EMT-Paramedic 120378 06/30/2005 4545965 PFT Burns ~,~..!.!.y, .............................. ~...:, ................................................ EMT-Paramedic 120248 06/30/2005 5207865 PFT Case Greg I. EMT-Paramedic 113788, 06/30/2005, 3254941 PFT Clayton Todd M. EMT-Paramedic 123797 06/30/2005 4836726 PFT Cockell II Robert C. EMT-Paramedic 123943 06/30/2005 6109120 PFT Fogarty Sean A. EMT-Basic 129083 06/30/2005 8582283 PFT =ormolo Curt J. !EMT-Paramedic 118901 06/30/2005 3738940 PFT Freiheit Matthew E. 'EMT-Paramedic 121237 06/30/2005 4927105 PFT ~adden Jennifer =A. EMT-Paramedic 124336 06/30/2005 3535298 PFT Hall !Christopher ID. EMT-Paramedic 123164 06/30/2005 4656782 PFT Hanstein 'David 'C. EMT-Paramedic 111814 06/30/2005 2524064 PFT Hard David K. EMT-Paramedic 127938 06/30/2005 8581745 PFT !Hickman Margueritte LR EMT-Basic 128889 06/30/2005 3676587 pFT Hollingsworth Scott VI. EMT-Paramedic 113607 06/30/2005 2830146 PFT Jones Gregory :{ees EMT-Basic 110972 06/30/2005 1423603 pFT LaCoste Rod T. EMT-Paramedic 127119 06/30/2005 4322818 PFT Martin Richard F. EMT-Paramedic 130001 06/30/2005 8543648 PFT Menold Lance ' W. EMT-Basic 125954 06/30/2005 6022755 PFT Rasor Marshall G. EMT-Paramedic 126969 06/30/2005 5067632'PFT Rogers Allan S. EMT-Paramedic 125456 06/30/2005 4777892 PFT Rosenlund Derek A. EMT-Paramedic 121067 06/30/2005 5541498 PFT Sallee Dana S. EMT-Paramedic 116336 06/30/2005 3654752 PFT !Sharkey Brent D. EMT-Paramedic 127124 06/30/2005 6110613 PFT Shepherd David G. EMT-Paramedic 123197 06/30/2005 3667291 PFT Stephens ~obert W. EMT-Paramedic 123787 06/30/2005 5856509'PFT Stidham Ryan _-. EMT-Paramedic 127950 06/30/2005 5182683 PFT Stoy John Trent ,EMT-Paramedic 118911 06/30/2005 4856227 PFT ...... NO RIGfIT~ UPON THE CF_~TI~C~TE HOI~DER OTI-IER T ~ CONFERS NA./,~D PARTICIPANT City' of Ash(and 20 East hL~fn Street Ashland, OR 97520 COMPANIES AFFO. RDING COV£RAG£ COMPANY A - City County InsuranCe SerYi[ce~ (CC/S) ! COMPANY g - FideJity and Deposi! of Maq~Land CO~°ANY C - NLC/dadtua[ This Is to certify that coverage documents lis(ed herein have been isled to the Named Participant herein for the Coverage'period indicated. Not ~lthstan~Jfng any requV~nent, tefra or com:lidon ~ any contract or other document ~ith r~p~ct to which :h~ certificate may bc f~sued or may pertain, the coverage afforded by r. he cayerage documents listed herein is subject ta al[ the terms, condlUon$ and e_zcl~ of such coverage documents. .TR Type of CoveraBe Certificate Genera( Liability Commerdat GencYai Liabfli~/ PubUc OfflcL~L~ Liability Emp(oyment Practlce~ Occurrence 03LASH AJJto Liability ~;cheduted Autc~ 03LASH ltl'red Auto~ Auto Physical Damage ~c:heduted ~Uto~ 03APDASH X.~ Property ~'~ Boiler and ALac~lnery '~ E~cess CHine 3E~ccess E~rthquake Excess Flood uz..,.t....,., Compensation 03P~LSH 03BASH ~IPTION: Effect. Ne Da, re 7/1/2003 7/1/2003 7/1 /2OO3 7/1/2OO3 7/1/2003 FICJ~TE HOLDER Jackson County 1105 East Main Street Medford, OR 97504 E.~p Iradon Date 6130/2004 6130/2004 6130/2004 6/30/2004 6/30/2004 General Aggregate Eact~ Occurrence Limits None $1,000,000 G~neral Aggregate .None Each Occurrence ~1,0C~,000 Per Fried Vatues Per Fi[ed Y'atues : C.~C~! ~ *TIOI~ Should any of U~e coverage docun'~ts ~rcin ~ ~ell~l b~ore ~ ~trat~n ~te ~r~f, COS ~[I e~vor ~ pr~de ]0 B~ w~en ~tlC~ to ~ c~{~ hol~r ~mod h~e~ ~t failure ~ mall such ~e ~lJ ~e no oblation or I~b(l~ of ~y H~ ~n C~$, i~ ~n~ or re~esen~tiv~ or ~e Issuer of ~ coiffure, I P~te: '.t EMERGENCY ME~. I _.AL.. :,ERg. ICE SEC:T ION ! 501 -E22£2'7'3 $ 80. 0 C., 2002 FORD TYF'E I C:itv o¢ Ash l~r'~d Keith E. Wc, odley~ C:hie¢ 455 S iskiy,:,u B tv,2 A, shlarld OR 97520 '~'"' :30 0.5 · .J ;,Jr"4 ... 0 4 / .'1. ?j / 4 8'F 0 3 .4 d, 2 310 0.1. EMERGENCY MEDiC:AL SERVICE SECTION ,-- 150 i -E21146,5 GROUY4'D 17:~'F¢'.-.-¢ FORD TYPE I I I L I C:EI'4SE NO. EZ 1 14,55 ,]LJN 30 05 C:ity o¢ Ash) and Keith E. W,:,,:,dley, Chie¢ 455 Siskiy,:,u B Iv,J Ash ! and OR :T¢7520 : .. :.,: . " 04/15/4 87'0Z 46Z :31001 . $80. OO EMERGENC:Y tflEDICAL SERVICE SECTION i501-E19568'~ GROUN:D 1 ".:¢':."*'.Z. . FL')RD TYPE i i L I C:ENSE NO, E :t. ':,'~=-':'.-.._,o,=,'""'"';, C:ity o¢ Ashiand Keith E. W,:,,:,dley, C:hie{' r-':~ -; S k 4 ..... b;, iy,:,u B lvd A s h i a n d 0 R '.=.~ 75'Z 0 JLIN :30 ()5 ! 501 -E 198560 GROUND 1 '.-.79c:, FORD TYPE I I I L I C.E.~.I,:,E' ~ ~ '" .NC~... ,, E "~. 98560 City c,~~ Ashland Keith E. Wc, odley~ 455 '~ ~,iskiy,:,u B lvd ~sbJand Chie ¢ OR 97D2:0 04/:1. C-;/4 8'F01 . ,JIJl',~ 30 05 46:-'Z :31001 EMERGENCY MEDI C:AL SERV I CE SECT ION i501 -E :t. 709T7' GROUND 1'.-.785 FORD TYPE ~II Lit' ~'- - ~ ....Et",I.=,E E 1TOg"T'T -'~ ,JUN :30 05 1501-E18695i EMERGENcy ME..'DIC:AI_ SERVICE SEC:TION ..-AMBLIL. ANCE GROUNI) 1 ':'.¢ '.-T., ::: FOF:D TYPE I I I L I C:ENSE I".}O E-'. 1 F~,'- '"',~'-',* ,,: $8(:). O0 City of' AshlAnd Ke i th E. Wood i ey, Chi ef 455 S iskiy,:,u B lvd Ash l and OR '.-}YS;':~O C, 4. / :t. 5 / 4 :D'T 0 C:, · .'i. 62"_' :31 O0 'l. AMBULANCE SERVICE PERSONNEL ROSTER Service: ASHLAND FIRE AND RESCUE (1501) East Name First Name MI Level " Cert # Expires !'DL # I Empl Stat Anders, Walt L. EMT-Basic 112485 06/30/2005 1955034!PFT Beck Todd E. I EMT-Paramedic 124333 06/30/2005 5837326 pFT Borosund Lars F. EMT-Paramedic 127032 06/30/2005 8716517 PFT Boyersmith ,Steven P. EMT-Paramedic 120378 06/30/2005 4545965 PFT Burns ...~.~!..!.Y~ ........................................... i.~,.: ........................................... EMT-Paramedic 120248 06/30/2005 5207865 PFT i"'~'~'~'~' Greg I. EMT-Paramedic 113788 06/30/2005 3254941 PFT Clayton Todd M. EMT-Paramedic 123797 06/30/2005 4836726 PFT Cockell II Robert C. EMT-Paramedic 123943 06/30/2005 6109120 PFT Fogarty Sean A. EMTAg-a,o'~JP/I~ ~2(,..129083 06/30/2005 8582283 P#T Formolo Curt J. EMT-Paramedic 118901 06/30/2005 3738940 PFT Freiheit Matthew _-. EMT-Paramedic 121237' 06/30/2005 4927105 PFT Hadden Jennifer A. EMT-Paramedic 124336 06/30/2005 3535298 PFT Hall Christopher D. EMT-Paramedic 123164 06/30/2005 4656782 PFT Hanstein David C. !EMT-Paramedic 111814 06/30/2005 2524064 PFT Hard David I K. EMT-Paramedic 127938 06/30/2005 8581745 PFT Hickman !Margueritte !LR EMT-Basic 128889 06/30/2005 3676587 PFT Hollingsworth Scott M. EMT-Paramedic 113607 06/30/2005 2830146 ,PFT 'Jones Gregory Rees EMT-Basic 110972 06/30/2005 1423603 PFT LaCoste Rod T. EMT-Paramedic 127119 06/30/2005 4322818 PFT Martin Richard - EMT-Paramedic 130001 06/30/2005 8543648'PFT Menold Lance W. ~EMT-Ii],A¢,~ t~,af¢~ ~,¢..125954 06/30/2005 6022755 PFT Rasor Marshall G. EMToParamedic 126969 06/30/2005 5067632 PFT Rogers Allan IS. EMT-Paramedic 125456 06/30/2005 4777892 PFT Rosenlund 'Derek A. EMT-Paramedic 121067 06/30/2005 5541498~PFT Sallee Dana S. EMT-Paramedic 116336 06/30/2005 3654752:PFT ~'-~' .... "' "' t2_7;~,+ uu/ou/2005 6~i0813'-PFT ,Shepherd David Go EMT-Paramedic 123197 06/30/2005i 3667291 PFT [Stephens Robert W, EMT-Paramedic 123787~ 06/30/2005 5856509 PFT iStidham Ryan -_-. EMT-Paramedic 127950 06/30/2005 5182683 PFT rStoy John Trent EMT-Paramedic 118911 06/30/2005 4856227 F'FT Department of Human Services- Health Services EMERGENCY MEDICAL SERVICES e 800 NE Oregon Street Ste. 607 Portland, OR 97232 · (503) 731-4011 · Fax (503) 731-4077 June 4, 2003 Walt LAnders 23 Wilson Road Ashland, OR 97520-9102 Congratulations on your recertification! Below is your new EMT-B certification card which expires 06/30/2005. Please review your certificate carefully. If there is an error in your name return your certificate immediately to our office with the corrections. Send the certificate to:Emergency Medical Services, PO Box 14450, Portland, OR 97293-0.450 and a corrected certificate will be issued to you. Keep your certificate in a secure place. Duplicates can be issued for a fee of $10.00. Please be aware that you are required to be familiar with the Oregon adrninistrative rules pertaining to your certification. These rules are available on our web site under rules and statutes at: www.dhs.state.or.us/publichealth/ems. You will always find the latest information from this office on the web site. We encourage you to use this tool frequentl>;. Some items you will find there other than the Administrative Rules are: Updates from the Director, a liSt of availabl[e classes from the mobile training unit, continuing education requirements for all levels of EMTs, current EMS Update (newsletter), current articles of interest, EMS hot topics, Awards Banquet information, EMS for Children, and a list of stafl."you can contact in our office for different programs... .. Thank you for your continual support and involvement in Oregon EMS. STATE OF .OREGON EMERGENC¥'i~i~'J:~- TECHNICIAN CERT. # 112485 .--:BASICEXPI~S 06~30/2005 Walt L AndergiT-',..-?,:'~_L:'-: :i':.'i:i:¥1.i.i'~ :. ' ' :~ 23 Wilson ROh~l' OR; :~'~4'~K_6'i09., ,_,.,.,., .,, .~ :' Ashland, The individual named above' and desi:ribed on the reverse of this card has completed the requirements set forth' in ORS {582 et seq. and is certified as an Emergency Medical Technician at the level indicated STATE OF OREGON - DEPARTMENT OF HUMAN SERVICES EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEMS IDENTIFICATION EMT-B (:I,:RT. # 112485 Walt L An(lers ,, HT: 6' 2" WT: 198 i I'.'Y}".S: }la:/_cl ;: :}:: Signature bf:(i~rtiiicate Holder Department of Human Services- Health' Services EMERGENCY MEDICAL SERVICES · 800 NE Oregon Street Ste. 607 Portland, OR 97232 · (503) 731-4011 · Fax (503) 731-4077 June 4, 2003 Kelly W Bums 2717 Clay Creek Way Ashland, OR 97520 { on Congratulations on your recertification! Below is your new EMT-P certification card which expires 06/30/2005. Please review your'Certificate carefully. If there is an error in .your name return your certificate immediately to our office with the corrections. Send the certificate to' '__Emergency Medical Services, PO Box 14450, Portland, OR 97293-0.450 and a corrected certificate will be issued to you. Keep your certificate in a secure place. Duplicates can be issued for a fee of $10.00. Please be aware that you are required to be familiar with the Oregon adrninistrative rules pertaining to your certification. These rules are available on our web site under rUles and statutes at: www. dhs.state.or.us/publichealth/ems. You will always find the latest information from this office on the web site. We encourage you to use this tool frequently. Some items you will find there; 'other than the Administrative Rules are: Updates from the Director, a list of available classes from the mobile.training unit, continuing education requirements for all levels of EMTs, current EMS Update (newsletter), current articles of interest, EMS hot topics, Awards Banquet information, EMS for Children, and a list of Staff!you can contact in our office for different programs. Thank you for your continual support and involvement in Oregon EMS. STATE CE OREGON · EMERGENOY:~ii'~;i; ' ::::::::-EI')ICAL'~HNICIA '-. IN CERT. # 120248 .eA~Mm)tC~PIRESO6/3O/2O05 Kelly W Burn${ i;,.71~ii:~ii! iil;ii. !.i?iii(!?~::!:;:!.:~!:i)::'~. ' Ashland, OR )~5~:0: ~'~'~ :': ? :-:::::'~: ?~ :.:: }- 5.:3 The individual "-,m: ~ ~ c'.-~:: ~7") ~'2'2¢~i~ oh the r~verse of this card has completed the ."':..':." .': ......... '.': :.': ifi::~S:~82:6'i seq. and is ce~ified as an Emergency '.', ...... ' :. ": ~" .:"t:fi~}i6vel:ih'~icated. Jonat~hin, Grant Higginson STATE OF OREGON - DEPARTMENT OF HUMAN SERVICES EMERGENCY MEDICAL S~,R¥16ES & TRAUMA SYSTEMS IDENTIFICATION EMT-P CERT~ # 120248'" . . , Kelly W Burns. . '" ..... :- HT: 6' 4" HAIR:.Da~k Brown WT: 200 EYt!S: Blue Signature of C:erd'iicate.-,,:~'i7'l'"i'""':,. u, ....... This certificate is the properly of the Department of Human 5o-/877 Services and must be surrendered by the holder on demand. Department of Human Services- Health Services EMERGENCY MEDICAL SERVICES · 800 NE Oregon Street Ste. 607 Portland, OR 97232 · (503) 731-4011 * Fax (503) 731-4077 June 4, 2003 Steven P Boyersmith PO Box 4514 Medford, OR 97501 ( on Congratulations on your recertification! Below is your new EMT-P certification card which expires 06/30/2005. Please review your certificate carefully. If there is an error in your name return your certificate immediately to our office with the'corrections. Send the certificate to: Emergency Medical Services, PO Box 14450, Portland, OR 97293-04.50 and a corrected certificate will be issued to you. Keep your certificate in a secure place. Duplicates can be issued for a fee of $10.00. Please be aware that you are required to be familiar with the Oregon administrative n41es pertaining to your certification. These rules are available on our web site under rules and statutes at: www. dhs.state.or, us/publichealth/ems. You will always find the latest information from this office On the web site.. We encourage you to use this tool frequently. Some items you will find there other than the Administrative Rules are: Updates from the Director, a list of available classes fi'om the mobile training unit, continuing education requirements for all levels of EMTs, current EMS Update (newsletter), current articles of interest, EMS hot topics, Awards Banquet information, EMS for Children, and a list of staff you can contact in.our office for different programs. Thank you for your continual support and involvement in Oregon EMS. STATE QE_OREGON CERT, Ct 120378 PAR~ME'D!6;: --~1,, S 06/30/2005 PO Box 4514;.'?',i:..':} Medford, OR ~¢~1)::i-: The individual named '-2 oh the roverse of this card has completed the requirer ...... S 882 r~.l seq. and is certified as an Emergency Medical Techhician-at STATE OF OREGON, DEPARTMENT OF HUMAN SERVICES EMERGENCY MEDICAL SE~IGES & TRAUMA SYSTEMS IDE~ITIFlr.:ATiOi~I EMT-P CERT.# 120378' '" Steven P Boyersn~ith ' HT: 5' I 1" I IA.I'R: Dark Brown WT: 170 EYES: 3rcen Signature 6~'~'~i~icate Holder Department of Human Services- Health Services EMERGENCY MEDICAL SERVICES · 800 NE Oregon Street Ste. 607 Portland, OR 97232 · (503) 731-4011 · Fax (503) 731-4077 June 4, 2003 Lars F Borosund 2190 Fernwood-Circle Lake Oswego, OR 97034 ( on Congratulations on your recertification! Below is your new EMT-P certification card which expires 06/30/2005. Please review your certificate carefully. If there is an error in your name return your certificate immediately to our office with the corrections. Send the certificate to: Emergency Medical Services, PO Box 14450, Portland, OR 97293-0450 and a corrected certificate will be issued to you. Keep your certificate in a secure place. Duplicates can be issued for a fee of $10.00. Please be aware that you are required to be familiar with the Oregon administrative 'rules pertaining to your certification. These rules are available on our web site under rules and statutes at: www.dhs.state.or.us/publichealth/ems. You will always find the latest information from this office on the web site. We encourage you to use this tool frequently. Some items you will find there other than the Administrative Rules are: Updates from the Director, a list of availabk; classes from the mobile training unit, continuing education requirements for all le'vels of EMTs, current EMS Update (newsletter), current articles of interest, EMS hot topics, Awards Banquet information, EMS for Children, and a list of staff you can contact in our office for different pro,-ams. ·" Thank you for your continual support and involvement in Oregon EMS. STATE QF. OREGON EM ERG ENCY~i~IED~I6~LTECH NlClA N CERT. # 127032 .PARA'MEDIC!EXPIRES 0613012005 :~'~ :.' -:- . · · ~ ': '~-'i' ' Lars F B orosur~d i: ;. ¢7'? :':i. ~"~;;':;:. _'.';'/ , -- 2190 rcm'.x ~,,., .... ~r~,, - Lake ()-'w~::,). ()[~ ')"~.:.I ;~' - The individual named above a'nd described oh the reverse of this car0 has completed the requirements set fodh in ORS '682-ei seq. and is certified as an Emergency Medical Technician.at the level indicated· STATE OF OREGON - DEPARTMENT OF HUMAN SERVICES EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEMS' IDENTIFICATION EMT-P CERT. # 12703:! Lars F Borosund HT: 5' 7" l-l..\ IR' l.ight [3rown WT: 157 ' EYES ! B :b~i:~ Signature 5~:d~iiiicate Holder Department of Human Services- Health Services EMERGENCY MEDICAL SERVICES · 800 NE Oregon Street Ste. 607 Portland, OR 97232 · (503) 731-4011 · Fax (503) 731-4077 June 4, 2003 Todd E Beck 21 Anna Laura Dr Jacksonville, OR 97530 (7 on Congratulations on your recertification! Below is your new EMT-P certification card which expires 06/30/2005. Please review your certificate carefully. If there is an error in your name return your certificate immediately to our office with the corrections. Send the certificate to: Emergency Medical Services, PO Box 14450, Portland, OR 97293-0450 and a corrected certificate will be issued to you. Keep your certificate in a secure place. Duplicates can be issued for a fee of $10.00. '~Please be aware that you are required to be familiar with the Oregon administrative rules pertaining to your certification. These rules are available on our web site under rules and statutes at: www. dhs.state.or, us/publichealth/ems. You will always find~the latest information from this office on the web site. We encourage you to use this tool frequently. Some items you will find there other than the Administrative Rules are: Updates from the Director, a list of available classes from the mobile training unit, continuing education requirements for all levels of EMTs, current EMS Update (newsletter), current articles of interest, EMS hot topics, Awards Banquet information, EMS for Children, and a list of staff you can contact in om' office for different programs. Thank you for your continual support and involvement in Oregon EMS. STATE OFDREGON RGENC - Todd E Beck 21 AnnaLau~Dr: ' .-. ' ' Jacksonville,10R- ¢75-3- ~ ~: -...._ -'~ _---' .. The individual named -'--'.'~-.;-~.--!.--.-'q - !' )n the _reverse of this card has completed the requ'rer ...... . : i 682. et seq. and is certified as an Emergency Medical Tech'nician at the level:indicated. STATE OF OREGON - DEPARTMENT OF HUMAN SERVICES EMERGENCY MEDICAL SERV CES & TRAUMA SYSTEMS IDENTIFICATION ~¢ EMT-P CERT. # 12433J Todd E Beck ' :~-:- HT: 6' 1" : ;;~ 'HAIR: Dark Brown WT: 215 EYES: Blue Signature '5~:C~i~ificate Hold'er This cerh'ficate is the property of the Department of Human 'Department of Human Services- Health Services EMERGENCY MEDICAL SERVICES · 800 NE Oregon Street Ste. 607 '-Portlandl OR 97232 · (503) 731-4011 · Fax (503) 731-4077 June 2, 2003 Sean A Fogarty 2035 SE 24th Ave Portland, OR 97214 ()regon Congratulations on.your recertification! Below is your new EMT-B certification card which expires 06/30/2005. Please review your certificate carefully.. If there is an error in your name return your certificate immediately to our office with the corrections. Send the certificate to: Emergency Medical Services, PO Box 14450, Portland, OR 97293-0450 and a corrected certificate will be issued to you. Keep your certificate in a secure place. Duplicates can be issued for a fee of $10.00. 'Please be aware that you are required to be familiar with the Oregon adn:tinistrative rules pertaining to your certification., These rules are available, on our web site under rules and statutes at: www. dhs.state.or, us/publichealth/ems. You will always find the latest information from this office on the web site. We encourage you to use this tool frequently. Some items you will find there other than the Administrative Rules are: Updates from the Director, a list of available classes from the mobile training unit, continuing education requirements for all levels of EMTs, current EMS Update (newsletter), current articles of interest, EMS'. hot topics, Awards Banquet information, EMS fOr Children, and a list of staff you can contact in our office for different pr°grams. .,.-'~: Thank you for your continual support and involvement in Oregon EMS. GE C'Y?~'~:ii':'~'~::T::E H lClAN ' STATE OF OREGON- DEPAFITMENTOF HUMAN SERVICES ! !DENT!,:ICATION SPan A rogartf;:.:.:!i::?~;i~?~;i?:i!}?:i!??~:;:_:".i?:-':~'::.. o, EMT B cERT' ~ 1~9083''' ." ' 2035 SE 24thq.;~5;~:::;~ ?.::~..::.: .~¢,.:~::3/~:'?:':. ~ SPan 'A Fogar~' ' ' v''. ' ':: '".... Portland, O~ '77~.4.'_. ~.},..:;; ¢?~..;:~..':..:, g ..' . , 1} HT: 6' 2" HA::R: Dark Brown j/~ ~ ~~ I :"' ..... ~" "' '"' '" '"'""" " Department of Human Services- Health Services EMERGENCY MEDICAL SERVICES · 800 NE Oregon Street Ste. 607 Portland, OR 97232 · (503) 731-4011 · Fax (503) 731-4077 June 4, 2003 Robert C Cockell II 455 Jeffrey Dr Ashland, OR 97520 Congratulations on your recertification! Below is your new EMT-P certification card which expires 06/30/2005. Please .review your certificate carefully. If there is an error in your name; return your certificate immediately to our office with the corrections. Send the certificate to: Emergency Medical Services, PO Box 14450, Portland, OR 97293-04.50 and a corrected certificate will be issued to you. Keep your certificate in a secure place. Duplicates can be issued for a fee of $10.00. Please be aware that you are required to be familiar with the Oregon administrative rules pertaining to your certification. These rules are available on our we]3 site under rules and statutes at: www. dhs.state.or.us/publichealth/ems. You will alwaYs find the latest information from this office on the web ~it,e. We encourage you to use this tool frequently. Some items you will find there other than the Administrative Rules are: Updates from the Director, a list of available classes from the mobile training unit, continuing education requirements for all levels of EMTs, current EMS Update (newsletter), current articles of interest, EMS hot topics, Awards Banquet information, EMS for Children, and a list of staff you can contact in our office .for different Programs. Thank you for your continual support and involvement in Oregon EMS. - ' ' I~JI~"BGE~-C~'~~6I~I~'~0v,, ..... 'l EMERGENCY MEDICAL SEflVlCES & TRAUMA SYSTEMS CERI' ~ 1z3~,,~3 PARg2MEDI~:~PIRE~u~/~ /zuu~ ...... ~ .......... z::"'~?:%~:: c::::~:~:?'?';' ::~':'Q:¥? :b ~ , ' ' Robe~ C Cock&ii..li:??::~-,,.~::;~,:;~:?:::z::,~?:5?', I, gMT-P CERT. # 123943 ,.. : 455 Jeffrey i~ Robe~ C Cockell 1'i:~.')'.' ' . ' Ashland, OR ):73} :~ ".. ".;.'"'":' . '. :~i'::?~; ~ ~-&" :~:::~¥~ ~" ::f'-.' ~ :?':" I = HT. .... 5 10 ' .}lAIR.' · ' Blonde ~ '~::: ". ..... .: ~ WT' 175 :EYES' Bhe The individual named .'.~': :". .5' '/':. :'~:':..'.~;:~ .':. 3h lhe ~everse of this card has' ' ~ ' completed the requirer'."." ' :.'.','. :.'". ,' ':~t,~ B82 p. LS.~q. and is certified as ~ an Emor~ency Medical Technician at the ~evel [nOi:ated. ~ff~ Signature ~f::~i~icate Holder ~ ~ m ~ a Department of Human Services- Health Services' EMERGENCY MEDICAL SERVICES * 800 NE Oregon Street Ste. 607 Portland, OR 97232 · (503) 731-4011 · Fax (503) 731-4077 June 4, 2003 Todd M Clayton 2144 Springbrook Rd Medford, OR 97504 ()regon Congratulations on your recertification! Below is your new EMT-P certification card which expires 06/30/2005. Please review your certificate carefully. If there is an error in your name return your certificate immediately to our office With the corrections. Send the certificate to: Emergency Medical Services, PO Box 14450, Portland, OR 97293-0450 and a corrected certificate will be issued to you. Keep your certificate in a secure place. Duplicates can be issued for a fee of $10.00. Please be aware that you are required to be familiar with the Oregon administrative rules pertaining to your certification. These rules are available on our web site under rules and statutes at: www. dhs.state.or.us/publichealth/ems. You will always find the latest information from this office on the web site. We encourage you to use this tool frequently. Some items you will find there: other than the Administrative Rules are: Updates from the Director, a list of available classes from the mobile training unit, continuing education requirements for all levels of EMTs, current EMS Update (newsletter), current articles of interest, EMS hot topics, Awards Banquet information, EMS for Children, and a list of staffyou can contact in our office for different programs. Thank you for your continual support and involvement in Oregon EMS. STATE O.E OREGON EMERGENCY CERT. # 123797 -:.-PA~I~iEDIC.EXPIRES 06/30/2005 ~ ~':~... ~..__: .... Todd M Clay~6fi .'".-'...: :-;_i".~i .'-'". 2144 Springbi:~-0~ Rd Medford, OR 97504 The individual named above and described on the reverse completed the requirements set forth in OF1S ~82 an Emergency Medical Technician at the'level indicated. STATE OF OREGON - DEPARTMENT OF HUMAN SERVICES EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEMS IDF. NTIFICATION EMT-P CERT. # 1237':)7 Todd M Clayton Signature Of C,grtificate Holder Department of Human Services- Health Services EMERGENCY MEDICAL SERVICES e 800 NE Oregon Street Ste. 607 Portland, OR 97232 · (503) 731-4011 · Fax (503) 731-4077 June 4, 2003 Greg I Case 816 Voris Avenue Ashland, OR 97520 () on Congratulations on your recertification! Below is your new EMT-P certification card which expires 06/30/2005. Please revieTM your certificate carefully. If there is an error in your name return your certificate immediately to our office with the corrections. Send the certificate to: Emergency Medical Services, PO Box 14450, Portland, OR 97293-04.50 and a corrected certificate will be issued to you. Keep your certificate in a secure place. Duplicates can be issued for a fee of $10.00. Please be aware that you are required to be familiar with the Oregon administrative rules pertaining to your certification. These rules are available on our web site under rules and statutes at: www. dhs.state.or, us/publichealth/ems. You will' always find the latest information from this office on the web site. We encourage you to use this tool frequently. Some items you will find there other than the Administrative Rules are: Updates.from the Director, a list of available classes from the mobile training unit, continuing education requirements for all levels of EMTs, current EMS Update (newsletter), current articles of interest, EMS hot topics, Awards Banquet information, EMS for Children, and a list of staff you can contact in our office for different pro_grams. Thank you for your continual support and involvement in Oregon EMS. STATE OE. OREGON GE ~.~ I 816 Voris Avenue Ashland, OR _9.75~'0 """ . . - . -.. . . The individual named above and desddbed on the reverse of this card has completed the requirements set forth in'ORS 682et seq. and is certified as an Emergency Medical Technician ht the level ihdicated. STATE OF OREGON - DEPARTMENT OF HUMAN SERVICES EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEMS IDENTIFICATION EMT-P CERT. # 1 ] 378 i~ "! :. Greg I Case _ WT: 180 , :: : :: Signature 0f'~'~ificate Holder This certificate is the property of the Department of Human APR, 2, 2004 8'22AM NO, 838 P, Department of Human Services - Health Services F_NIERGENCY MF_/)ICAL SERVICES · 800 NE Oregon Street Ste. 607 Portland, OR 97232 · (503) 731-4011 · Fax (503) 731-4077 O gon April 1, 2004 Seen A Fogarty 170 Central Avenue Ashland, OR 97520 Congratulations on becoming an Oregon-certified EMT-P and a member of Oregon's professional prehospital emergency medical care team! Your passing score on the'written examination was 88 %. Please review your certificate carefully. If there is an error in your name return your certificate immediately to our office with the corrections. Send the certificate to: Emergency Medical Services, PO Box 14450, Portland, OR 97293-04.50 and a corrected certificate will be issued to you. Keep your certificate in a secure place. Duplicates can be issued f_or a fee of $10.00. Please be aware that you are required to be familiar with the Oregon administrative roles pertaining to your certification. These roles are available on our web site trader rotes and statutes at: www.dhs, stat_e_,or._us/publiehealth/ems.. You will always find the latest information from this office on the web site. We encourage you to use this tool frequently. Some items you will find there other than the Administrative Rules are: Updates from the Director, a list of available classes from the mobile training unit, continuing education requirements for all levels of EMTs, current EMS Update (newsletter), current articles of interest, EMS hot topics, Awards Banquet information, EMS for Children, and a list of staffyou can contact in our office for different programs. Again, welcome to the team. STATE OF OREGON EMERGENCY MEDICAL TECHNICIAN CERT. # 129083 PARAMEDIC EXPIRES 061~0/200~ Sean I Fogar~ I70 Cen~ Av~ue . Ashland, OR .97~20 , The Individual n~m~ ~ov, ~n~ ~s~ed on Ibc t~veme o[ completed the requlrem~nla eel ~odh · OR8 6B2 ~t ~oq. and an Emergency Medlc,l ~chnlclan ~t t~e level lndleatea. 'bonal~nln, ~ranl Higgi~sen . ..~ Signature ~' Cedtitea~e Holder Tt~i~ ~ertllioato ~s Ihe properly of file Osparlment of Pltlnlafl $O~'Oosa,tlmv,,b~urrend~ted~by,,~,hOlfle, OJlCl,lttt~ng. 62893 STATE Q.EDREGON CERT. # 1~ G E~~L~qlN~A ~6/30/2005 1883-- ... ~.~, ~: -~ ~,- ~,.~ .,,,,.-- -,.., ~...~-. ~ . -~.~.-, -.~,~- The individual named '''~' . ';: .... ~)' ' ":;?::;~::':"/"~h::{~e ~verse of this card has completed the requirer · :,,' ,'::~82.::~'~ seq. and is certified as an ~mergency Medical lec~mc ~n~at tn.e~le~l:i~dicated. ~ -, Jonat~hin, Grant Higginson B u Director of EMS & Trauma Systems State Public Health Officer STATE OF OREGON - DEPARTMENT OF HUMAN SERVICES I EMERGENCY MEDICAL SER:M'I~ES & TRAUMA SYSTEMS [ IDENTIFICATION I EMT-P CERT.'# 118901. ,":' . , = Curt J Formolo , ., ',', .'.'.'i .. i · · :i' ~'t" .. , '..'. . ~ HT: 6' !" 'ItAIR:'Dat~k'Br,own I-~ WT: 185 : ':" i';: EVES:"l~'ro,//n." /, -'-' Services and must be surrendered by the holder on dernan~t .{ Department of Human Services- Health Services EMERGENCY MEDICAL SERVICES o 800 NE Oregon Street Ste. 607 Portland, OR 97232 · (503) 731-4011 e Fax (503) 731-4077 July 8, 2003 Matthew E Freiheit PO Box 535 Ashland, OR 97520 ( on COngratulations on your recertification! Below is your new EMT-P certification card which expires 06/30/200'5. Please review your certificate carefully. If there is an error in your name return your certificate immediately to our office with the corrections. Send the certificate to: Emergency Medical Services, PO Box 14450, Portland, OR 97293-0450 and a corrected certificate will be issued to you. Keep your certificate in a secure place. Duplicates can be issued for a fee of $10.00. Please be aware that you are required to be familiar with the Oregon administrative rules pertaining to your certification. These rules are available on our web site under rules and statutes at: www.dhs.state.or.us/publichealth/ems. You will always find the latest information from this office on the web site..We encourage you to use this tool frequently..Some items you will find there other than the Administrative Rules are: Updates from the Director, a list of available classes from the mobile training unit, continuing education requirements for all levels of EMTs, current EMS Update (newsletter.), current articles of interest, EMS hot topics, Awards Banquet information, EMS for Children, and a list of'staff you can contact in our office for different programs. Thank you for your continual support and involvement in Oregon EMS. STATE OF. OREGON EMERGENCY: ~E D-!:C~'i~:TEC H N I CIA N CERT. # 121237 ;PA~'Mi~iC!-RXPIRES 06/30/2005 PO Box 535 -'.,.:. :...:~:.:'.':: '::. ~, :...-- :.:.~i '~ ' Ashland, OR-97520 -. The in0ividual named above and 0es~'ribed on the reverse of this cato has completed the requirements set'.fo~fl"in OBS:~82 et se~ an0 is certified as _. an Emergency Medical Technician at the level::in0icated. STATE OF OREGON - DEPARTMENT OF HUMAN SERVICES EMERGENCY MEDICAL SEFVICES & TRAUMA SYSTEMS IDENTIFIOATION EMT-P CE'RI'. # 1212~7 Matthew E Freiheit HT: 6' 0" Signature 6iTE~ificate Holder Thi¢ c~rtifirr.~t~ i~ tht: nrnnprfl/ nf th¢ D¢n~rwn¢nt ,hi Mt¢rn~n ....7 ~ .? ~7, ,75 Department of Human Services- Health Services EMERGENCY MEDICAL SERVICES · 800 NE Oregon Street Ste. 607 Portland, OR 97232, (503) 731-4011 · Fax (503) 731-4077 - June 4, 2003 Jennifer A Hadden 1313 Mill Pond Rd Ashland, OR 97520-7321 (gregon , Congratulations on your recertification! Below is your new EMT-P cen:.ification card which expires 06/30/2005. Please review your certificate carefully. If there is an error in your name return your certificate immediately to our office with the corrections. Send the certificate to: Emergency Medical Services, PO Box 14450, Portland, OR 97293-0450 and a corrected certificate will be issued to. you. Keep.your certificate in a secure place. Duplicates can be issued for a fee of $10.00. Please be aware that you are required to be familiar with the Oregon administrative rules pertaining to your certification. These rules are available on our web site under rules and statutes at: www.dhs.state.or.us/publichealth/ems. You will always find the latest information from this office on the web site. We encourage you to use this tool frequently. Some items you will find there other than the Administrative Rules are: Updates from the Director, a list of available classes from the mobile training unit, continuing education requirements for all levels of EMTs, current EMS Update (newsletter), current articles of interest, EMS hot topics, Awards Banquet information, EMS for Children, and a list of staff you can contact in our office for different programs. Thank you for your continual support and involvement in Oregon EMS. STATE OF_OREGON EMERGENCY :i~:~i-~:£' TECH NlClA U CERT. # 124336 :::PARA'MEDI~iEXPIRES 06/30/2005 : ":'-"tL,-?. 'i-:",~2 i ...~ '.:c..:--.' .'.~:::.. '~': :~.-~ . Jennifer A Had'den~ 1313 Mill Pdfi~;:Rd?' ".'"- . -- Ashland, O . , The individual named -' ...... '.,'" .- ':':. -' t~- rz'.'-'se of this card has completed the requirer":": : ' :,.'..' .i',';... · :. ;: and is certified as an Emergency Medica. ' .... :' · · ....... STATE OF OREGON - DEPARTMENT OF HUMAN SERVICES EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEMS IDENTIFICATION EMT-P CERT..# 124336 Jennifer A tladden ' HT: 6' 0" tlAIl;:: Light Brown WT: 143 ~ EYES: Hazel ~ Signat~ of C~tlificate Holder This ceflificate is the prope~y of the Depa~ment of Human Department of Human Services- Health Services EMERGENCY MEDICAL SERVICES, 800 NE Oregon Street Ste. 607 Portland, OR 97232 o (503) 731-4011 o Fax (503)'731-4077 July 8, 2003 Christopher D Hall 3189 Cheltenham Way Medford, OR 97504 () on Congratulations on your recertification! Below is your new EMT-P certification card which expires 06/30/2005. Please review your certificate carefully. If there is an error in your nam.: return your certificate immediately to our office with the corrections. Send the certificate to: Emergency Medical Services, PO Box 14450, Portland, OR 97293-0450 and a corrected certificate will be issued to you. Keep your certificate in a secure place. Duplicates can be iSsued for a fee of $10.00. Please be aware that you are required to be familiar with the Oregon administrative rules pertaining to your certification. These-rules are available on our web site under rules and statutes at: www. dhs.state.or.us/publichealth/ems. You will always find the 'latest information from this office on the web site. We encourage you to use this tool frequently. Some items you will find there other than the Administrative Rules are: Updates from the Director, a list of available classes fi.om the mobile training unit, continuing education requirements for all levels of 'EMTs, current EMS Update (newsletter), current articles of interest, EMS hot topics, Awards Banquetinformation, EMS for Children, and a list of staff you can contact in our office for different programs. Thank you for your continual support and involvement in Oregon EMS. STATE O. EDREGON EMERGENCY"~Dilc~L'TECHNIClAN CERT. # 123164 ~PAR~'.~E~Id;EXPIRES 06~30/2005 Christopher D~'aii'?:~'!.:':'::':-:!:!ii!:;::~'''?i', :i'~' _.__ _Chc]tcnh~i~iix~a~:-; ~.' .. "':'-'~'- 3 189 :~-- . - :f- _, Medford, OR:.;~7504 . :.:_ The individual named above' and des" of this card has completed the requirements set forth nd is certified as an Emergency Medical Technician at the evel. ndicated'. STATE OF OREGON - DEPAR'I-MENT OF HUMAN SERVICES EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEMS IDENTIFICATION <:~ .., EMT-P CEI:Ur. # 123164 , HT: l 1" H,;\II-,. D,u k Bio ', n WT: 160 ' EYE!.;;: }'-t'azcl /7;,,_ ,,~ ...~ Signature 6f::"C~fiificate Holder This certificate is tho, nrnn~.rfv nf th~ I')~n~rfrn~nt nf Fh~rn~n ,~ ~ ~,~ ~-~ .~,r.-~ Department of Human Services- Health Services EMERGENCY MEDICAL SERVICES · 800 NE Oregon Street Ste. 607 Portland, OR 97232 · (503) 731-4011 · Fax (503) 731-4077 June 4, 2003 Scott M Hollingsworth 3077 E Main Ashland, OR 97520 Congratulations'on your recertification! Below is your new EMT-P cm~ificat/on card which expires 06/30/2005. · . Please review your certificate carefully. If there is an error in your name return your certificate immediately to our office with the corrections. Send the: certificate to: Emergency Medical Services, PO Box 14450, Portland, OR 97293-0450 and a corrected certificate will be issued to you. Keep your certificate in a secure place. Duplicates can be issued 'for a fee of $10.00. Please be aware that you are required to be familiar with the Oregon adnfinistrative rules pertaining to your certification. These rules are available on our web site under rules and statutes at: www.dhs.state.or.us/publichealth/ems. You will always find the latest information from this office on the web site. We encourage you to use this tool frequently. Some items you will find there other than the Administrative Rules are: Updates from the Director, a list of available classes from the mobile training unit, Continuing education requirements for all levels of EMTs, current EMS Update (newsletter), current articles of interest, EMS', hot topics, Awards Banquet information, EMS for Children, and a list of staff'you can contact in our office for different programs'. .. Thank you for your continual support and involvement in Oregon EMS. STATE .O_ F._OREGON 3077 E Main-, - . .... ' ;; Ashland, OR '9'7!51~6~:~ ";": :' ''''~ ~-~' '~i~i'~ "': '~" The individual named above an~"de~dribed on the reverse of this card has completed the requ rements .set fbrth.ih:~aS 6~2 ~'et seq. and is certified as an Emergency Medical Tech'niciaa.at the evel:indicated. Jonath~}n, Grant Hi99inson STATE OF OREGON - DEPAFITMENT OF HUMAN SERVICES EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEMS IDEN'I"II:'I~ATION EMT-P CERT.'# 11361)7 Scott M llolling'swbrth ~ ; HT: 6' 2" HAIR: Black WT: 195 EYES: Brown Signature b'~ ~g~'{ificate Holder Th/s cert/ficate /s the property of the Department of Human Serv/ces and must be surrendered by the ho/der on demand, Tho individual named above:,:,qna~ d6~'~'~if~,d'Oh fho ~:~vorso of this card has I '-~ completed the requireme'hts s~:t~.i~rih in ORS 682 et se.q,, and is certified as I ~o an Emergency Medical Tec~h cia'n~t tho level indicated. Jonath~-C~in, ' Grant Higginson ~ B J Director of EMS & Trauma Systems State Public Health Officer J EMERGENCY MEDICAL SERVI3ES & TRAUMA SYSTEMS IDENTIFICATION :~:~rr-B c,s~rr....# Margueritte I_; Hi~kn'~an :', , Il'F: 5' 5" . :i.." ..: HAIR;"L/~ht Brown WT: 165 '.':i'.':'.5' .',.EVES;"Gr~¢n '..,.. '/~,,~igrl:~t0re c~f Certif cate Holder ThiscertificateistPFe'propertyoftheDeparlrnentofHuman 5927 4 Services and must be surrendered by the hold~;r on demand. Department of Human Services- Health Services EMERGENCY MEDICAL SERVICES · 800 NE Oregon Street Ste. 607 Portland, OR 97232 · (503) 731-4011 · Fax (503) 731-4077 June 4, 2003 David K Hard 671 Spring Creek Dr Ashland, OR 97520 ( on Congratulations on your recertification! Below is your new EMT-P certification card which expires 06/30/2005. Please review your certificate carefully. If there is an error in your name return your certificate immediately to our office with the corrections. Send the certificate to: Emergency Medical Services, PO Box 14450, Portland, OR 97293-0450 and a corrected certificate will be issued to you. Keep your certificate in a secure place. Duplicates can be issued for a fee of $10.00. Please be aware that you are required to be familiar with the Oregon administrative rules pertaining to your certification. These rules are available on our web site under rules and statutes at: www. dhs.state.or.us/publichealth/ems. You will always find the latest information from this office on the web sitie. We encourage you to use this tool frequently. Some items you will find there other than the Administrative Rules are: Updates from the Director, a list of available classes from the mobile training unit, continuing education requirements for all levels of EMTs, current EMS UpdateO'mws~ter)Fcurr~~ of'interest, EMS-h~ topics, Awards Banquet information, EMS for Children, and a list of staff you can contact in our ofrice for different programs. Thank you for your continual support and involvement in Oregon EMS. STATE OE.DREGON Ei~ERG ENOY':M;~bi:~'L'TECH NICIAN CERT. # 127938 PA~MEDICi;~XPIRES 06/30/2005 David K 671 Spring c)~;Dr Ashland, OR '975 The individual named ';'!'...: :.. · ":'.-"se of this card has completed the requirer" .' ' .', ' ';i,'.'.: .":... :.. and is certified as an Emergency Medica .... STATE OF OREGON - DEPARTMENT OF HUMAN SERVICES EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEMS IDENTiFiCATION EMT-P CERT. # 12792;8' ~ David K H,'trd ' ' " HT: 6' 1" HAIR: Blonde § WT: 195 . .,,EYES: Blue ,,. -~ ' :: L .:' ".' ;' ~:;:? '{ :; t: ..: :, :::~ }~': i: : 7~ ': ,,9_© Signature 0f Cedificate Holder Thiq n~rtifin~t~ iq- th~ nrnn~rtl/ nf thp Dpn2rfmpnt nf l-hlm~n Department of Human Services- Health Services EMERGENCY MEDICAL SERVICES · 800 NE Oregon Street Ste. 607 Portland, OR 97232 · (503) 731-4011 · Fax (503) 731-4077 June 4, 2003 David C Hanstein 1516 Larkspur Medford, OR 97504 Congratulations on your recertification! Below is your new EMT-P certification card which expires 06/30/2005. Please review your certificate carefully. If there is an error in your name return your certificate immediately to our office with the corrections. Send the certificate to:'Emergency Medical Services, PO Box 14450, Portland, OR 97293-0450 and a corrected certificate will be issued to you. Keep your certificate in a secure place.. Duplicates can be issued for a fee of $10.00. Please be aware that. you are required to be familiar with the Oregon administrative rules pertaining to your certification. These rules are available on our wet) site under rules and statutes at: www.dhs.state.or, us/publichealth/ems. You will always find the latest information from this office on the web site. We encourage you to use this tool frequently. Some items you will find there other than the Administrative Rules are: Updates from the Director, a list of available: classes from the mobile training unit, continuing education reqUirements .for all levels of EMTs, current EMS Update (newsletter), current articles of interest, EMS ihot topics, Awards Banquet information, EMS for Children, and a list of staff you can contact in our office for different programs. Thank you for your continual support and involvement in Oregon EMS. STATE OEDREGON David C Hans.t'ein" ..:!' '_: i.i~i(i~.~ :-i ~ 'i~ · .:. 1516 Larkspur`../. : ~- ...:.-:-. :~:_ Medford, OP~:797504': '~:' -' .... ' '--? The individual named above and' described' on the reverse of this card has completed the requirements set for' ..'.'.' .... and is certified as an Emergency Medical Technician .... .' : STATE OF OREGON - DEPARTMENT OF HUMAN SERVICES EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEMS iDENTIFICATION 1814 David C IIanstein HT: 6' 2" : I:' 'LM'It'.'~.~)~rk Brown WT: 245 Signature of:Cedificate Holder This certificate is the property of the Deparfmen! of Human '~ ¢,'~ ? ~ ,f'.~.~ -1 I EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEMS !CERT. # 130001. ~!i;~~J. 06'30{2005 :l'. , :'~,: ..:.:: 'iMARTIN,,RICHARD:~:%?:<.-::.~i:?-~:~,': "" .... :' " . · . :~ ..... ::h:,~,7~4:~.477.;.:;~:,.,:..:.~;:~~, ~27~.',~;~~ Th~ individual named abcve, a~d'dei~cdbed on tho rewme of this card has completecl fl'm r~quirermh~ts sot lo)lb m ORS 823.010 e~ ~ and is certified as aO Er~rgency Medical Technician at the ' ,. level ind[catod. / 4 Jonat~'Chin, Director of EMS & Trauma Systems STATE OF OREGON - DEPARTMENT OF HUMAN SERVICES . Thomas W. Johnson,~,.,/ Administrator, O.RH.S. STATE oF OREGON EMERGENCY MEDICAL TECHNICIAN IDENT!.?,, EMT-P Richa~d;~] WT: 200 ,'.j i~'~ ...~;.~,,.'..i:,.':~l? ..,.d~ .,.;,,.¢ · ATTACH PHOTO HERE 54184 This certificate is the property of the Department of Human Services and must be surrendered by the holder on demand. i~ ~ National Registry of o,~ ~,,, ' EMERGENCY MEDICAL TECHNICIANS here~ certifies that Richard F. Martin HAVING FULFILLED THE PRESCRIBED REQUIREMENTS AND SATISFACTORILY PASSING THE WRFrrEN AND PRACTICAL EXAMINATION IS DULY REGISTERED AS AN EMERGENCY ~F. DICAL TECHNICIAN IN THE CLASSIFICATION USTED BELOW P0953231 0313112005 I EMT - Paramedic . o... ...................--- CORRESPONDENCE TO THE NATIONAL REGISTRY,EXECUTIVE DIRECTOR Department of Human Services- Health Services EMERGENCY MEDICAL SERVICES · 800 NE Oregon Street Ste. 607 Portland, OR 97232 · (503) 731-4011 · Fax (503) 731-4077 June 4, 2003 Rod Lacoste PO Box 146 Jacksonville, OR 97530 ()regon Congratulations on your'recertification! Below is your new EMT-P certification' card which expires 06/30/2005. Please review your certificate carefully. If there is an error in your name return your certificate immediately to our office with the corrections. Send the certificate 'to: Emergency Medical Services, PO Box 14450, Portland, OR 97293-0450 and a corrected certificate will be issued to you. Keep your certificate in a secure place. Duplicates can be issued for a fee of $10.00. Please be aware that you are required to be familiar with the Oregon administrative rules pertaining to your certification. These rules are available on our web site under rules and statutes at: www.dhs.state.or.us/publichealth/ems. You will always find the latest information from this office on the web site. We encourage you to use this tool frequently. Some items you will find there other than the Administrative Rules are: Updates from the Director, a list of available classes from the mobile training unit, continuing education requirements for all levels of EMTs, current EMS Update (newsletter), current articles of interest, EMS; hot topics, Awards Banquet information, EMS for Children, and a list of staff you can contact in our office for different programs. Thank you for your continual support and involvement in Oregon EMS. STATE OF.OREGON EMERGENCY: :~'~'i~t.:-'rE C" N ICIAN CERT. # 127119 -:PA~'MEDIC~-EXPIRES 0613012005 .-. ',:-:'.':~i~ .... ':~-' :~' ': -..: "i. '~:' .' Rod Lacoste ':'? · : ::""-';' ;;;?':-~-~.( .:':!.:!'-'-"' 5:" PO Box 146 ..... Jacksonville, 0R!;9~'3'0:': :' ' '-'~ ' -:;~ :- The individual named aoove and described on_the reverse of this card has completed the requiremerits set forth in' OF]S 682e~ seq. and is certified as an Emergency Medica Technician at-ihe level indicated. STATE OF OREGON - DEPARTMENT OF HUMAN SERVICES EMERGENCY MEDICAL SE'=tVICES & TRAUMA SYSTEMS IDENTIFICATION EMT-P CER~. # 127119 Rod Lacosf~~I~ nT: 5'11" ., :: !:': .: : WT: 175 .... EYES: riluc Signature ~ ~',~hi:ficate Holder Department of Human Services- Health Services EMERGENCY MEDICAL SERVICES * 800 NE Oregon Street Ste. 607 Portland, OR 97232, (503) 731-4011 e Fax (503) 731-4077 June 4, 2003 Gregory R Jones 107 N Wi ghtman Ashland, OR 97520 Congratulations on your recertification! Below is your new EMT-B certification card which expires 06/30/2005. Please review your certificate carefully. If there is an error in your name return your certificate immediately to our office with the corrections. Send the certificate to: Emergency Medical Services, PO Box 14450, Portland, OR 97293-045:0 and a corrected certificate will be issued to you. Keep your certificate in a secure place. Duplicates can be issued for a fee of $10.00. Please be aware that you are required to be familiar with the Oregon administrative rules pertaining to your certification. These rules are available on our web, site under rules and statutes at: www.dhs.state.or.us/publichealth/ems. You will always find the latest information from this office on the web site.. We encourage you to use this tool frequently. Some items you will find there other than the Administrative Rules are: Updates from the Director, a list of available,, classes from the mobile training unit, continuing education requirements for all levels of EMTs, current EMS Update (newsletter), current articles of interest, EMS hot topics, Awards Banquet information, EMS for Children, and a list of staff you can cent act in-om--o ~ce:~for~fferent program.sc- Thank you for your continual support and involvement in Oregon EMS. STATE OF OREGON EMERGENCY MEDICAL TECHNICIAN CERT. # 110972 BASIC. EXPIRES06130/2005 Gregory R Jones 107 N Wightman Ashland, OR 97520 The indMdual named above and described on the reverse of this card has completed the requirements set forth in ORS 682 et se~. and is certified as an Emergency Medical Technician at the level indicated. ?; ,4: ~ Signa~/e of Certificate Holder /! This ce~ificate is lhe prope~y ¢~he DepaCu~ent of Human e,~,;r.~c =nd .mu~t ho. .eurrend~red by the holder on demand_ STATE OF OREGON - DEPARTMENT OF HUMAN SERVICE', EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEMS IDENTIFICATION EMT-B CERT. # 110972 Gregory R Jones HT: 6' 0" HAIR: Dark Brown WT: 180 EYES: Hazel Department of Human Services- Health Services · EMERGENCY MEDICAL SERVICES · 800 NE Oregon Street Ste. 607 Portland, OR 97232 e (503) 731-4011 · Fax (503) 731-4077 June 12, 2003 Derek A Rosenlund 642 Wilson Road Ashland, OR 97520-9324 ()regon Congratulations on your recertification! Below is your new EMT-P certification card which expires 06/30/2005. Please review your certificate carefully. If there i's an error in your narne return your certificate immediately to our office with the corrections. Send the: certificate to: Emergency Medical Services, PO Box 14450, Portland, OR 97293-0'450 and a correCted certificate will be issued to you. Keep your certificate in a secure place. Duplicates can be issued for a fee of $10.00. Please be aware that you are required to be familiar with the Oregon administrative rules pertaining to your certification. These rules are available on our web site under rules and statutes at: www.dhs.state.or.us/publichealth/ems. You will always find the latest information from this office on the web site. We encourage you to use this tool frequently. Some items you will find there other than the Administrative Rules are: Updates from the Director, a list of available classes from the mobile training unit, continuing education requirements for all levels of EMTs, current EMS Update (newsletter), current articles of interest, EMS hot topics, Awards'Banquet information, EMS for Children, and a list of staffygu can contact in our office for different programs. Thank you for your continual support and involvement in Oregon EMS. STATE O'E..OREGON I'--S~AT-'~O-~F O--~RE-'~-'O7- '~EPAR-'~M~NT OF HUMAN SERVICES EMERGENCY':~D~CA'E::TECHNICIAN { EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEMS CERT. ~ 121067 .PA~MEDIC:,.EXPIRESO6/30/2005 ' ?..: .:..::...~::.~? ...... _~.- ~ IDENTIFICATION Derek A Rosenlun&./;'-'~.: ::":!,,.~:: -:'~ 642 Wilson Road Ashland, OR 975:20-9324' . .. _ The individual named above and described on the reverse of this card has completed the requirements set forth ih ORS 682 et seq. and is certified as I an Emergency Medical Technician at the level ir~dicated. Derek A l,tosenlund HT: 6' 1" HAIR: Dark Brown WT: 202 EYES: Blue / ,'5;cir;,?,uro .,',f Certi[ica".e I=.,¢ ~."~ \ ThiscertfflcatelsthepropertyoftheDesartmentofHuman~ Services and must be surrendered by the holder on demand. ~.~-~ Department of Human Services- Health Services EMERGENCY MEDICAL SERVICES · 800 NE Oregon Street Ste. 607 Portland, OR 97232 · (503) 731-4011 · Fax (503) 731-4077 June 4, 2003 Allan S Rogers 2578 Rabun Way Central Point, OR 97502 () on Congratulations on your recertification! Below is your new EMT-P certification card which expires 06/30/2005. Please review your certificate carefully. If there is an error in your name return your certificate immediately to our office with the corrections. Send the certificate to: Emergency Medical Services, PO Box 14450, Portland, OR 97293-04'.50 and a corrected certificate will be issued to you. Keep your certificate in a secure place. Duplicates can be issued for a fee of $10.00. Please be aware that you are required to be familiar with the Oregon administrative rules pertaining to your certification. These rules are available on our web site under rules and statutes at: www. dhs.state.or.us/publichealth/ems. You will always find the latest information from this office on the web site. We encourage you to use this tool frequently. Some. items you will find there other than the Administrative Rules are: Updates from the DirectOr, a list of available classes from the mobile training unit, continuing education requirements for all levels of EMTs, current EMS Update (newsletter), current articles of interest, EMS hot topics, Awards Banquet information, EMS for Children, and a list of staff you can contact in our of~,-ce '~oi ~lil~iClCli[ t, Jl (3Si &i3-i~. : Thank you for your continual support and involvement in Oregon EMS. STATE OE OREGON CERT. # 125456 :PARA~EDlb)'E~NI~6/30/20O5 The individual named ))...4:' :;' :1" I.']' ':::';:: '.':' oh ~(~ r~>,.,,rs.> of this card has · . ' ,, ,.,, complete0 the requirer ...'. .. ' .S r.:8,: ~t s.3q. ,and is certifie0 as an Emergency Medical Tecflnieia:~:.]~t STATE OF OREGON - DEPARTMENT OF HUMAN SERVICES EMERGENCY MEDICAL SERVIGES & TRAUMA SYSTEMS IDENTIFICATION EMT-P CERT.'# 125456, , , Allan S Rogers HT: 5' 10" I1AIR: Light Brown WT: 175 EYES' Brown Signature~:~tiiicate Holder Department of Human Services- Health SerVices EMERGENCY MEDICAL SERVICES · 800 NE Oregon Street Ste. 607 Portland, OR 97232 · (503) 731-4011. Fax (503) 731-4077 June 4, 2003 Marshall G Rasor 6407 Harlan Drive Klamath Falls, OR 97603 ( egon Congratulations on your recertification! Below is your new EMT-P certification card Which expires 06/30/2005. ... Please review your certificate carefully. If there is an error in your name return your certificate immediately to our office with the corrections. Send the certificate to: Emergency Medical Services, PO Box 14450, Portland, OR 97293-0450 and a corrected certificate will be issued to you. Keep your certificate in a secure place. Duplicates can be issued for a fee of $10.00. Please be aware that you are required.to be familiar with the Oregon administrative rules pertaining to your certification. These rules are available on our we, b site under rules and statutes at: www. dhs.state.or.us/publichealth/ems. You will always find the latest information from this office on the web site. We encourage you to use this tool frequently. Some items you will find there: other than the Administrative Rules are: Updates from the Director, a list of available classes fi'om the mobile training unit, continuing education requirements for all levels of EMTs, current EMS Update (newsletter), current articles of interest, EMS hot topics, Awards Banquet information, EMS for Children, and a list of staff'you can contact in our office for different programs. Thank you for your continual support and involvement in Oregon EMS. STATE QFDREGON EM EFIG ENCY:'~ ~'i:(~AI~T-.ECHNIClAN CERT. Ct 126969 ,PARAMEDIC--.EXPIRES 06/30/2005 ' '~.:'. ".--,-';. Marshall G Ra'~¢r'. 6407 Harlan D~'~' - . ".?- Klamath FalI'S~'~ . - ... . The individual named above and described onthe reverse of this card has completed the requirements set f0dh-in: O~S'682.;~ and an Emergency Medical Technician at t'~ level ih~icated. STATE OF OREGON - DEPARTMENT OF HUMAN SERVICES EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEMS II) ENTIFIO,~TION Signature 5i certificate Holder This certificate is the property of the Depaz?ment of Human Department of Human Services- Health Services EMERGENCY MEDICAL SERVICES · 800 NE Oregon Street Ste. 607 Portland, OR 97232 · (503) 731-4011 · Fax (503) 731-4077 March 16, 2004 Lance W Menold 7138 Hwy 66 Ashland, OR 97520 C gon Congratulations on becoming an Oregon-certified EMT-P and a member of Oregon's professional prehospital emergency medical care team! Your passing score on the written examination was 83 %. Please review your certificate carefully. If there is an error in your name return your certificate immediately to our office with the corrections. Send the certificate to: Emergency Medical Services, PO Box 14450, Portland, OR 97293-0450 and a corrected certificate will be issued to you. Keep your certificate in a secure place. Duplicates can be issued for a fee of $10.00. Please be aware that you are required to be familiar with the Oregon administrative rules pertaining to your certification. These rules are available on our web site under rules and statutes at: www.dhs.state.or.us/publichealth/ems. You will alWays find the latest information from this office on the web site. We encourage you to use this tool frequently. Some items you will find there other than the Administrative Rules are: Updates from the Director, a list of available classes from the mobile training unit, continuing education requirements for all levels of EMTs, current EMS Update (newsletter), current articles of interest, EMS hot topics, Awards Banquet information, EMS for Children, and a list of staff you can contact in our office for different programs. Again, welcome to the team. STATE OF OREGON EMERGENCY' MEDICAL TECHNICIAN --I--s~AT~E O-~ 0-~E-~-ON- DEPA--RT--~ENT--~F H~MMA-~ ~EER~ICES EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEMS CERT. # 125954 PARAMEDIC EXPIRES 06/30/2005 Lance W Meno!d 7138 Hwy 66 Ashland, OR 97520 : The individual named above and described on the reverse of this card has completed the requirements set forth in ORS 682 et seq, and is certified as an Emergency Medical Technician at the level indicated. IDENTIFICATION EMT-P CERT. # 125954 Lance W Menold HT: 5' 9" HAIR: Blonde WT: 165 EYES: Blue ~ig n~'~re~e rtifi~e//C~old e r This certificate is the property of the Department of Human Se~ices and must be surrendered bv thP, holder on demand. Department of Human Services- Health Services_ EMERGENCY MEDICAL SERVICES e 800 NE Oregon Street Ste. 607 Portland, OR 97232 · (503) 731-4011 · Fax (503) 731-4077 June 4, 2003 David G Shepherd 3775 Coleman Creek Rd Medford, OR 97501 () on Congratulations on your recertification! Below is your new EMT-P certification card Which expires 06/30/2005. Please review your certificate carefully. If there is an error in your name return your certificate immediately to our office with the corrections. Send the certificate to: Emergency Medical Services, PO Box 14450, Portland, OR 97293-0450 and a corrected certificate will be issued to you. Keep your certificate in a secure place. .Duplicates can be issued for a fee of $10.00. ,_ Please be aware that you are required to be familiar with the Oregon administrative rules pertaining to your certification. These rules are available on our web site under rules and statutes at: www. dhs.state.or, us/publichealth/ems. You will always find the latest information from this office on the web site. We encourage you to .use this tool frequently. Some items you will find there other than the Administrative Rules are: Updates from the Director, a list of available classes from the mobile training unit, continuing education requirements for all levels of ,EMTs, current EMS Update (newsletter), current articles of interest, EMS hot topics, Awards Banquet information, EMS for Children, and a 4ist of staff you can contact in our office for diff%re,,t proo~rams. Thank you for your continual support and involvement in Oregon EMS. STATE OE. OREGON CERT. # 123197 ,PA.RAs' ~;ME ~e;EXmR S 06/30/2005 3775 Coleman'~:~b'~E~d. Medford, - : ., The individual named above-a'nd degddbed'-on the reverse of this card has completed the requirements set fodh hf ORS' 5a2 ct scq. and is certified as an Emergency Medical Technician.hr I--S-~ATE OF OREGON-DEPARTMENT OF HUMAN SERVICES HT: 6' 0" l l,.'\IR: Dark Brown WT: 175 EYE,';: Green Signature ~e~ificate H~der This cert/fi~t¢ i.~ th~ nr¢n~dv nf th~ D~t*~n'm¢nt ~f M.m~n EMERGENCY MEDICAL SEFVICES & TRAUMA SYSTEMS i ""' . I ' I~ '.¢'~ EMT-P CE'Rrlr. # 123197 David G Sh~l~hertl ' · Department of Human Services -Health Services EMERGENCY MEDICAL SERVICES · 800 NE Oregon Street Ste. 607 Portland, OR 97232 · (503) 731-4011 · Fax (503) 731-4077 June 4, 2003 Dana S Sallee 170 Brierwood Dr Talent, OR 97540-8618 ()regon Congratulations on your recertification! Below is your new EMT-P certification card which.expires 06/30/2005. Please review your certificate carefully. If there is an error in your name return your certificate immediately to our office with the corrections. Send the certificate to: Emergency Medical Services, PO Box 14450, Portland, OR 97293-0450 and a corrected certificate will be issued to you. Keep your certificate in a secure place. Duplicates can be issued for a fee of $10.00. Please be aware that you are required, to be familiar with the Oregon administrative rules pertaining to your certification. These rules are available on our web site under rules and statutes at: www.dhs.state.or.us/publichealth/ems. You will always find the latest information from this office on the web site. We encourage you to use this tool frequently. Some items you will find there other than the Administrative Rules are: Updates from the Director, a list of available classes from the mobile training unit, continuing education requirements for all levels of EMTs, current EMS Update (newsletter), current articles of interest, EMS hot topics, Awards Banquet information, EMS for Children, and a list of staffyou can contact in our office for different programs. Thank you for your continual support and involvement in Oregon EMS. STATE OE..OREGON EME RG ENC¥--~'~ bi~AL"'rECHN~ClAN CERT. # 116336 _::pA};E&7-MEDIC..EXPIRES 06/30/2005 170 Brim~voM:D?' -- Talent, OR 07540-861 The individual named ,.... -...,. ,-4..~'~.,~ ..... ,: '.'-- '7'.'."-se of this card has completed the requirer .... '., ' f' ': .... ' ': h and is certified as an Emergency Medica ........ . · STATE OF OREGON - DEPARTMENT OF HUMAN SERVICES EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEMS iDENTIFICATION EMT-P CERT. # 1163216 Dana S Sallee HT: 6' 0" WT: 200 ['lAIR: Dark Brown EYES: Blue Signature Of:¢i?iiicate Holder EMERGENCY M'EDIC/~. c~:°~:¥-~':c -' NE ~" ..... '- Portland.. OR ="~" o,~/.:oz · ,'"q ' "....lb ) '"/o i -4t.~ i' '~ I ~ Fax'~' 5()'~ i.,. .... "q,_. i -4()77. June 4, 2003 Robert W Stephens 100 Alder Street Phoenix, OR 97535-7721 Congratulations on your recertification! Below is your new EMT-P certification card which expires06/30/2005. · Please revie~v your certificate carefully. If there is an error in your name return your certificate immediately to our office with the corrections. Send the certificate to: Emergency Medical Services, PO Box 14450, Portland, OR 97293--0450 and a corrected certificate will be issued to you. Keep your certificate in a secure place. DupliCates can be issued fbr a f~.e of $10.00. Please be aware that you are required to be familiar with the Oregon administrative ruleS pertaining to your certification. These rules are available on our web site under rules and statutes at: w~a~a,.dhs.state.or.us/publichealth/ems. You will always find the latest information from this office on the web site. We encourage you to use this tool frequently. Some items you will find there other than the Administrative Rules are: Updates from the Director, a list of available classes fi'om the mobile training unit, continuing education requirements for all levels of EMTs, current EMS Update (newsletter), current articles of interest, EMS hot topics, Awards Banquet infonmtion, EMS for Children, and a list of staff you can contac t..~, our..ofiic, e..fo r different programs. ................. Thank you for your continual support and involvement in Oregon EMS. Robert W Stephens 100 Alder Street Phoenix. OR 97535-772I STATE '-'7 "-' ~' ....... ~,- ,~.~,tztooi,l - DEPARTMENT OF i ii_Jk,gM'-4 SEFV EMERGENCY MEDICAl_ SERVICES & ~,-,~, ~,~,.'/' ~A. o:'"'Cr .~ .... u IDEr-ITIFIOATION co,mp:eteo r, ne reouiremen?s set fo;ih m OHS 682 e~ seq. ano ..'[' cert4~ea as ' -- --.4;~ :.- ..-,.- t-'+q'.~fF' · '~'~'~" EMT-P CERT. # 123787 .-= Robert W Stephens HT: 6' 0" HAIR: Light Brown ~ WT: 219 EYES: Brown S {uLq* ~e ~f Cr-tt:f,?0t', :-{; '~:. 7'/~: dc~' Q';3:.5: :a: ~:::: ;. ,"..'/~7"(F c'" ~!:~ [.5o.2,-~'~:r~r:;,: :.'[' Department of Human Services- Health SerVices EMERGENCY MEDICAL SERVI~CES · 800 NE Oregon Street Ste. 607 Portland, OR 97232 · (503) 731-4011 · Fax (503) 731-4077 June 4, 2003 Ryan E Stidham 220 W Rapp Rd #99 Talent, OR 97540 ( on Congratulations on your recertification! Below is your new EMT-P certification card Which expires 06/30/2005. Please review your certificate carefully. If there is an error in Your name return your certificate immediately to our office with the corrections. Send the certificate to: Emergency Medical Services, PO Box 14450, Portland, OR 97293-0450 and.a corrected certificate will be issued to you. Keep your certificate in a secure place. Duplicates can be issued for a fee of $10.00: Please be aware that you are required to be familiar, with the Oregon administrative rules pertaining to your certification. These rules are available on our web site under rules and statutes at: www.dhs.state.or, us/publichealth/ems. You will always find the latest information from this office on the web site. We encourage you to use this tool frequently. Some items you will find there other than the Administrative Rules are: Updates fi.om the Director, a list of available classes from the mobile training unit, continuing education requirements for all levels of EMTs, current EMS Update (newsletter), current articles of interest, EMS hot topics, Awards Banquet information, EMS for Children, and a list of staff you can ~contact in our oz~Sce for different pro,:ams Thank you for your continual support and involvement in Oregon EMS. · STATE QE..OREGON EtvlE R G E N C-Y:~;~ ~j~C~:~:~EC H NiCIAN CERT. # 127950 .-PA~ED!C~E~IRES 06/30/2005 :,:;:'-;.-?:-.-.::: :, .~..., ::-:: :i~..i,:: ::~:('?:: '% · . .-~ :.. Talent, OR 775 ( [:,/ :- '?-~} The individual named ..... , ~ ' ' ' ' o. ? .,~,, d(:.ski'i!')~:?d cr'l 1}'o ~everse of this card has completed the requiremor% ~;o: fcrth ~:' ORS ~2 of seq. and is certified as an Emergency Medical 'recnniei~n pt t.~e-~V¢~ indicated. STATE OF OREGON - DEPARTMENT OF HUMAN SERVICES EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEMS IDENTIFICATION EMT-P CERT. # 12795) Ryan E Stidh;un HT: 6' 0" IL-\IR: l,ight Brown WT: 190 EYES: Hazel Signature 8f ~iilcate Holder This certificate is the nrooertv of the. Do.n~rfm~=nt nf l~,,mo,, June 4, 2003 John T Stoy 955 Grandview Dr Ash'land, OR 97520 C..'ongratulations on your recertification! Below is your new EMT-P certification card which expires 06/30/2005. Please review your certificate carefully. If there is an error in your name return your certificate immediately ~o our office with the corrections. Send the certiificate to: Emergency Medical ServiCes, PO iBox 14450, Portland, OR 97293-0450 and a corrected certificate will be issued, to you. Keep your certificate in a secure peace. _Pu_plicates can be issued tbr'a fee of $10.00. Please be aware that you arc required to be familiar with the Oregon administrative rules pertai~ling to 'your certification. These roles are available on our web site under roles and statutes at: www. dhs.state.or, us/publichealth/ems. You will always find the latest information from this office on the web site. we e-ncourage you to use'this tool frequently. Some items you will find them other than the Administrati've Rules are: Updates fi'om the Director, a list of available classes fi'om.the mobile training unit, continuing education requirements tbr all levels o'f EMTs, current EMS Update (newsletter), current articles of interest, EMS hot topics, Awards Banquet inIbrmation, EMS for Children, and a list of staff you can contact in our office l:0r dif/brent programs. Thank you -lbr your continual support and involvement in Oregon EMS. :(r,';b...~i-'.::.-',.r.;{i"4C¥ f'~EDIC,&L TECHNICIAN CEli'r. # 11891 I I'...~, ib~.M I:,DI(' EXPIRES 06130/2005 JOhll '1' .15> Grandvicw Dr Ashland, OR t P E,~,!T!FiCAT~ON ~MT-P CF. RI', ~118~)11 ,lolm T Stoy HT: ti' i" HAIR! Dark Brown WT: 195 EYES: Blue EMERGENCY MEDICAL TECHNICIAN CERT. # 130277 INTERMEDIATE, EXPIRES 06/30/2005 Todd C Stubbs 711 Palm St Medford, OR 97501 The individual named above and described on the reverse of this card has completed the requirements set forth in OIlS 682 et seq. and is c0rtified as an Emergency Medical Technician at the level indicated. Jonath~r'Chini"' Grant Higginson Director of EMS & Trauma Systems State Public Health Officer EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEMS IDENTIFICATION EMT-I CERT. # 130277 Todd C Stubbs HT: 6' 2" HAIR: Light Brown WT: 200 EYES: Green ~cate Holder Thiscertificateis the propertyof the Departmentof Human 57 542 Services and must be surrendered by the holder on demand.