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Home My WebLink About2008-063 License - Ambulance Operators 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# License # 1. 1985 BRAUN BRAUN 1FDJE30L8FHA49888 EXEMPT 2. 1992 FORD WHEELED 1 FDJS34M4NHA34394 EXEMPT COACH 3. 1992 FORD LIFELINE 1 FDKE30M7PHA05945 EXEMPT 4. 1996 FORD LIFELINE 1 FDKE30F8THA48282 EXEMPT 5. 1999 FORD LIFELINE 1FDXE40F2XHA00469 EXEMPT 6. 2002 FORD LIFELINE 1FDXF47F63EA10341 EXEMPT o 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. o Enclose with the application, the initial license fee of $300 plus $100 per ambulance. o Enclose a performance bond in the amount of $500,000. o Enclose an insurance policy meeting the requirements of AMC 96.40..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. / Si~nature: rr4A..-f;,.4o..- t- U~~ P~lnt name: ~/J.:I, c t,JpoA Ie U Title: ./'/ ;_( ~/ r' 1 D t r/~~ ~/~ a e: h?i~<nr H:\Council Communications\Council Communications\Ambulance Agreements\Ambulance License Application.doc May 16, 2003 ...., c CJ) 0 E -.;;t () <0 Q) ~ L- tn ns Q) +-' s::: Q. 0.. rn Q) CJ) .c 0 C Om .- 00 ..J CJ) 0 ::s ~o tn CJ <t:~ ~Z - 0 t/) -0 L.. 0(1') 0 +-' CJ) O( -0 0:: ~O> ...... Q) c c CO :J "'C Q) :J >-...1 L.. (/) E""") Q) (/) c ~:I: Q) (/) Q. Q) ns L- Q) .- L- a (/) :J.- Ur./) c CJ) .,0" ~ Q) ... ~ Q) Q) 0 ~ ---I U. =0> 0 "'C rn (/) s::: +-'C C Q) Q) CO ns E.2 - (/)---1 ::J - .c .c rn t/) .c E <( Q) Q) <( 'I- (/) 0 c Q) ~ 0 ...., ---I .- 0 Agent Wilson Heirgood Associates 2930 Chad Drive Eugene, OR 97408-7382 This certificate is issued as a matter of information only and confers no rights upon the certificate holder other than those provided in the coverage document. This certificate does not amend, extend or alter the coverage afforded by the coverage documents listed herein. Named Member or Participant City of Ashland 20 East Main Street Ashland, OR 97520 Companies Affording Coverage COMPANY A - City County Insurance Services (CIS) COMPANY B - National Union Fire Insurance Company of Pitts, PA COMPANY C - RSUllndemnity This is to certify that coverage documents listed herein have been issued to the Named Member herein for the Coverage period indicated. Not withstanding any requirement, term or condition of any contract or other document with respect to which the certificate may be issued or may pertain, the coverage afforded by the coverage documents listed herein is subject to all the terms, conditions and exclusions of such coverage documents. Type of Coverage Certificate # Effective Expiration Limits Date Date General Liability 07LASH 7/1/2007 7/1/2008 General Aggregate $15,000,000 X Commercial General Liability Each Occurrence $5,000,000 X Public Officials Liability X Employment Practices X Occurrence A Auto Liability 07LASH 7/1/2007 7/1/2008 General Aggregate None X Scheduled Autos Each Occurrence $5,000,000 X Hired Autos X Non-Owned Autos A Auto Physical Damage 07 APDASH 7/1/2007 7/1/2008 X Scheduled Autos X Hired Autos X Non-Owned Autos A Property 07PASH 7/1/2007 7/1/2008 Per Filed Values Boiler and Machinery 07BASH 7/1/2007 7/1/2008 Per Filed Values B Excess Crime 07CASH 1/11/2008 7/1/2008 Per Loss $250,000 Excess Earthquake Excess Flood Workers' Compensation escription: Ambulance Service Area #3 Agreement for the period of 7-1-08 to 6-30-09 (Ashland Fire & Rescue). City of Ashland 20 East Main Street Ashland, OR 97520 CANCELLATION: Should any of the coverage documents herein be cancelled before the expiration date thereof, CIS will provide 30 days written notice to the certificate holder named herein. but failure to mail such notice shall impose no obligation or liability of any kind upon CIS, its agents or representatives, or the issuer of this certificate. ertificate Holder By: ~-A14Il - ..4 ,. Date: May 5, 2008 City of Ashland Application for Ambulance Operator License 2008 Vehiclesl EQuioment Level *as of 01-00-08 VEHICLES MILEAGE TYPE LEVEL Unit # Year Model License VIN# ALS/BLS Shop # Ford 8831 2006 Lifeline E233465 1FDXF47F06ED06467 32,844 1 ALS 552 F - 450 4X4 Ford 8832 2003 Lifeline E222273 1FDXF47F63EA10341 90,342 1 ALS 462 F - 450 4X4 Ford 8833 1998 Lifeline E211465 1FDXE40F2~00469 121,736 3 ALS 364 E-450 4X4 Ford 8834 1996 Lifeline E198560 1FDRJE30F8TFU\48282 113,023 3 ALS 283 E-350 4X4 Ford 8835 1992 Lifeline E195689 1FDRJE30M7PHA05945 88,392 3 ALS 133 E-350 4X4 Ford 8836 1993 Wheeled E186951 1FDJS34M4~494 89,797 2 ALS 68 Coach E-350 ,. ~. ~ ,. ~ 0 tT:l en >-i 0 ~ ..... CJ1 t:O z ......... ~ >- 0 ~ n '-l b:l 0 tT1 ......... ~ ~ Z J\:l ~ en 0 ~ ~ ..... 0 CIl 8 '-l CIl ~~~ c:: (J ~. ::r: c: ;::s (J o~ en a 1-3 ~. -. ~ ~~ ~ ~ =--0 q ;::s ~ ~ ~ .., ~CZl to CD ~ O:l 8~} I ~o 0 ..... ::r: n' r:n I-<l z .....0 ~ C':l c;J z~ ~ 0 ~~ ;::s ~ "Os en ~ CIl ~ S; Q . t:x:l 'd ::r:~ C':l ~ ..... c: 1""1' CD 1""1' ~ t:: v:l ~ ~ e:.. .., CD ::::r ()~~ CZl lB. ~ I--' ;:j CZl ~~~ n 1""1' ::::s .., ~ t':I p) 0 <:r' (J 1-3 ~ ~ en ::::s os t:S C':l ::r: t':I ~ p.. ::::s "'1 ~ 1-4 5!~ ~ p) ~ .... CZl .., en n p.. 0 t':I 0\ C en en .... ~ ;;i t:x:l ......... c: ~ C,..j d 1-4 @ en 0 ..... (J ~ 'd ......... '. ~ .., J\:l CD 0 ~ en CIl ~ 0 CD 0 Z >%j a 00 ::.l n ~ r:n t':I ..... ~ ~ ,. c6 ,. ~ s.c;cJ ~ I@ COCl 3gI ~o Vl CD Cf) ro"'C <~ (1'3 ro CD V> :::s ...... OREGON DEPARTMENT OF HUMAN SERVICES EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEM '.~'C' ~"c=-== A~~IT N;==~-=~ :! if n .' .. . :i CERT1F~m~~BER: ii I:; :1 AMBU~9gvr6rd II . : .' ~ ; 80.00 AMBULANCE UCENSE -POST IN VEHICLE ~ PAYMENT RECEIVED " . ~ Ii ,I i' i II ~ . ~ j EXPIRATION DATE MO. OAY VR. 06/30/2008 .r--.-.--------.-.-.-.-.-.-.-.-.-.-.-..-..-.-.-..-.-.-.-.-----.-.-.-.-.-.->-.-.-.-.-.---.-.-.-.-.-.-.., i . i .-j i i i i i i . i L._._._._._._._._._._._._._._._._._._._._._._____._._._._._._._._._._ .-.-.-.-.-.-.-.--.-.---.-..; City of Ashland 455 Siskiyou Blvd Ashland OR 975202068 - ",-'~="=-=-""''''''-'''~-e:-~~'_''~_''~'"'''''::;:"'''~~~~_'f;lI'_ _." . . - - - -. .<- ~ MUST BE POSTED IN A CONSPICUOUS PLACE - NOT TRANSliERRABLE '. '~-OREGONDEPARTMEr.H OF HUMAN~ SERVICES ....,~.,~---c_=z~c="__'~-'07="=C'..c,~=~~~;;~~'=."~''l EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEM .... '.' , ~ 80.00 . ~ ! ! l fj r. U n . Ii CE~F~~~BER: , PAYMENT RECEIVED' EXPIRATION DATE MO; O~Y VA. 06/30/2008 : AMBu~~ev~cird AMBULANCE LICENSE - POST IN VEHICLE !'._._._._._._._._._....._._._._._._........._._~-.-._._._._.'-._._._._._._._._.__._.__._;_._......_._._.~ I I i i i City of Ashland i '. "j i : 455 Siskiyou Blvd : : Ashland OR 975202068 i i ~ i i ! ! 1..._._._._.___.___._._._._._._.___._____ "___.___._._._____.___._._._._._._._._._._._._._._._.___." i t t' . ~~,.,~ ~ . ~ M ,1 b . 1 . .~. . .... _~~7~~'=~"="'~Z"'=~~7""'.",.,~~~~~,,=,=' . ... '.', MUST BE POSTED IN A CONSPICUOUS PLACE - NOT TRANSFERRABLE OREGON DEPARTMENT OF HUMAN SERVICES . E:MERGENCY MEDICAL SERVICES & TRAUMA'SYSTEM AUOltNO. CERTlF~~~BER: 80.00 AMBU~r6rd PAYMENT RECEIVED EXPIRATION DATE IAo.DAY . YR. .' 06/30/2008 AMBULANCE LICENSE - POST IN VEHICLE . . . r-'-'-'-'-'-'-'-'-'-'---'-'- .-.-.-.-.--.-.-.-.-.-.-.-.-.-.---.-.-.....-.-.-.-.---.-.-.-.......-.-.-.1 j i i City of Ashland i i i : 455 Siskiyou Blvd : i Ashland OR 975202068 : i i i i ! i ....-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.---.-.-.-.-._._._._._.___._._._._._._.___._._._._._._._._. _._o..i . it ~ 'I !~ I I: ~MERGENCY MEDICAL SERVICES & TRAUMA SYSTEM r: cERn~~~~R: U ,J AMBU~~PE Ii H f: I: it ,. !! i I: I' ;:- ~.. .:" -":-:-.-:'--:-'~""""'--:~'._",-_,,:-,~ ...,-__.__~:~ :-~---""'~---=_.".."'-"'-"c--,'-:C::::l'=.-'--:~ ._.-----~__=~ OREGON DEPARTMENT OF HUMAN SERVICES . - - u _.mud .~_.._"- . ----;UDlTNO. ~I' EMERGENCY MEDICAL SERVICES & TRAUMA'SYSTEM : 80.00 1 I n ~ ! i ~ I! ~ I: n ,I: ii ~;-_-_c"::'7"'~=-'II..;1 ._.. _._4.__.'._'_'__'_' _._hO__ OREGON DEPARTMENT OF HUMAN SERVICES EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEM AUDIT,NO. CERTI~~ER: PAYMENT RECEIVED EXPIRA TlOH DATE MO. DAY YR. 06/30/2008 AMBU~2'llbrd AMBULANCE LICENSE""; POST IN VEHICLE ,;..-.-,;.:,.-.-.-..:....-....::-.-.-.--.--.'-"-.-.-.-.-.-.-.-.-.-.-.-.-......-.-......-.-.-.-.-.-.-.---.-.-.-.-., .i i i i i City of Ashland : i 455 Siskiyou Blvd : : Ashland OR 975202068 : i i i i i i MUST BE POSTED IN A CONSPICUOUS PLACE - NOT TRANSFERRABLE OREGON DEPARTMENT OF HUMAN SERVICES AUDIT. NO. PAYMENT RECEIVED EXPlRATlOH DATE MO. DAy YR. 06/3012008 AMBULANCE LICENSE -POST IN VEHICLE ...-.-.-.-.-.-.-.-.-.---.-.-.-.-.-.-.-.-.-.-.-----.-.-.-.-.-.-.-.-.-.-.--.-.-.-.-.-.-.-.-.-.-.-... i i i i i City of Ashland i i 455 Siskiyou Blvd i i Ashland OR 975202068 : i i i i i i i..._._._._._._._._._._:_._,,_,_,_,_,_,._._._._._._._._._._._._._._._ __._._._._._._._._._._._._._._... MUST BE POSTED IN A CONSPICUOUS PLACE - NOT TRANSFERRABLE ,. cERn~g~g'1BER: AMBULAf99~'Fbrd PAYMENT RECEIVED EXPIRATION ' DATE MO. DAY. yR. 06/30/2008 AMBULANCE LICENSE - POST IN VEHICLE t.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-;.-.-.-.-;-.-.-.-.-.-.---.-.-.....-.-.-.....-.-..-.-........-.-.-."1 ~ i ." ! City of Ashland i ! i : 455 Siskiyou Blvd : : Ashland OR 975202068 i ! i ! i ! i ...-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-._._._._._._._._._._._._._._~._._._._._._.,; . -",_:"';'.;,,-,-,~:.-"-.:;;.'~ 80.00 ASHLAND FIRE & RESCUE APPLICATION FOR AMBULANCE OPERATOR LICENSE 2008 First Level Last Name Name MI Expires Empl Stat Anders, Walt L. EMT -Basic 6/30/2009 PFT Beck Todd E. EMT -Paramedic 6/30/2009 PFT Boyersmith Steven P. EMT -Paramedic 6/30/2009 PFT Burns Kelly W. EMT -Paramedic 6/30/2009 PFT Case Greg I. EMT -Paramedic 6/30/2009 PFT Cocke II II Robert C. EMT -Paramedic 6/30/2009 PFT Earl William J. EMT - Paramedic 6/30/2009 PFT Formolo Curt J. EMT -Paramedic 6/30/2009 PFT Foss Justin EMT -Paramedic 6/30/2009 PFT Freiheit Matthew E. EMT -Paramedic 6/30/2009 PFT Hadden Jennifer A. EMT -Paramedic 6/30/2009 PFT Hanstein David C. EMT -Paramedic 6/30/2009 PFT Hickman Margueritte LR EMT -Basic 6/30/2009 PFT Hollingsworth Scott M. EMT -Paramedic 6/30/2009 PFT Knutson Brent A. EMT -Paramedic 6/30/2009 PFT LaCoste Rod T. EMT -Paramedic 6/30/2009 PFT Manning Donald R. EMT -Paramedic 6/30/2009 PFT Martin Richard F. EMT -Paramedic 6/30/2009 PFT Menold Lance W. EMT -Paramedic 6/30/2009 PFT Rasor Marshall G. EMT -Paramedic 6/30/2009 PFT Roselip David EMT -Paramedic 6/30/2009 PFT Rosenlund Derek A. EMT -Paramedic 6/30/2009 PFT Sallee Dana S. EMT -Paramedic 6/30/2009 PFT Shepherd David G. EMT -Paramedic 6/30/2009 PFT Stephens Robert W. EMT -Paramedic 6/30/2009 PFT Stoy John Trent EMT -Paramedic 6/30/2009 PFT Stubbs Todd C. EMT -Paramedic 6/30/2009 PFT Trask Robert EMT -Paramedic 6/30/2009 PFT Turner Shannon W. EMT -Paramedic 6/30/2009 PFT ASHLAND FIRE & RESCUE ANNUAL REPORT 2007 First Level Last Name Name MI Cert # Expires DL# Empl Stat Anders, Walt L. EMT -Basic 112485 6/30/2009 1955034 PFT Beck Todd E. EMT .Parart:ledic 124333 6/30/2009 5837326 PFT Boyersmith Steven P. EMT -Paramedic 120378 6/30/2009 4545965 PFT Bums Kelly W. EMT -Paramedic 120248 6/30/2009 5207865 PFT Case Greg I. EMT -Paramedic 113788 6/30/2009 3254941 PFT Cockellll Robert C. EMT .Paramedic 123943 6/30/2009 6109120 PFT Earl William J. EMT - Paramedic 128504 6/30/2009 9507843 PFT Formolo Curt J. EMT -Paramedic 118901 6/30/2009 3738940 PFT Foss Justin EMT -Paramedic 6/30/2009 PFT Freiheit Matthew E. EMT -Paramedic 121237 6/30/2009 4927105 PFT Hadden Jennifer A. EMT -Paramedic 124336 6/30/2009 3535298 PFT Hanstein David C. EMT -Paramedic 111814 6/30/2009 2524064 PFT Hickman Margueritte LR EMT -Basic 128889 6/30/2009 3676587 PFT Hollingsworth Scott M. EMT -Paramedic 113607 6/30/2009 2830146 PFT Knutson Brent A. EMT -Paramedic 130961 6/30/2009 5263705 PFT LaCoste Rod T. EMT -Paramedic 127119 6/30/2009 4322818 PFT Manning Donald R. EMT -Paramedic 129281 6/30/2009 9613555 PFT Martin Richard F. EMT -Paramedic 130001 6/30/2009 8543648 PFT Menold Lance W. EMT -Paramedic 125954 6/30/2009 6022755 PFT Rasor Marshall G. EMT -Paramedic 126969 6/30/2009 5067632 PFT Roselip David EMT -Paramedic 6/30/2009 PFT Rosenlund Derek A. EMT -Paramedic 121067 6/30/2009 5541498 PFT Sallee Dana S. EMT -Paramedic 116336 6/30/2009 3654752 PFT Shepherd David G. EMT -Paramedic 123197 6/30/2009 3667291 PFT Stephens Robert W. EMT -Paramedic 123787 6/30/2009 5856509 PFT Stoy John Trent EMT -Paramedic 118911 6/30/2009 4856227 PFT Stubbs Todd C. EMT -Paramedic 130277 6/30/2009 9309381 PFT Trask Robert EMT -Paramedic 6/30/2009 PFT Turner Shannon W. EMT -Paramedic 126208 6/30/2009 3263694 PFT May 23, 2007 Department of Human Services - Health Services EMERGENCY MEDICAL SERVICES. 800 NE Oregon Street Ste. 607 Portland, OR 97232. (971) 673-0520 . Fax (971) 673-0555 Walt LAnders 23 Wilson Road Ashland OR 97520 Below is your new Oregon-certified EMT -Basic certification card which expires 06/30/2009. 4 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: http://www.oregon.gov/DHS/ph/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 ofEMTs, 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. ,- - - - - -STATEqr: OREGON - - - - - -'-STATE OF OREGON - DEPARTMENT OF HUMAN SERVICES- I EMERGEN.CY Me01CAj..;reCHNICIAN I EMERGENCY MEDICAL ES & TRAUMA SYSTEMS I I ~ ~ CERT # 11248SEMT~BlIskExpires:06130/2009 I I Q) I.' WaltLf\lidl!rs Ii. 23 Wilson-Road = I AshlandOR97S20 . I! II The individual named iilbO.Ve and described on the reverse of this card has 'I! completed the requirements set forth in ORS 682 ~ and is certified as :E I an Emergency Medical Technician at the level indicated. ih~, I ~i,.o nf ("""",n'\! Init" I-Iaolth 2. l-Ioalth Cl-:on...in.... t:~"c::: n;r^....'..... EMT-Basic (;1.1"# 1124SS . Walt L Aliders .. HT:74 WT: 198 lIA$1 Blonde lJair EYEs: Hazel Eyes 4062 Signature of Certificate Holder This certificate is the property of the Department of Human 7 7 4 9 5 Services and must be surrendered by the holder on demand. AUDIT NO. May 24, 2007 Department of Human Services - Health Services EMERGENCY MEDICAL SERVICES. 800 NE Oregon StreetSte. ffJ7 Portland, OR 97232. (971) 673-0520. Fax (971) 673-0555 Todd E Beck 21 Anna Laura Dr Jacksonville OR 97530 Below is your new Oregon-certified EMT -Paramedic certification card which expires 06/30/2009. 4 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: http://www.oregon.gov/DHS/ph/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 artic1esofinterest, EMS hot topics, Awards Banquet information, EMS for Chi1dren;and a list of staff you can contact in our office for different programs. Again, welcome to the team. 1- - - - - - - - - - - - - - - - - -1- - - - - - - - - - - - - - - - - -- STATE.9F QREGON STATE OF OREGON - DEPARTMENT OF HUMAN SERVICES I EMERGENCY-MEOICAb.TECHNICIAN I EMERGENCY & TRAUMA SYSTEMS ",.,- ..,.,:...-.'..,'........ \ I CERT # 124333 EM'l'~PIl~ilJnedicExpires: 06/30/2009 I I I., I v' ToclclE~~k> I ~ 21 Anna Uaura' Dr = I Jacl<sonviUeOJl9'1~30, '" 1 ~ : :~~~~~~~d~:~ ~:~~r~:~.~~e s~~~o~~m~g;~J~ee:~~~~:n~' ~I~e~~~~dh:: : I : 'A;M'Y ""''''' ""~"i'i~ "~'J"""".""'" I Grant Hlgg~rator ' I Offir.p. nf r.nmmllnitv l-Itt.~lth ,It I-Itt.::tlth PI::tnninn I=rut~ niNloMnr HT:73 WT:215 ,/( 7538 ' Signature Holder This certificate is the property of the Department of Human 7 8 5 9 3 Services and must be surrendered by the holder on demand_ AUDIT NO. May 23,2007 Department of Human Services - Health Services EMERGENCY MEDICAL SERVICES. 800 NE Oregon Street Ste. 607 Portland, OR 97232. (971) 673-0520 . Fax (971) 673-0555 Steven P Boyersmith 1110 La Lorna Dr Medford OR 97504 Below is your new Oregon-certified EMT -Paramedic certification card which expires 06/30/2009. 4 n-'PleasereVlew 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: I Emergency Medical Services, PO Box 14-150, 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 l1.l1es are available on our web site under rules and statutes at: http://www.oregon.gov/DHS/ph/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 progratr...:k---n-...n----. - .._.--- ..-------- .._._._________________n._.______ Again, welcome to the team. ,- - - - -STATE OF OREGON - - - - - -I-STATE OF OREGON. DEPARTMENT OF HUMAN SERVICES - I EMERGENCy",~P1CA,btECHNICIAN I EMERGENCY MEDICAL ES & TRAUMA SYSTEMS I . ...... . . ... I IDE ION I CERT# 120378 .~l\ff-:P.t~fu~lcExpir~;06/30/2009 I CD c: I I~ SteY~~":~r&!~.."itb CD I 1111J'f:i" L9ll\a.Dr: I ~ Medford Olt'91s01f . g l ~~~~e~~~~ ~:~~~:rie~~\~i~o~~~;~J~e~:~~~~:n~ :'~e:r~dh:: : i : ~::T""I.~~J!""."'t.. : I Grant Hi9gl~~n~~inl~lralor . I I 0lIice of Community Health & Health Planning, EMS Director I HT:71 WT:170 4200 This certificate is the property of the Departmenf of Human 7 Services and must be surrendered by the holder on demand. Z 1 5 9 AU IT~. May 23,2007 Department of Human Services - Health Services EMERGENCY MEDICAL SERVICES. 800 NE Oregon Street Ste. 607 Portland, OR 97232. (971) 673-0520. Fax (971) 673-0555 Kelly W Bums 2691 Mickelson Way Ashland OR 97520 Below is your new Oregon-certified EMT-Paramedic certification card which expires 06/30/2009. 4 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: http://www.oregon.gov/DHS/ph/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 OFOREGON - - - - - -I-STATE OF OREGO-;- DEPARTMENT OF HUMAN SERVICES - I EMERGENCYNII=P1CI\L.TECHNICIAN 1 EMERGENCY MEDICAL ES & TRAUMA SYSTEMS I I IDE ION I CERT # 120248EMT.J.>Ilf8in~dic:EJ;pll"es: 06130/2009 I ~ EMT _Pal'u .,; 1 K~lf~~lcirl1f. ..... . . I ~ Kelly W I 26~lMickels?n",ay I ~ I Asbland 0&9'7520 I f I The individual namedabove~nd ~e.sQribedonthe r~yerse of this card has 1:!2 completed the requiremllnts setfoi'thiliOFlS682 ~ and is certified as .E : ~"'M'd1~' """""9;!\""J"ro' 'r",,,.d. : "" I Gmm "~_, I =-~:.'::.'=:::::::=:::::::,. 7 7 ';{ 6 0 I Office of Community Health & Health Planning, EMS Director I Auf.IT~h . HT:76 WT: 200 May 23, 2007 Department of Human Services - Health Services EMERGENCY MEDICAL SERVICES. 800 NE Oregon Street Ste. 607 Portland, OR 97232. (971) 673-0520. Fax (971) 673-0555 Greg I Case 816 Voris Avenue Ashland OR 97520 Below is your new Oregon-certified EMT-Paramedic certification card which expires 06/30/2009. 4 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: ED;1ergency 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$lO.OO. 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: http://www . oregon. gov/DHS/ph/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. r-----------------~------------------- STATE ()EORtGON STATE OF OREGON - DEPARTMENT OF HUMAN SERVICES I EMERGE~ev;r,;jp1c~;rlE~HNICIAN I EMERGENCY MEDICAL ES & TRAUMA SYSTEMS I ,".....i"'.\'.)."........ ' I IDE I CERT # 113788.~~.~a~~~~tf]l:~pi..es; 06/30/2009 I " I v' Gr~gJ~~~~\}\ ....., I ~ I 81~ \iol'isr\!el!~lt<. ", I ~ I Ash'ani1Ql.t~l~~~\, " .,' .' Ii I The individual named,~bove!lIjd~~~9rib~~('ln.the rl;)verse of, this card has I:s!,g completed the require~f1ts set\t~t'Ih:in;OR~:6112 etsea. and is certified as I a~n Emergency Medical TeChniCi!\W~J~~$0~~Velif1dicated. I I ~ I 4189 I I This certificate is the property of the Department of Human F7 7' 3 7' 0 Grant HigginsQn in'strator ' Services and must be surrendered by the holder on demand. , " I Office of Community Health & Health Planning, EMS Director I AUDIT NO. ' EMT -Pa Greg I C HT:69 Wf: 180 May 23, 2007 Department of Human Services - Health Services EMERGENCY MEDICAL SERVICES. 800 NE Oregon Street Ste. 607 Portland, OR 97232 . (971) 673-0520 . Pax (971) 673-0555 Robert C Cockell II 2101 Dead Indian Memorial Road Ashland OR 97520 Below is your new Oregon-certified EMT -Paramedic certification card which expires 06/30/2009. ~ 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: http://www.oregon.gov/DHS/ph/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 ofEMTs, 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 QFQREGON - - - - - -I-STATE OF OREGON - DEPARTMENT OF HUMAN SERVICES- I EMERGENCY MePICAJ.;:,TeCHNICIAN I EMERGENCY MEDICAL ES & TRAUMA SYSTEMS ~':'.-',:; ".::" - '.:.,.';.";"-:: I ..... "i'i>'.. I IDE ION I CERT # 123943 .~~~~a~~0f~ii:EXpl;~s;Q6/30/2009 I ~ I l0 ROb~~t~~Oi:ke,ll;*1 I ~ I 21 O~';d~dl~diaJi~eniiJrili( alllill I ~ AslllandOR975.2Q.,' '" I '. ...... ......... I~ I The individual named~bovfl.al)dde~.l:ri!)ed 9nlhe r~"erse of this card has 1:!l,E completed the requirements set fo'fth irl ORS 682 etseQ. and is certified as : r;:,"OYM";~"''''~;''4'~l~'t"' ~'"'''''' : 4213 I Grant Hlgg~rator I ~:~~:~~~~e,:,~:::~o::e%~~~~~:::~~: ~~~~:~~d. 7 7 3 4 8 I Office of Community Hea~h & Health Planning, EMS Director I AUDIT NO, ---~ :1' May 23,2007 Department of Human Services - Health Services EMERGENCY MEDICAL SERVICES. 800 NE Oregon Street Ste. 607 Portland, OR 97232 . (971) 673-0520 . Pax (971) 673-0555 William J Earl 115 Nunan Street Jacksonville OR 97530 Below is your new Oregon-certified EMT -Paramedic certification card which expires 06/30/2009. 4 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$lO.OO. 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: http://www.oregon.gov/DHS/ph/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 prograrns. Again, welcome to the team. ---------------1 STATE91:.,PfWGON I EMERGE~CV"'MEPlcAj:i.~~HNICIAN /::~'." .":;;~:-"::",'l;};-;',~ I CERT # 128504 ,,:#~;~ft5~~~i~~~rr~!;~6/30/2009 II ~ Willi'OiiJ. ~ ~~~e:J:hle,'Q' .;;,(i," .H I! The individual named~'ab~~~:a~k \'.;~~tfie re."~rse of this card has II! completed the requi~em~~ts'$~~f,<,. , . :~~:6~2 ~r'5eq. and Is certified as .e a~n. Eme.rgency Medical Te~r:~I~I,a9'~!'~~~Vell~~"cated. I ~...,...,::.:.. I I Grant HlggtnsQn tnlstrator I Office of Community Heanh & Health Planning, EMS Director -.... STATE OF OREGON - DEPARTMENT OF HUMAN SERVICES EMERGENCY MEDICAL ES & TRAUMA SYSTEMS IDE ION EMT -Pa . William HT:73 WT: 185 4233 This certificate is the property of the Department of Human 7 7 3 2 8 Services and must be surrendered by the holder on demand. AUDIT NO. May 23, 2007 Department of Human Services - Health Services EMERGENCY MEDICAL SERVICES. 800 NE Oregon Street Ste. 607 Portland, OR 97232. (971) 673-0520. Fax (971) 673-0555 CurtJ Formolo 1883 Valley View Medford OR 97504 4 Below is your new Oregon-certified EMT-Paramedic certification card which expires 06/30/2009. 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: http://www .oregon.gov/DHS/ph/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 progran1S. Again, welcome to the team. JJ'-' 1- - - - - STATE OF OREGO;:; - - - - - -I~STATE OF OREGON - DEPARTMENT OF HUMAN SERVICES - EMERGENCY~EPICAI-J1:CHNICIAN I EMERGENCY MEDICAL $~~"I(;;ES & TRAUMA SYSTEMS I IPENl'!FICATION I" I~ I~ 0> I~ I~ I I 4195 I This certificate is the property of the epartment of Human 17' 17 ";L rt,' 4 Services and must be surrendered by the holder on demand. I;'; ~) . . I CERT # 118901 . El\lT.Pll.ramedie.E~pires; 06/30/2009 v'~ Curt J Fonnolo 1883 Valley View Medford OR 97504 EMT-Parame"ieCEill.T # 118901 Curt J Formolo . The individual named above anddes~tibedon the reverse of this card has completed the requirements seUorth in ORS682 ~ and is certified as an Emergency Medical Technician tltthelevel indicated. ~~ Office of Community Health & Health Planning, EMS Director AUDIT NO.. I ,E 0;'- OREGON-- D-EPARTME~~(;F HUMAN SERVIC~~ I ERGENCY MEDICAL ES & TRAUMA SYSTEMS I IDE I!!!C EMT .Par I ~Bii Justin D. ' ,,- IgCD ~ BT: 71 I iF!= WT: 220 1~C":t /' ,8711 S nature Ie Holder ~te is the property of the Department of Human 8 0 2 5 5 ""s and must be,~rrenderecl by the hokIe, on demand, AUDIT NO. 'a # STAT5QE.qElEGON EMERGE~CY~J:PI.cA....,.'...L... ....T.. ...E..........c. . HNIC...'AN I CERT # 13170SE~Plll'.~if.E~Pi..lis:09/24/2008 '. "';'i:". Jus~~.Di/ .. ~ ."d~ 3i:f ,~~:~, ~L m dW I completed the reqUi~erii",llts~iIO' " ". , A6~2 ~ and is ce....as an Emergency Medical ~~nlda~ ~1~l!!~vell!1l1lcated. &9 "'. ~ Grant HigginsQIl iniSlrator OffICe of Community Health & Health Planning, EMS Director 'f. ""'" May 24, 2007 Department of Human Services - Health Services EMERGENCY MEDICAL SERVICES. 800 NE Oregon Street Ste. 607 Portland, OR 97232. (971) 673-0520. Fax (971) 673-0555 Matthew E Freiheit 492 Thimbleberry Lane Ashland OR 97520 Below is your new Oregon-certified EMT -Paramedic certification card which expires 06/30/2009. 4 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$10.00. Please be aware that you are required to be familiar with the Oregon administrative rules pertaining to your certification. These rules are available on our web site under rules and statutes at: http://www.oregon.govIDHS/ph/ems/. You will always find the latest information from this office on the web site. We encourage you to use this tool frequently. Some items you will find there other than the Administrative Rules are: Updates from the Director, a list of available classes from the mobile training unit, continuing education requirements for all levels of EMTs, current EMS Update (newsletter), current articles of interest, EMS hot topics, Awards Banquet information, EMS for Children, and a list of staff you can contact in our office for different programs. Again, welcome to the team. 1- - - - - -STATE OF OREGO;; - - - - - -I-STA~ OF OREGON - DEPARTMENT OF HUMAN SERVICES- I EMERGENCY MEPICALTECHNICIAN I EMERGENCY MEDICAL SI;fW1CES & TRAUMA SYSTEMS I I IDENTIFICATION CERT # 121237 EMT.Paramedic Expires: 06/30/2009 : l" Manhew E:Fr~illeit : ~ I ~t~::r~~~;r5io Lane I ~ Ol I I~ I The individual named libolle and deScribed on the reverse of this card has I_Eo completed the requirements set forth In OR$ 682 ~ and is certified as I an Emergency Medical Technician lit the level indicated. I :~~_ 1 EMT-Paramedic CERT 1# 1:~1237 Matthew E Frf.!lheit HT:72 WT: 180 HAIR: Btonlle Hair EYES: Btlle Eyes 7453 $ignliture of Certificate Holder This certificate is the property of the Department of Human 7 8 6 '7 8 Services and must be surrendered by the holder on demand. AnnJT NO. . May 23, 2007 Department of Human Services - Health Services EMERGENCY MEDICAL SERVICES. 800 NE Oregon Street Ste. 607 Portland, OR 97232. (971) 673-0520. Fax (971) 673-0555 Jennifer A Hadden 1313 Mill Pond Rd Ashland OR 97520 Below is your new Oregon-certified EMT -Paramedic certification card which expires 06/30/2009. 4 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: http://www.oregon.gov/DHS/ph/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. 1------------------------------------- STAT~9FOfWGON STATE OF OREGON - DEPARTMENT OF HUMAN SERVICES I EMERGEt,iCY ",EPICAL.:tE<:;HNICIAN EMERGENCY MEDICAL ES & TRAUMA SYSTEMS I ",' ',':'i' IDE I CERT # 124336EMT.Paramedilf~ipi~es: 06/30/2009 " ~ I I I I I I I I 1:J " '5 1:J Cl " o The individual named,,~bove,,;,-,~~d.,d~~qr~b~,d-pn,,~e r~Yerse of this card has ~ completed the requiremerts sllt,~i'lh'lJiORS;ll82 ~tseq. and is certified as :e 'J:'"OY M,di'" """"~"\"""!"~ :",'"., Grant Higg~rator ' OffICe of Community Health & Health Planning, EMS Director Jennifer A ifadiIlm l3l}MiU P&nd Rd ' Ashland OR 97520 HT:12 WT: 143 77346 AUDIT NO. May 23,2007 Department of Human Services - Health Services EMERGENCY MEDICAL SERVICES. 800 NE Oregon Street Ste. 607 Portland, OR 97232 . (971) 673-0520. Fax (971) 673-0555 David C Hanstein 1516 Larkspur Medford OR 97504 4 Below is your new Oregon-certified EMT -Paramedic certification card which expires 06/30/2009. 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$10.00. Please be aware that you are required to be familiar with the Oregon administrative rules pertaining to your certification. These rules are available on our web site under rules and statutes at: http://www.oregon.gov/DHS/ph/ems/. You will always find the latest information from this office on the web site. We encourage you to use this tool frequently. Some items you will find there other than the Administrative Rules are: Updates from the Director, a list of available classes from the mobile training unit, continuing education requirements for all levels of EMTs, current EMS Update (newsletter), current articles of interest, EMS hot topics, Awards Banquet information, EMS for Children, and a list of staff you can contact in our office for different progra111S. Again, welcome to the team. ,- - - - - - - - - - - - - - - - - -,- - - - - - - - - - - - - - - - - -- STATEqEQB~GON STATE OF OREGON - DEPARTMENT OF HUMAN SERVICES I EMERGENC'f~E,PICA"'ll:(;HNICIAN I EMERGENCY MEDICAL ES & TRAUMA SYSTEMS It,.,'>,. I IDE rlON , CERT # 111814 .i~.!"T:~a~a~e~Ic~#Pirt!$: 06130/2009 I '" I D~~'i4~n~~~t~liii' I ~ I V' 15f6L~r$Pllf I ~ I MidforitOR97s04 , i I The individual name(:fjlbO\ie.a~d'~1l~~Hlle~9nlhll r~lIersll of this card has 1__'; completed thll rllquirllmellts Sllt.f~i'thiI10FlS.682 ~ and is certified as I 1;'"" ""'~' t"'21~'~~~\!"o;"""", I I ~.."'''~_ .. .. 1 I OffIce of Community Health & Health Planning, EMS Director I EMT-Pa David C ir HT:74 WT: 245 ~'Q~~ 4186 .. Signaturll This certificate is the property of the Department of Human Services and must be surrendered by the holder on demand. 77373 AUDIT NO. Department of Human Services - Health Services EMERGENCY MEDICAL SERVICES. 800 NE Oregon Street Ste. flJ7 Portland, OR 97232. (971) 673-0520. Fax (971) 673-0555 May 23, 2007 Lance W Menold 7138 Hwy 66 Ashland OR 97520 ~ _...___-. ._~._. _... n_ ________ Below is your new Oregon-certified EMT -Paramedic certification card which expires 06/30/2009. - .._---~_.~--_. ..-.-..- - ~--- - 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: http://www.oregon.govIDHS/phlems/. 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 ~'ff . ul Jocrent progiau.ls. ,- - - - - STATE OF OREGO;- - - - - - -I-STATE OF OREGON - DEPARTMENT OF HUMAN SERVICE~ I EMERGENCY MEDICAL TECHNICIAN I EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEMS I I IDENTIFICATION I CERT 1# 125954 . EMT -Panllnedic · Expires:86I3OJ1809 I.e EMT..paramedk CERT# 125954 I Lance W Menold Ii Luft W MenoId I '" 7138 Hwy 66 III . Astaland OR 97520 -: 'I The indMduaI named above and described on the __ of lhis ClIId has I, ! completed the requirements set forth in OAS 682 AlHQ.. and Is certIlied as .2 I an Emergency Medical Technician at the level Indicated. I I J..c:..... ~ ~ I . Again, welcome to the team. HT:" Wf: 165 HAIR: Blonde Hair EYES: mue Eyes 4221 Signature of Certificate Holder June 5, 2007 Department of Human Services - Health Services EMERGENCY MEDICAL SERVICES. 800 NE Oregon Street Ste. 607 Portland, OR 97232. (971) 673-0520. Fax (971) 673-0555 Richard F Martin 2701 N Keene Way Drive Medford OR 97504 Below is your new Oregon-certified EMT -Paramedic certification card which expires 06/30/2009. 4 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$lO.OO. 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: http://www.oregon.gov/DHS/ph/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. 1- - - - - STAT~qEQFlEGON - - - - - -I-STATE OF OREGON- DEPARTMENT OF HUMAN SERVICES - EMERGEN.CY P.tEPICALTECHNICIAN I EMERGENCY MEDICAL ES & TRAUMA SYSTEMS CERT # 130001 i'~I\f1'.!ar~~ediei~~Pltt!Sl06/30/2009 : " EMT-Pa IDE ION \~ Ri~hjrdF~llrt(!l.> ... I ~ Richard ~:~;~J:~~;~~l])rIVe I ! HT: 72 . . I ~ WT: 200 The individual named~bove af)d ~e~eribeil on the reverse of this card has I 32_0 completed the requireme~ts set !or:!hinQRS682 ~ and is certified as I;,"OYM"." ,.."'".;,,~~."'"' ,"'...., :..., 8 3 7 1 0 Grant Higg~rator I ~~:vr:::a~de,:~:~~:r;::e%~:e~eb~~h:~~~~~: ~~:~~d. nffi,...... ...f f""'""",,,,,,,,...ih, UO<!llth R. I-Ioalt.h Cia......;...... ~UCl: ni.........tn.. I AUDIT NO; May 23,2007 Department of Human Services - Health Services EMERGENCY MEDICAL SERVICES. 800 NE Oregon Street Ste. 607 Portland, OR 97232. (971) 673-0520. Fax (971) 673-0555 Donald R Manning 1392 Litlia Way Talent OR 97540 Below is your new Oregon-certified EMT -Paramedic certification card which expires 06/30/2009. ~ 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$10.00. Please be aware that you are required to be familiar with the Oregon administrative rules pertaining to your certification. These rules are available on our web site under rules and statutes at: http://www.oregon.gov/DHS/ph/ems/. You will always find the latest information from this office on the web site. We encourage you to use this tool frequently. Some items you will find there other than the Administrative Rules are: Updates from the Director, a list of available classes from the mobile training unit, continuing education requirements for all levels of EMTs, current EMS Update (newsletter), current articles of interest, EMS hot topics, Awards Banquet information, EMS for Children, and a list of staff you can contact in our office for different programs. Again, welcome to the team. 1- - - - - STATE OF OREGON - - - - - -I-STATE OF OREGOt{- DEPARTMENT OF HUMAN SERVICES - I EMERGENCYMEPICAL.OtECHNICIAN I EMERGENCY MEDICAL ~I;IjtVIQES & TRAUMA SYSTEMS I. I IDEN'tJFJQ~TION I CERT # 129281E~t-Patll.ltI~icExpihlS: 06130/2009 I.. I DOnld~~~a.l1n!..g I ~ I 139~LitliaWay 1 ~ I Talent OR 91540 I f I. The individual named~boV~and de~Cribed(mthe rl;lverse of this card has I_Bo completed the requirements s$t.foqhinQRS682 ~ and is certified as : :t;""" -" "'~"I~"'''l,!,'!.","II"_d : "30 5ig..... ""'iiII~te H<>Id~ I _"'~_ I =--:::m':..":.~='::=d?l~ 2 2 I Office of Communilv Health & Health PI~nninn FMl': nir~"'nr t EMT -Par. Donald R HT:74 WT: 190 :DI(.P G~ Hair May 23, 2007 Department of Human Services - Health Services EMERGENCY MEDICAL SERVICES. 800 NE Oregon Street Ste. 607 Portland, OR 97232. (971) 673-0520. Fax (971).673-0555 Rod Lacoste 11525 Dead Indian Memorial Road Ashland OR 97520 ~ Below is your new Oregon-certified EMT -Paramedic certification card which expires 06/30/2009. 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: http://www.oregon.gov/DHS/ph/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 differentprog[an~. Again, welcome to the team. ,- - - - - STAT~OEQR~GON - - - - - -I-STATE OF OREGO-;- DEPARTMENT OF HUMAN SERVICES- I EMERGEt'lICy~~pICAL:;1E,!:;HNICIAN I EMERGENCY MEDICAL ES & TRAUMA SYSTEMS I !;"i;:;,,::,\': (. Y , , IDE ON I CERT# 127119 ,i~~,,~af;!!-~~i~:~~pfr~J06130/2009 I CIl c: I I~ I ",' 'Z,~~I~IIt~l;d I ! I The individual named\~bo~~~~1i'~El~rj~~'~n,tiIe rEl'lerse of this card has I! I completed the requireme,rts SEl!f~rt~:ln0'3~682 ~ and is certified as I:E I an Emergency Medical te(:tlniciay~'tI1Eqflvel indicated. I II ~Gr'an t H,'gg l~nSQn'~ ,'n"Slr'ator .' Ci I' This :;;;cate is the property of the Department of Human ~ Services and must be surrendered by the holder on demand. 7 7 3 3 4 I Office of Community Health & Health Planning, EMS Director I AUDIT NO. I I HT:71 WT: 175 May 24, 2007 Department of Human Services - Health Services EMERGENCY MEDICAL SERVICES. 800 NE Oregon Street Ste. 607 Portland, OR 97232. (971) 673-0520 . Fax (971) 673-0555 Brent A Knutson 5830 Havencrest Drive Klamath Falls OR 97603 Below is your new Oregon-certified EMT -Paramedic certification card which expires 06/30/2009. 4 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$IO.OO. 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: http://www.oregon.gov/DHS/ph/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. ,- - - - - STAT~.oFPR~GON - - - - - -I-STATE OF OREGO-;. DEPARTMENT OF HUMAN SERVICES- I EMERGE~Cy~~iJlCA,L;,'fECHNICIAN I EMERGENCY MEDICAL & TRAUMA SYSTEMS I ..............,.i:.i............'....... I IDE I c CERT .1_.:.,j~;~..l'~'1J'I3012009 I ~ I 58~O Hmm~t~t.l)fir~. I ~ I K1~math~!l11$~~.~1?O~:< Ii I The individual named'",bovea~ijde~ibe(l on. the rEtverse of this card has I:!;!.e completed the requirerhents set fOr'!hJrl-OR,S.682 ~ and is certified as i '~~~I"!~l'1!';~II";<'~d i =.::::','0;::':'-",,,:::::;;;: 7 8 8 9 4 I Office of Community Health & Health Planning, EMS Director I AUDIT NO. May 23, 2007 Department of Human Services - Health Services EMERGENCY MEDICAL SERVICES. 800 NE Oregon Street Ste. 607 Portland, OR 97232. (971) 673-0520. Fax (971) 673-0555 Scott M Hollingsworth 3077 E Main Ashland OR 97520 Below is your new Oregon-certified EMT -Paramedic certification card which expires 06/30/2009. 4 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: http://www.oregon.gov/DHS/ph/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 pre grams. Again, welcome to the team. ,- - - - - -STATE 9F013EGON - - - - - -I-STATE OF OREGON - DEPARTMENT OF HUMAN SERVICES - I EMERGE~t>('Mel:J1C"b:tEpHNICIAN I EMERGENCY MEDICAL ES & TRAUMA SYSTEMS I "i'j ;i': ,':: ",';:"":'l. ' I IDE :nON : ~TNlI~:k~~~~~;rn009 l~ =~. I 30'fiE\Mlllli?,:\j'"..,,',:,::,,' I ~ I As~~~nd?R,:. ' :;:::, , ii i. I i I The individual named'~bovl!i'anlf . on, .!lie r~jterse of this card has I :g.e completed the requlreril~ts lie!,fO.. ",s;,aS2 ~ and is certified as : :C~'" __.1 f,,!:~i'il~~l ~_d : I Grant Higg~rator I I Office of Community Health & Health Planning, EMS Director I HT:74 WT:195 4188 This certificate is the property of the Department of Human Services and must be surrendered by the holder on demand, Z:l..~7 1" .11 -'-'---- - May 23, 2007 Department of Human Services - Health Services EMERGENCY MEDICAL SERVICES. 800 NE Oregon Street Ste. 607 Portland, OR 97232. (971) 673-0520. Fax (971) 673-0555 Margueritte L Hickman 1891 Orangewood Dr Medford OR 97504 Below is your new Oregon-certified EMT-Basic certification card which expires' 06/30/2009. 4 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$IO.OO. 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: http://www.oregon.gov/DHS/ph/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 (newslet~er), 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. ,- - - - - STATEOE .OfisGON - - - - - -'-STATE OF OREGO;-. DEPARTMENT OF HUMAN SERVICES ~ , EMER. GE."'" p. V'.~Pt....' 'C. A. 'k. ;:r.....E.'.. P... HNICIAN I EMERGENCY MEDICAL $.....f5.~.........~.>..Y....I...C.:.ES & TRAUMA SYSTEMS I I /~ ,'.: .... .... . I IDEN'gFly~T10N . CERT # 128889E!\ir'''tiis!e'~~P!..ii$;:0(I/~iJr2009 I/\;:r/I;>' I Ql I ",. Maffgn~ri~et> .11' .. I ~ 189J(il:r!lngl!~ ~ I Me~foriAO~'7~~(7ii;' ...... '~~: ~~5 )' The individual namedabo.. Ve,~ry.d......d.'.el.i.'9..ri.b. 89. .' onthe...r~verse of this card has ,'! completed the requirements se\forthin OFl$..662 ~ and is certified as :g , an Emergency Medical Technicia.nalll):elevel. il)9icated. :~~- ... I f"\Hi,..a nf t"'........_.._:... U..._'.L D ..~ _.u...., . _. __ _. [:~ l~ s~: 37;'; 4092 This certificate is the property of the Department of Human 7 7 4 6 6 Services and must be surrendered by the holder on demand. May 24, 2007 Department of Human Services - Health Services EMERGENCY MEDICAL SERVICES. 800 NE Oregon Street Ste. 607 Portland, OR 97232. (971) 673-0520. Fax (971) 673-0555 John T Stoy 955 Grandview Dr Ashland OR 97520 Below is your new Oregon-certified EMT -Paramedic certification card which expires 06/30/2009. ~ 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: http://www.oregon.gov/DHS/ph/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, A wards Banquet information, EMS for Children, and a list of staff you can contact in our office for different programs. Again, welcome to the team. 1- - - - - -STATE OF OREGO;- - - - - - -I-STATE OF OREGON - DEPARTMENT OF HUMAN SERVICES I EMERGENCY MEDICAL TECHNICIAN I EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEMS I I IDENnFICATlON CERT #1118911 EMT-Paramedic Expires: 06130/2009 I I" I John T Stoy ,.c \" 955 Grandview Dr i I I~ Ashland OR 97520 ;;. " The individual named above and described on the reverse of this card has II! completed the requirements set forth in ORS 682 ~ and is certified as :Ii I an Emergency Medical Technician at the level indicated. :~x- I Office of Community Heanh & Health PlanninQ. EMS Director EMT-Paramedlc CERT #I 118911 John T Stoy HT:73 wr: 195 HAIR: Dk. Brown Hair EYES: Blue Eyes 7409 Signature of Certificate Holder This certificate is the property of the Department of Human 7 8 7 ,) 3 Services and must be surrendered by the holder on demand. ,- , AlIDlT NO. May 23,2007 Department of Human Services - Health Services EMERGENCY MEDICAL SERVICES. 800 NE Oregon Street Ste. 607 Portland, OR 97232. (971) 673-0520 . Fax (971) 673-0555 Robert W Stephens 100 Alder Street Phoenix OR 97535 Below is your new Oregon-certified EMT -Paramedic certification card which expires 06/30/2009. 4 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$10.00. Please be aware that you are required to be familiar with the Oregon administrative rules pertaining to your certification. These rules are available on our web site under rules and statutes at: http://www.oregon.gov/DHS/ph/ems/. You will always find the latest information from this office on the web site. We encourage you to use this tool frequently. Some items you will find there other than the Administrative Rules are: Updates from the Director, a list of available classes from the mobile training unit, continuing education requirements for all levels of EMTs, current EMS Update (newsletter), current articles of interest, EMS hot topics, Awards Banquet information, EMS for Children, and a list of staff you can contact in our office for different programs. Again, welcome to the team. 1- - - - - STATE OF OREGON - - - - - -I-STATE OF OREGON - DEPARTMENT OF HUMAN SERVICES - I EMERGENCY ~J:PICAL..TE.pHNICIAN I EMERGENCY MEDICAL ~.~fflMl~ES & TRAUMA SYSTEMS . I IDE"'rl'f"'~TION CERT # 123787 . EMT-..ara.medicExpires: 06130/2009 I Q) Ro~~~\V~t.llli~e"s I i 100 Xlder Street I ~ PhOenixOR97535 . Ii The individual named .abov$al)d ~eS!:rlbed on the reverse of. this card has 't:l completed the requirements set,fot1hlnORS 682 ~ and Is certified as l:e an Emergency Medical Tectlniclarjatthe..tevel inllltated. I ~.!Ic- : OffICe of Community Heanh & Health Planning, EMS Director I May 23, 2007 Department of Human Services - Health Services EMERGENCY MEDICAL SERVICES. 800 NE Oregon Street Ste. 607 Portland, OR 97232. (971) 673-0520.. Fax (971) 673-0555 David G Shepherd 3775 Coleman Creek Rd Medford OR 97501 Below is your new Oregon-certified EMT -Paramedic certification card which expires 06/30/2009. t 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$lO.OO. Please be aware that you are required to be familiar with the Oregon administrative rules pertaining to your certification. These rules are available on our web site under rules and statutes at: http://www.oregon.gov/DHS/ph/ems/. You will always find the latest information from this office on the web site. We encourage you to use this tool frequently. Some items you will find there other than the Administrative Rules are: Updates from the Director, a list of available classes from the mobile training unit, continuing education requirements for all levels of EMTs, current EMS Update (newsletter), current articles of interest, EMS hot topics, Awards Banquet information, EMS for Children, and a list of staff you can contact in our office for different progranls. Again, welcome to the team. ,- - - - - STATE OF OREGON - - - - - -I-STATE OF OREGON - DEPARTMENT OF HUMAN SERVICES - I EMERGENCYMEI'ICAL.TE(:HNICIAN I EMERGENCY MEDICAL ~~f!~!PES & TRAUMA SYSTEMS I . I IDEN~FIQ;4TION I CERT # 123197JJ:MT.Para.l1iedicE~plres: 06/30/2009 I Ql I ,., Da*i~(;S~~~hc.;tJ I ~ I 3775'ColemaitCr~elc Rd I ~ I M~dford OR 97501 . I f I The individual named~bOv$al)dd~~(:ribed on. the reverse of this card has 1322 completed the requirements S$t forthinOR$682 ~ and is certified as : ~"M"." T"h".">t""(i>ol'''''',,"' : I Grant Higgi~rator I I Office of Community Health & Health Planning, EMS Director I HT:72 WT:175 ,",., 4209 This certificate is the property of the Department of Human 7 7 3 5 2 Services and must be surrendered by the holder on demand. AUDIT NO. . May 23, 2007 Department of Human Services - Health Services EMERGENCY MEDICAL SERVICES. 800 NE Oregon Street Ste. 607 Portland, OR 97232. (971) 673-0520. Fax (971) 673-0555 Dana S Sallee 170 BrierWood Dr Talent OR 97540 Below is your new Oregon-certified EMT -Paramedic certification card which expires 06/30/2009. 4 '..._ '.~_'._.,. _."..u.....--------'-_"~ '~" ,;..;....,.....__............;~__~_..i\.;.,~_._,~'-...:...- 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: http://www.oregon.gov/DHS/ph/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 Jiffei tht. pi ugl a1l1~. ...----...-...-........-. Again, welcome to the team. 1- -- -- STATE OF OREGON - - -.- - -I-STATE OF OREGON - DEPARTMENT OF HUMAN S~~V.;~~S I EMERGENCY MEDICAL TECHNICIAN I EMERGENCY MEDICAL ~~4~ES & TRAUMA SYSTEMS I I IDENtiFl'ftTION . : CERT # 1163~:n.:::~:aramediC Expires: 06130/2009 \ io ~:.~-;~\t..!~~~.tV":f*tt~~ji, I 170'Brierwood Dr I I 1<' Talent OR 97540 . I j I The individual named above and described on the reverse of this card has I ~ completed the requirements set forth in ORS 682 ~ and Is certified as :!:! I an Emergency Medical Technician at the level indicated. I ~X- : I 0fIlce of Community Health & Health Planning. EMS Director I I HT:72 Wf: 200 Signature of':certlflcate Holder 4191 This certificate is the property of the Department of Human Services and must be surrendered by the hOlder on demand. '7...1.-3<6 8 May 23, 2007 Department of Human Services - Health Services EMERGENCY MEDICAL SERVICES. 800 NE Oregon Street Ste. 607 Portland, OR 97232. (971) 673-0520. Fax (971) 673-0555 Derek A Rosenlund 642 Wilson Road Ashland OR 97520 Below is your new Oregon-certified EMT -Paramedic certification card which expires 06/30/2009. 4 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: http://www.oregon.gov/DHS/ph/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 f.or Children, and a list of staff you can contact in our office for different prugrams. Again, welcome to the team. 1- - - - - STATE O;-OREGON - - -- --- - -1- S~~~E OF OREGO-;- DEPARTMENT OF HUMAN SERVIC~ I EMERGENCY MEDICAL TECHNICIAN I EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEM: - I I IDENTIFICATION I CERT # 121067 EMT-Paramedic Expires: 06/30/2009 I ., I Derek A Rosenlund I i I ,,~ 642 Wilson Road I ~ I Ashland OR 97520 I i I The individual named above and described on the reverse of this card has 1:22 completed the requirements set forth In ORS 682 ~ and is certified as I an Emergency Medical Technician at the level indicated. I I Q~ I 4203 I ~ I This certificate is the property of the Department of Human Grant HigginSQn .inistrator Services and must be surrendered by the holder on demand. "c I Office of Community Health & Health Planning, EMS Director I A,mt'Nq;' EMT-Paramedic: CERT # 121067 Derek A Rosenlund HT:73 WT: 202 HAIR.: Dk. Brown Hair EYES: Bille Eyes (/) W(/) O~ -LW ~~ W(/) (/)>- z(/) << ~~ ::J::J ::c~ u.~ Oocsz ~(/)O Zw- W ~ li: ~ W...Jw 0<0 ,0- zO OW C)~ W>- a:o Oz u.W oC) wffi ~~ I-"W (/) ltl =-'" \C- ~~ . BUll PBllOP 6uOl8 PlOI ".,....---------- z c( 2 UlUl 111111 .c.'C '0'" B~ .!!~ =.~ o-g "'III i,,~~ '" 'i", '6N~' '<:'~- . Q'rh' ~ '.', /O.lt'" ;1 'g ;\1 z o C)" If, W.,..l,I'P crr <(""ii! ~(~((" 0\1:1<\: ~\;~': :cc ~ < " ,,~, ~ '\;' w.:. CJ a: w :::lE w ';-'-~i~\~~~:t' ':i,J .-u ,*,;i;j: . ::,-;~:r"':;. \:;::1 ~i, ~:t~~ ':;.!~! ':~.l!! ;ic' .8 j:F .!!!:'E "iii :o"C ~ .2 ~'S 'i ~ ~~ ~ 2i g ~-g ~ "C'Q)CD .5 a. E "'EW .c.o<: 1-0111 :-:.'\" - \C ltl = ... - 'II: t= f;r;l V ~~ ..... .~ ~ N if:',.g O'\~ lJ::'... -< 'Ii C:i ~~ " a - ... II 2lli CDS ~j o~ t~ ~" ..." li~ .fa ! J!!1: ;:: i! : .n i!:~ 6 1:5 l!! C rn ::; w cii <: 'c <: III ii: E III CD ...::t: ~oll i~ .e~ ~ 'c <: ::I gE " E -g8 :Eo Efl ,~F May 23, 2007 n Department of Human Services - Health Services EMERGENCY MEDICAL SERVICES. 800 NE Oregon Street Ste. 607 Portland, OR 97232. (971) 673-0520. Fax (971) 673-0555 Marshall G Rasor 2500 Lindley Way Klamath Falls OR 97601 Below is your new Oregon-certified EMT -Paramedic certification card which expires 06/30/2009. 4 , ...--....".,--..,_...--..._"-_._~-_._- .....~--~-~------...,-------..-.-.- --."- .-...~_.-~._...-..., .._"...... .-.-..... ~- __~_ ...-__.__.."'_' _ ___ _". ._~._.__'k.._.._..._, .__,.___,_,..'..__..____.~_..__..._ 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$IO.OO. 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: http://www.oregon.gov/DHS/ph/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 proglams. .---.--.-....- -------------.- .-----.----------------------.. .-------------'--- ------.-------- Again, welcome to the team. 1- - - - - STATE OF OREGON - - - - - -'-STATE OF OREGON - DEPARTMENT OF HUMAN SERVICES - I EMERGENCY ~PICAL/rECHNIClAN I EMERGENCY MEDICAL ES & TRAUMA SYSTEMS I - ..- I IDE ON_ I CERT# 126969 .!~."Ilt.~it ExpirClS: Q(j130/2009 I.. c I I~ M.rl~." q Ras,O~ ~ I 2socH:.lilCUey Way I 0 ," Kllmat1l. Falls()J{"7~1 g. I The individual named above ar,dde~ QIl the reverse of this card has I ~ I completed the requirements set forth in. ORS 682 etHg. and Is certified as l:e I an Emergency Medical TechniCial).ll.t tl1eleVel indicated. I ~ 'lk:riIo .. I Grant Higgl~~~in~trator I I Office of Community Heafth & Health Planning, EMS Director I 0:. 4226 Signature This certificate is the property of the Department of Human Services and must be surrendImKJ by the holder on demand. ?ul~.3 5 February 2,2007 Department of Human Services - Health Services EMERGENCY MEDICAL SERVICES. 800 NE Oregon Street Ste. 607 Portland, OR 97232. (503) 731-4011 . Pax (503) 731-4077 Shannon W Turner PO Box 4 Phoenix OR 97535-0000 Below is your new Oregon-certified EMT -Paramedic certification card which expires 06/30/2009. 4 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: http://www.oregon.gov/DHS/ph/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. 1- - - - - STATE OF QREGO;:;- - - - - - -I-STATE OF OREGON- DEPARTMENT OF HUMAN SERVICES EMERGENCy"[jCAl..t~CHNICIAN I EMERGENCY MEDICAL cES & TRAUMA SYSTEMS ....... ..' ........ '., .... ...... .... I IDE ION CERT# 126208 EW-p~r~~~~:e.iE~pir~~06/3012009 I" c: I~ I~ C> I~ The individual named ab()vs'ancl d~dbec:tonthe .reverse of this card has I J2 completed the reqUirements.sstfort~in<i>I'IS 58? ~ and is certified as ,g an Emergency Medical Technician at the]evel indicated. I 1 I I 0' f7 r~\ {) (~ l- i "-.,. !..~ C " ~": Shanfto!l WTurner PO Bo.:J.4 . Phoeqj~x OR ,9753>0000 This certificate is the property of the Department of Human Services and must be surrendered by /he holder on demand. AUDIT NO, June 14,2007 Department of Human Services - Health Services EMERGENCY MEDICAL SERVICES. 800 NE Oregon Street Ste. 607 Portland, OR 97232. (971) 673-0520. Fax (971) 673-0555 Robert A Trask 415 Nugget Drive Rogue River OR 97537 Below is your new Oregon-certified EMT -Paramedic certification card which expires 06/30/2009. 4 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: http://www.oregon.gov/DHS/ph/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. r-- - - - - - - - - - - - - - - - - - -,- - - - - - - - - - - - - - - - - -. STATE qFOREGON STATE OF OREGON - DEPARTMENT OF HUMAN SERVICES I EMERGEt,leYM~f)IC~;rECHNICIAN I EMERGENCY MEDICAL ES & TRAUMA SYSTEMS I c..f .... ",,""0 I IDE' CERT # 130008Ei\tt~P~;;fu~tntl)l;ip(~~~96/30/2009 I ./ I" ,. c: I \0 Robett~t",sk,.. : I ~ I 41SNII~_erDrive '.' .,' , ,~ Roglle IljverQR~7~~7;...r I . ./ "...... .. . I ~00l "', , ::,';;,..-',>""':c.,,'-" \U I The individual named'Elbov~aridi:l~.~pri~Elp.9n.llie reyerse of this card has I 31_0 completed the requirements setf?l'Iti(:lhOR~',6a2 ~ and is certified as : '~'''''M'''''~' T""".;"'''\Il~.''' ,,""""'<1. : I Grant Higg~rator I I Office of Community Health & Health PlanninQ, EMS Director I HT:69 WT: 225 10632 Signature ate Holder This certificate is the property of the Department of Human 8 2 1 1 0 Services and must be surrendered by the holder on demand. AUDIT NO; May 23, 2007 Department of Human Services - Health Services EMERGENCY MEDICAL SERVICES. 800 NE Oregon Street Ste. 607 Portland, OR 97232. (971) 673-0520. Fax (971) 673-0555 Todd C Stubbs 715 G St Jacksonville OR 97530 Below is your new Oregon-certified EMT -Paramedic certification card which expires 06/30/2009. 4 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: http://www.oregon.gov/DHS/ph/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 progranlS. Again, welcome to the team. ,- - - - - STATEpF OREGO;; - - - - - -1- STAT-; OF OREGON - DEPARTMENT OF HUMAN SERVICES - I EMERGENCY MEOICAL.:TECHNICIAN I EMERGENCY MEDICAL $,; , ES & TRAUMA SYSTEMS I 'IDE :T10N I CERT # 1302771;1\rt.Pat~!UedictIpir~s: 06/30/2009 ., .. EMT -Parlli(;)!l\IlT #,'ri30Z'i7 , I~ ,<, To4dG.$tllbbs " Todd C sm ....., , 7150St . I~ , Jac~onville 0&<<11530 Ii 'The individual named aboVe and described on the reverse of this card has I J2 completed the requirements set forth. in ORS682 ~ and is certified as .g , an Emergency Medical Technician at the.levellndicated. I I k 'JI1-,n" I --. ""_d"" """-","""" 7 7 3 1 9 I _"";';"~I_ . I __ ""m~"'_"'''_M _"'. .. I Office of Community Health & Health Planning, EMS Director' AUDIT NO. HT: 74 . t; Brown Hair WT: 200 . . . teen J!;yes /2,,)i~ 4242 /. Signature of Certificate Holder Agent Wilson Heirgood Associates 2930 Chad Drive Eugene. OR 97408-7382 This certificate is issued as a matter of information only and confers no rights upon the certificate holder other than those provided in the coverage document. This certificate does not amend, extend or alter the coverage afforded by the coverage documents listed herein. Named Member or Participant City of Ashland 20 East Main Street Ashland, OR 97520 Companies Affording Coverage COMPANY A - City County Insurance Services (CIS) COMPANY B - National Union Fire Insurance Company of Pitts, PA COMPANY C - RSUI Indemnity This is to certify that coverage documents listed herein have been issued to the Named Member herein for the Coverage period indicated. Not withstanding any requirement, term or condition of any contract or other document with respect to which the certificate may be issued or may pertain, the coverage afforded by the coverage documents listed herein is subject to all the terms, conditions and exclusions of such coverage documents. Type of Coverage Certificate # Effective Expiration Limits Date Date General Liability 07LASH 71112007 7/1/2008 General Aggregate $3.000.000 X Commercial General Liability Each Occurrence $1.000,000 X Public Officials Liability X Employment Practices X Occurrence 07LASH 711/2007 711/2008 General Aggregate None Each. Occurrence $1,000,000 Auto Physical Damage X Scheduled Autos X Hired Autos X Non-Owned Autos 07 APDASH 711/2007 711/2008 Property 07PASH 07BASH 711/2007 711/2007 7/112008 7/112008 er Filed Values B C Boiler and Machinery Excess Crime er Filed Values Excess Earthquake Excess Flood Workers' Compensation cription: Jackson County is named as additional insured per the agreement made between Jackson County and the City of Ashland Ivlng Ashland Fire & Rescue the exclusive right to provide ambulance service in ASA #3 effective through midnight, December 31, 010. Jackson County 10 South Oakdale, Room 214 Medford, OR 97501 CANCELLATION: Should any of the coverage documents herein be cancelled before the expiration date thereof, CIS will provide 30 days written notice to the certificate holder named herein, but failure to man such notice shall impose no obligation or liability of any kind upon CIS, its agents or representatives, or the issuer of this certificate. ertlficate Holder By: ~-,t2... - -4 Date: Sept. 13,2007 SAFETY NATIONAL CASUALTY CORPORATION EXCESS WORKERS COMPENSATION INSURANCE BINDER NAME INSURED EMPLOYER: ADDRESS: POLICY NUMBER: TYPE OF INSURANCE: LOCATION(S}: POLICY LIABILITY PERIOD: CITY OF ASHLAND 20 EAST MAIN STREET. ASHLAND. OR 97520 SP -1S87-0R Specific Excess Workers' Compensation and Employers' Liability Insurance OREGON July 1. 2007 through July 1. 2008 This is to certify that the above named Insured Employer is covered by Specific Excess Workers' Compensation and Employers' Uability Insurance by the CORPORATION. Maximum Limit of Indemnity Per Occurrence Employers' Uabillty Maximum Umit of Indemnity Per Occurrence and Aggregate $ $ $ $ 600,000 400,000 STATUTORY Self-Insured Retention Per Occurrence for Code 7539 Self-Insured Retention Per Occurrence for All Other 1,000.000 Premium Rate $0.174 per $100. of Payroll Minimum Premium for the Liability Period Deposit Premium for the Payroll Reporting Period $ $ 22,155 22,155 This binder Is effective July 1,2007 to polley Issuance and is subject to all the terms and conditions of, and shall be automatically terminated and superseded by, the Excess Workers' Compensation Agreement and Employers' Liability Insurance Agreement when issued. Issued at St. Louis, Missouri, on June 29, 2007. SAFETY NATIONAL CASUALTY CORPORATION ~ R.. rYj~ By: Gene R. Maier, Senior Vice President of Underwriting 2043 Woodland Parkway Suite 200 S1. Louis MO 63146 314-995-5300 fax 314-995-3843 XWC 1004 001101 Endorsement Schedule RE: CITY OF ASHLAND Polley No: SP -1S87-OR Effective Date: 12:01 A.M. July 1. 2007 Number XWC 0036 01 0902 XWC 0098 00 0395 XWC 0236 00 0593 XWC 0288 00 0898 XWC 0467 02 1105 XWC 0528 01 0105 XWC 0823 00 0301 XWC 1061 050106 Title OREGON WORKERS' COMPENSATION ENDORSEMENT OREGON CANCELLATION ENDORSEMENT VOLUNTEER EXCLUSION EMPLOYERS LIABILITY PER OCCURRENCE & AGGREGATE MAXIMUM LIMITS OF LIABILITY EMPLOYERS' LIABILITY MAXIMUM LIMIT AND AGGREGATE MAXIMUM LIMIT OF INDEMNITY SELF-INSURED RETENTION PER OCCURRENCE PREMIUM DUE DATE ENDORSEMENT FOREIGN TERRORISM ENDORSEMENT CITY OF A.SHLAND Memo DATE:05-01-2008 TO: Cindy Hanks CC: Barbara Christensen, City Recorder FROM: Greg 1. Case, Fire Dept - Division. Chief RE: Renewal of City of Ashland Ambulance Operator License Fee Cindy, I received a note from Barbra Christensen that a check must accompany our Ambulance license renewal. Could you do an inter-departmental transfer or Check for the Ambulance Licensing Fees From the EMS account # 110.07.13.00.604160 to the City of Ashland accounts receivable. It needs to be included in the renewal Application for Ambulance Operators License that includes are the required certifications and documentation required by the AMC 6.40. Keith has sent the Memo to Martha and a Council Communication requesting ambulance license renewal and is scheduled for the May 6th council meeting. As in the past the fees and bond have just been charged to our budget - let me know if this is still correct. Should you need any other information please let me know and I will get it to you as soon as possible. Thank you! Ashland Fire & Rescue 455 Siskiyou Blvd. Ashland. Oregon 97520 www.ashland.or.us Tel: 541-482-2770 Fax: 541-488-5318 TTY: 800-735-2900 rA1 From: To: Date: Subject: Cindy Hanks Greg Case 5/2/2008 2:22:33 PM Re: Ambulance renewal fee This works great and we will get this done. Thanks Cindy >>> Greg Case 05/01/2008 5:12 PM >>> Cindy, attached is the request memo for Ambulance Licensing fees. Thanks for your help! let me know if you need anything else! Thanks again!! Greg Greg I. Case Division Chief / Training Officer Ashland Fire & Rescue 455 Siskiyou Blvd. Ashland, OR 97520 541. 482.2770 www.ashland.or.us This e-mail is official business of the City of Ashland, and is subject to Oregon public records law for disclosure and retention. If you have recived this message in error, please notify me. >>> Barbara Christensen 5/1/20084:20 PM >>> Greg, I spoke to Cindy Hanks and she said that if she could get written permission from your department to transfer the fees that would work. Please cc me on the transfer request so I can include it in the packet we keep on file. Also, I have all the electronic files but the cover sheet that has the original signature needs to be sent to my office to keep with the file. Thanks! Barbara Barbara Christensen City RecorderlTreasurer City of Ashland Ashland OR 97520 (541) 488-5307 PUBLIC RECORDS LAW DISCLOSURE This is a public document and is subject to the Oregon Public Records Law. Messages to and from this email may be available to the public. cc: Barbara Christensen P