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Home My WebLink About2009-072 License - Ambulance Operators 1 CITY OF ASHLAND APPLICATION FOR AMBULANCE OPERATOR LICENSE AMC Ch. 6. 6.40 2009 Applicant's Name: CITY OF ASHLAND . Trade Name, if any: ASHLAND FIRE & RESCUE Address: 455 Siskiyou Boulevard Ashland OR 97520 Teleohone number: (541) 482-2770 Ambulance descriDtions Manufacturer Vin# License # 1. 1992 FORD LIFELINE 1 FDKE30M7PHA05945 EXEMPT 2, 1998 FORD LIFELINE 1FDXE40F2XHA00469 EXEMPT 3. 1996 FORD LIFELINE 1 FDKE30F8THA48282 EXEMPT 4, 2002 FORD LIFELINE 1 FDXF4 7F63EA 10341 EXEMPT 5, 2006 FORD LIFELINE 1FDXF47P06ED06467 EXEMPT 6. 2008 FORD LIFELINE 1FDXF47R48ED90832 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. /J~ Signature: ~c::x--<-- Print name: Greg I. Case Title: Division Chief Date: 05-08-2009 H:\AmbuJance Iic\City Licensing\2009 lic\2009lic renewaL doc April 1 0, 2009 CITY OF ASHLAND Memo DATE: 05-07-2009 TO: Cindy Hanks CC: Barbara Christensen, City Recorder FROM: Greg I. Case, Fire Dept - Division, Chief RE: Renewal of City of Ashland Ambulance Operator License Fee Cindy, It is time once again for our ambulance renewal and 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 the required certifications and documentation required by the AMC 6.40, the Chief has sent the Memo to Martha and a Council Communication requesting ambulance license renewal and is scheduled for the June 16th 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 Fa" 541-488-5318 TTY: 800-735-2900 ~~, [(sin/ioo-g) Barbara christensen - Re: Payment -lor renew-aF6tCity Ambulan'ce'Operator's License -Page 111 , From: To: CC: Date: Subject: Cindy Hanks Greg Case Barbara christensen 5/8/2009 1:37 PM Re: Payment for renewal of City Ambulance Operator's License Yup.., We take care of it. Thank you for all the information, Cindy >>> Greg Case 05/07/2009 4:03 PM >>> Memo DATE: 05-07-2009 TO: Cindy Hanks CC: Barbara Christensen, City Recorder FROM: Greg I. Case, Fire Dept - Division. Chief RE: Renewal of City of Ashland Ar:nbulance Operator License Fee Cindy, ' It is time once again for our ambulance renewal and 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 the required certifications and documentation required by the AMC 6.40. the Chief has sent the Memo to Martha and a Council Communication requesting ambulance license renewal and is scheduled for the June 16th 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 soo,"! as possible. Thank you! Attached is a copy. Greg L Case Division Chief / Training Officer '\ Ashland Fire & Rescue 455 Siskiyou Blvd. Ashland, OR 97520 541. 482.2770 WW'N.ashland.or.us This e-mail is offidal business of the Oty 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. City of Ashland ANNUAL REPORT 2009 Vehicles/ EQuipment Level *as of 01-01-09 VEHICLES MILEAGE TYPE LEVEL Unit # Year Model License VIN# ALS/BLS Shop # Ford 8831 2006 Lifeline E233465 I FDXF4 7P06ED06467 53,932 I ALS 552 F - 450 4X4 Ford 8832 2008 Lifeline E244368 I FDXF47R48ED90832 4,818 I ALS 615 F - 450 4X4 Ford 8833 2002 Lifeline E222273 I FDXF47F63EA 1034 I 103,410 I ALS 462 F - 450 4X4 Ford 8835 1998 Lifeline E2II465 I FDXE40F2XHA00469 126,829 3 ALS 364 E-450 4X4 Ford 8834 1996 Lifeline EI98560 1 FDKE30F8THA48282 114,671 3 ALS 283 E-350 4X4 Ford 8836 1992 Lifeline EI8695I I FDKE30M7PHA05945 88,857 3 ALS 133 E-350 4X4 ORo:GON DEPARTMENT OF HUMAN SERVICES EMERGENCY MEDICAL SERVIC!;;S & TRAUMA SYSTEM AUOIT NO_ CI:RTlrrG^IION NUMllIiR: 12563 . 80[)0 1993 Ford P^YMENT RECEI....ED EllPlRAl10N DATE MO. DAY YR. E186951 AMBULANcE IVl'E': 06/30/2009 .. AMBULANCE L1CENSE-_~()_~~!I'l_~~!=_I'lC:,v_"" "", r -.-.- - -'-'-'-'-'~ - - - -,- - - - - - -.-.- - i , , , ; , , , ; ; , , "~'~-~"""-'-'-'''''''''''''''''=''''"",'''''''"'_'_'''"'_'_''-''-'_'_,___._.___,_.____'-__,___._.~...,&,&._._,J City of Ashland #1501 455 Siskiyou Blvd Ashland OR 97520 ADMINISTRATOR STATE HEAtTH DIVISION -MUSTBE"POSTEDIN A CONSPICUOUS pLACE'" NOT TRANSFERRABL'E OREGON DEPARTMENT OF HUMAN SERVICES EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEM AUOITNO cErniFICATICiN NUf.@iR: 12566 80.00 1"198560 1996 Ford liAYMENT RECEIVED EXPIRATION OATE MO, DAY YR A~,1FlUI-ANCE TYPE: AMBU~ANCE LICENSE - POST IN AGENCY -----.- -.-,... -'-"-'-.-.-------.-----...'" -',....'".-:.~ :..--,-,;...._--,_.-._._,_._._.~,,,.'-.,;;,-,_._.. [)6/:l0/2009 City of Ashland #1501 455 Siskiyou Blvd Ashland OR 97520 ; I , , I , , ,""'- -'-'-'-.-.-.-.-.-,-.- _ _'_'_'_'_'_'_'_ ..,~'" '-,_.J AbMINISTRATOR STATG HEALTH DIVISION , i.._._.___ _.___,_,_._._._._ _._,~.".o,.,._ MUST-BE POSTED IN A CONSPICUOUS PLACE - NOT TRANSFERRABLE OREGON DEPARTMENT 01' HUMAN SERVICES EMERGIiiNCY MEDICAL SERVICES & TRAUMA SYSTEM AU01T NO CERDF1CATIQN NUM~H~ 12567 80.00 E2i 1465 PAYMENT RECEIVED EXPIRAnoN bAn' MO. DAY YR. AMBULANCE TYP(' 1999 Ford _ AMBUL!'\,fIICE LICENSE ~ POST IN AGENCY '-'-'-'-'-'---'-'---"" -,-,_,_,_,_,___,_,___,_,_,c;,_,_,___,_,_,_"""-,_-",-,,,_,_,_'_____._._.___, , . , , ; , 06/30/2009 City of Ashland #1501 455 Siskiyou Blvd Ashland OR 97520 ,_..;.__.c;,_._.""",:.".~."_,,,,-;;;.,-.__,_._ ; " ---'-'-'_--'-'_'~'*''''''''':'';'';'''-'''--'-'-'--_._._._.;...,,,,__._;,-,1 ADMINISTRATOR .STAfF. HEALTH DIVISION MUST BE POSTEo IN A CONS'PICUOUS PLACE - NOT TRANSFGRRABLE OREGON DEPARTMENT OF HUMAN SERVICES EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEM AUDIT NO 15211 80.00 CERTIFICATION NUMBER E244368 PAYMPH RECEIVED EXPIRATION DATE MO. DAY YR. AIIIl3ULANCE TYPE: ;W08 FORD 06/30/2009 AMBULANCE LICENSE - POST IN AGENCY i -:"'-.-.-,';.--.-.-----.-.-.-.-.-.-.-.-.-.-.-.-,---.-.-.-__________'________0.__________;___;___', : city of Ashland #1501 i i I j 455 Siskiyou Blvd l i Ashtand OR 97520 : I. i j i I i .._,_._._:_;~....;_,,,:""'_,_;._,_,,_;-'._.-',_._,_,___,_,_,_,".___,,......,_,_,_,_,-'..'-,.:..-'.,-'-_=-.'-_-'_"-.___._.J ADMINISTRATOR STATE HEALTH DIVISION MUST BE POSTED IN A CONSPICUOUS PLACE - NOT TRANSFERRABLE OREGON DEPARTMENT OF HUMAN SERvicES EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEM AUDIT NO CEnTlFlCATlON NUMBER: 12572 80.00 E233465 PAYMENT RECEIVED EXPIRATION DAre MO. DAY YR. AMSUlANCE TYPE' 2006 06/30/2009 AMBULANCE LICENSE ~ POST IN AGENCY [,"',:';'''''''''''''''''''':''."'''''''''';--''-''''----'-'-'-'-;-'-'-'-'""'-0..-'-''-"'-'=''---'-'-''''''-''-';::''--;:;'';':;::'-''-'-'1 : City of Ashland #1501 : ! 455 Siskiyou Blvd : i Ashland OR 97520 i i j j i I i L_,_.___._._...;.-,-,_"..,.....,-,-.-""""".""",.;.,,,,,,,,,,,,,,,,..,,,-,_.,'-.,.;;.,_,_-_,_,_._,_____._,________._,-'-._,_._.1 ADMINISTRATOR STATE HEALTH DIVISION MUST BE POSTED IN A CONSPICUOUS PLACE -' NOT TRANSFERRABLE OREGON DEPARTMENT OF HUMAN SERVICE-S EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEM AUDlTNO. CEr1TlFICATlON NUMI:JI:.H: 12570 80.00 E222273 PAYMENT RECEIVED EXPIRATlON DAn; YO, DAY YR. AMRU1ANCIi TYPE. 2002 Ford __AMBULANCE LICENSE-:: POSTI/IIA(;~NCY r- -, ~.- -.-.- - -.- -.-.-.-.-.- -.-.- - - - - - - - - - - - - - - - -.- - - -.-.- -'-'---'-'. I i , , I I I i i ! I ..-'.=."'.....,=,.,,'-'.-.-.-,'-.-.-.--.-.-.-.-,-,-,-'"""-.-.-.-.-.-.-.-.-.------.-,-,-,-.-'---,=."""''''"j 06/30/2009 City of Ashland #1501 455 Siskiyou Blvd Ashland OR 97520 AOMINtSTRA TOR STATE HEALTH DIVISION MUST BE POSTEO IN A CONSPICUOUS PLACE ~ Not TRANSFERRABLE 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 -2H42-0R Specific Excess Workers' Compensation and Employers' Liability Insurance OREGON July 1, 2008 through July 1, 2009 This is to certify that the above named Insured Employer is covered by Specific Excess Workers' Compensation and Employers' Liability Insurance by the CORPORATION. Self-Insured Retention Per Occurrence for code 7539 Self-Insured Retention Per Occurrence for All Other $ $ $ $ 600,000 400,000 STATUTORY Maximum Limit of Indemnity Per Occurrence Employers' Liability Maximum Limit of Indemnity Per Occurrence and Aggregate 1,000,000 Premium Rate $0,174 per $100, of Payroll Minimum Premium for the Liability Period $ $ 25,960 25,960 Deposit Premium for the Payroll Reporting Period . This binder is effective July 1, 2008 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 Sl. Louis, Missouri, on June 20, 2008, SAFETY NATIONAL CASUALTY CORPORATION ~ R.. ?11~ By: Gene R. Maier, Senior Vice President of Underwriting 2043 Woodland Parkway Suite 200 SI. Louis MO 63146 314-995-5300 fax 314-995-3843 28it~ll~~Y!!!Yl!n~~fa[i!~.I~~rvi~!f:,'7{~= ' "--_'0 ~; :'GE~'1TIF.IGf,l.:l!E(0F.I..G0.vER:4:.GE' - '. -. .,;>~ .' - -; ?..:;;"Z '_~, - ~.: " - ":';"f3e2n!?JP~ Agent This certificate is issued as a matter of information only and confers no rights upon the DIRECT 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. Companies Affording Coverage Named Member or Participant COMPANY A - City County Insurance SelVices (CIS) City of Ashland COMPANY B - National Union Fire tnsurance Company of Pitts, PA 20 East Main Street COMPANY C - RSUllndemnity Ashland, OR 97520 ~CO.VERAGES~1i't;};r:1,l:giL~.l"i);~.'"'~ . -:lE~~::f'j~~';S. ,,', :,:,.-_::-,-,-7;;";,,,,, - ''-.'Iii;:';';''::';:' 'f;''''.i.\W~~ 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 alf the terms, conditions and exclusions of such coverage documents. CO Type of Coverage Certificate # Effective Expiration Limits LTF Date Date A General Liability 08LASH 71112008 71112009 General Aggregate $15,000,000 X Commercial General Liability Each Occurrence $5,000,000 t Public Officials Liabitity ~ Employment Practices X Occurrence I-'-' A Auto Liability 08LASH 71112008 71112009 General Aggregate None I-,-, X Scheduled Autos Each Occurrence $5,000,000 ~ Hired Autos ~ Non-Owned Autos A Auto PhYSical Damage 08APDASH 71112008 71112009 I-,-,- X Scheduled Autos t Hired Autos .!. Non-Owned Autos A .!.J Properly 08PASH 71112008 71112009 Per Filed Values A XI Boiler and Machinery 08BASH 71112008 71112009 Per Filed Values B Kl Excess Crime 08CASH 71112008 71112009 Per Loss $250,000 C ~ Excess Earthquake C ~ Excess Flood A W Workers' Compensation pescription: Jackson County is named as additional insured per the agreement made between Jackson County and the City of Ashland J!:jiving Ashland Fire & Rescue the exclusive right to provide ambulance service in ABA #3 effective through midnight, December 31, 010. erlificate Holder 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 Jackson County such notice shall impose no obligation or liability of any kInd upon CIS, its agents or representatives, or the 10 South Oakdale, Room 214 issuer of this certificate. Medford, OR 97501 By: ~V2. 4 Date: July 2, 2008 First Level Last Name Name MI EXDires EmDI 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 ~J1Y. 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 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 Garfa.s-knowles Ronald W EMT -Paramedic 6/30/2009 PFT Knutson Brent A. EMT -Paramedic 6/30/2009 PFT LaCoste Rod T. EMT -Paramedic 6/30/2009 PFT May Ashley L 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 APPLICATION FOR AMBULANCE OPERATOR LICENSE 2009 r May 23,2007 Department of Human Services - Health Services EMERGENCY MEDICAL SERVICES 8 800 NE Oregon Street Ste. 607 Portland, OR 97232. (971) 673-05200 Fax (971) 673-0555 WaIt 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 rul~s 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 contactin our office for different programs, Again, welcome to the team. 1- - - - - STATE OFOREGO;:;- - - - - ,-- -I-STATE OF OREGO-;T- DEPARTMENT OF HUMAN SERVICES - I EMERGENc'{i.lEOICAC.TECHNICIAN \ EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEMS 1<-'" ... IIDENTiFiC~TtON . CERT # 11248S,EMT~Ba:Sic:.~F;xpir~s:,06/30/2009 . '".' I .'. .... ....... I. EMT-B.sicC~il'l'#Ii24~5 I '" Walt:LAnders I~ . WaltLAndefs,,-:;:,,~r '", .:.::;' I 23 Wiiscin:R~ad " l.g :._;.-_~.' "j-:.~; .,' II Th, Indwld,,' n~::~'~b:::r::::crlb~d on th' reverse of this card has I I 10 ~: ~~8 . .:,~~:::~~;:,~~~~~r. completed the rS(]lIlrenlenls iiet fOrth -il ().=l:- ;"'l~ elm and h 'f~ilip,1 ~'J _ an .:,',,"r; 0 ~' . . . ;,'J n";;c.r \. . . ~ ~n~'" Grant HigginsQn minlslralor This certificate is the property of the Department of Human 7 7 Li. 9 5 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 StreetSte, 607 Portland, OR 97232. (971) 673-05200 Fax (971) 673-0555 . . Todd E Beck 21 Anna Laura Dr Jacksonville OR 97530 4 Below is your new Oregon-certified EMT -Paramedic certification card which expires 0,6/30/2009. 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; E~.-1S for Childnm,.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 OREGO~ DEPARTMENT OF HUMAN SERVICES- I EMERGEN.Cy'ME:oicA)::;TECHNICIAN I EMERGENCY MEDICAL SEl'IVtCES & TRAUMA SYSTEMS ~- '\0;'" __- u'-. '_'.I,,' _. ,,,,,-.'-'.....,- I .-!',.... ,:C~',c"<...,'.( I IDENTIFICATION I CERT# 124333, ,,;,~,~T~;ai:imedi~-~.~.~r.tf~,,;:;,'.~6/30/2009 ,;1:. 't-" ::-..~-.~: . . '_'-,C. I ell EMT-Pararne(tic__::-c::,~~T_#:;:t243J3t'.~.. . II i~ J;aloC~ks"~o'~n'~v!L,;el:.al~e~to~~R";~9::~7':'5:":3"0 .~ ~..:'" .'~';';"'.' '. II i Todd E BeW?;:,,';",' '0'}5fi';" , _:' ;...:j . . CD HT: 73 "_'!IIAiR;__D,IC:,B~fo~l1Hair II The Individual named:abo~~,':~~':di~'t:;ib~:d on. th'~ reJ~rse of this card has II! WT: 215 ':'r<;:.~*.~.::~J~,~,:~~:~'.:": ;:;:- ",,'mpfeled th'"! r9quiremen\~'";-'!llortli'in OAS 68'2 fl!.r:>". ,mo;s r"'rtifled <'1<: ~ ./?y '!"W. . = -~:"ll :( ) ~, th,. h \ , ' (,~"~ .., GrantHlgginsqn mlnlstralor I' This ~rlificate is the property of the Department of Human 1 e b ':i 3 Services and must be surrendered by the holder on demand. .. TlnT'T' !'Jf' 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 PBoyersmith 1110 La Lorna Dr . Medford OR 97504 Below is your new Oregon-certified EMT-Paramedic certification card which expires 06/30/2009. 4 onmn-" _,_....... _.,~ ---Please review yourcertific-aie carefully. Ifthere 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 st';cure 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 f\lIes 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 ofEMTs, current EMS Update (newsletter), current articles of interest, EMS hottopics, Awards Banquet information, EMS for Children, and a list of staff you can contact in our office for different program3:----------.----.-'-'-...--..------ .----- - ------- ------ Again, welcome to the team. r - - - - - STATE OF ORE GO;; - -, - - - -I-STAT~ 0-;- OREGO;-- DEPARTMENT OF HUMAN SERVICES - I EMERGENCY';,fEOicAbTECHNICIAN I EMERGENCY MEDICAL SEBVIe:ES & TRAUMA SYSTEMS I '" ,," ;. . ,,>" " I IDE ":'"'":"JIDN I CERT# 120378~~t-_~~~~fu.dICEXpi~~~;~613012009 I. I Ste,yi~:':~~~r~.~iw,i~h' .... :."" I ~ I". 1110--UaLo"irta Dr:'. ," .:; , I ~ I M~dfor~ -6~ '?:7~p':,~: >--:':"' I i I The Individual named';aboJe.a~~::d~~trjbed-~nJhe rev~rse of this card has I"" completed the requirements set'.Jonh~'i/"l .cRS 682 ~ and is certified as ~ . I an Emergency ,\J.~dif:nl Technir:i~n":<l.t:lh,f.Ll.e';et imlic"fE'd. " ~ '.. '" EMT-Pal1 Steven P ""., ir HT: 71 WT: 170 I Grant Higg!nson\y..~infslrator Office of Community Health & Health Planning, EMS Director - ------,-----~ I SeN/ces and must be surrendered by the holder on demand. l.ulT~,5 9 May 23, 2007 Department of Human Services - Health Services EMERGENCY MEDICAL SERVICES (I 800 NE Oregon Street Ste. 607 Portland, OR 97232.. (971) 673-0520 ..Pax (971) 673-0555 Kelly W Bums 2691 Mickelson Way Ashland OR 97520 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 inunediately 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. r - - - - - -;'TAT~E,OREGO;- - - - - - -I-STATE 07 OREGO;- DEPARTMENT OF HUMAN SERVICES - I EMERGENCYMElliCAI;TECHNICIAN I EMERGENCY MEDICAL SERVIGES & TRAUMA SYSTEMS 1<> . . ;.!", '....... c.. ". '. I IDEN!IEi9~TION . III CERT # 1202~:il;!:T;::;:;medi: Expire.",06/30/2009 Ii ~o: ~~I~ -~~"~~~!~r~i~T'~';ft~2~i,\., 2691'Mickelso_~__War _":>>, ... .-: , If Ash.lan~ 'O~::~..i~~~c::". :< . II ~_oo~ ~~: ~~o .'.".;.-~...;','~.~'.'.'~.:~.',"..'.'.',YE.'.,..'..ffi..,'.',~.'.s.,..,;.iD.'B..'.'.j.'u..:'.'.:':..':,'_:.;,..:o,:.y;."~.e.'..,.,.\..H...' ..,..,~ir The individual named'~bo~-e~'an:d'.~~~'c.t-jbe~:'(m:.;lie reverse of this card has ~ _. ,:__ _ ~ completed the requirements seUol1:h:in'ORS.682 f'J~seQ.... and is certified as ." , ! flI1,r:rr'=':f1Anr.y \flf!rll('"ITE'~h,,'(i;l"-2i 11 '""_1:'1 ii"';: l:, ,.- ..~ ~~~~ ~~gjl~~~~._". .~,l~~~:~a~o:, This certificate is the property of the Department of Human 7 7- .~ e 0 Services and must be surrendered by the holder on demand. ~ 0 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 Greg I Case 816 Voris Avenue Ashland OR 97520 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: EllJergency 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 .e1I' f"F.eront nrogr~~o U.L..L V.l -.f:iJ. 0.111>:). Again, welcome to the team, 1- - - - - -;'TATE OEOREGO;- - - - - - -I-STATE 070REGO;:;-- DEPARTMENT OF HUMAN SERVtCES- I EMERGENC'tM'EDic-lil:;TECHNICIAN I EMERGENCY MEDICALSERVIGES & TRAUMA SYSTEMS I ~/<;~~~:;"._:3f~~~'is~;;~~')~;,:.;., . I ~/IDE~t~!'~1TIO~~~~_ I CERT # 113788 fEMT..P:iramcdic~,E~pir'es:06/30/2009 I f.::,.".:\,y,.. \{:; - ~{,: __'.~.,:~;f:.;-g,., : '" ~~i~~~ii~Al:'.ltt{,:;tr,~";,\:' :t ~~; ~p~~1rJ~~ltl~;}~~~~~0' I Ashland Q~':!)7.~2Q-:'~J':i.'"',;::",:,< .-"f, I g> HT: 69 . ::,,~~';i;iIA[R~.Dk-:Brown',Hair I The individual name~:'Y1bO~e:;~~~_~~~~;?~~~\~:;h:~ r~?~rse of this card has I ~o \Vf: 180 "~i:J,f~t~)\:~~~rfi~.~ti~,~J~lf" completed the requiremeflls set.!orth"in,Of:!S-6B2 ~r"seo. and is certified as _ -:";.::.-:.' """-'~.!::'" '., -,"'." I 'l,,;\Emergp -'I f 1 dic;! T",~h;' -;:.fl -,'I ~ I~v, ll~d_ Gran';~igginSQn~~ministrator Office of Communltv Health & Health Planninn_ FM'<: nl",,"'nr I S;;:Vi~;;;'~~d;';~;i'b;~;;~;;d;~~d-b;th;h~id~;~~'d~'~~'~d. II j 10 .1 .t.l1nl'l'Nn_ ,- May 23,2007 > Department of Human Services.- Health Services EMERGENCY MEDICAL SERVICES" 800 NE Oregon Street Ste. 607 Portland, OR 97232 0 (971) 673-0520 ..Fax (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. 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 itelTis 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 progTams. Again, welcome to the team. 1- - - - - STATE OE.OREGO;:;- - - - - - -I-STATE OF OREGO;- DEPARTMENT OF HUMAN SERVICES- \ EMERGENCYM"E:iiicAGTECHNICIAN I EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEMS : CERT # 123943'~~'i~;~;i~it1~~ti~:i06/30/i009 1.:)}{.:~~N~rfl%t~~;i\ : \,'<....,'.....,....... ' i~ EMT-Parame~;<"GJ;:~T#123943" I ~~:'~:~~~~~i1~~~~~,~~~":: if ~};;~\1~: FIn ~mU'l , 1::" Medic,,1 .....,ctlr,il:r~.... at in,) I.' . ;'l.:lir:"It (, .., . ..... .' , Gran-t.~lgginSQn\\a.~mjnistrator Office of Community Health & Health Planning, EMS Director '''"....''''''''~'''.,.''''''''''~OVI.'"'''yv'"'''/JC'IJ<'''''''''''.<JI''<''''.,,' "' .-, .{ 4, till SeNices and must be surrendered by the holder on demand. ! f oj g AUDIT NO. May 23,2007 Department of Human Services - Health Services EMERGENCY MEDICAL SERVICES s 800 NE Oregon Street Ste. 607 Portland, OR 97232" (971) 673-0520" Fax (971) 673-0555 CurtI 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 $10.00. Please be aware that you are required to be familiar with the Oregon administrative rules pertaining to your certification. These rules are available on our web site under rules and statutes at: http://www.oregon.gov/DHS/ph/ems/. You will always find the latest information from this office on the web site. We encourage you to use this tool frequently. Some items you will find there other than the Administrative Rules are: Updates from the Director, a list of available classes from the mobile training unit, continuing education requirements for all levels ofEMTs, current EMS Update (newsletter), current articles of interest, EMS hot topics, Awards Banquet information, EMS for Children, and a list of staff you can contact in our office for different programs. J.J~' Again, welcome to the team. 1- - - - - STAT~OE OREGON - - - - - -I~STAT~ 07 OREGO;:;, DEPARTMENT OF HUMAN SERVICES' 1 EMERGENCYMEDICA.lTECHNICIAN I EMERGENCY MEDICAL SE.RVICES & TRAUMA SYSTEMS I' .' .... ........, I IDENtIFi~ATION . I CE~T# 118901 ..:'E:~l.T-.p'ar:~rri~d~~'-E,i:pi~es: ~.6/3012009 I III <',_ '. ':-: ":':. ; ',' ", I . 1 ~ EMT-Paralr1edic:,.C~RT #.'.118901. 'Cu~t"~.:F()r,T:~li' . ~ 'CurtJ Fo"rrn4h>':": ,;: I 1883ValleY'View - . . 1.8 .- -< "'.: . ,: . ":" I MedforiO~ '9750,4 : I_.~ HT: 73 "~." -:_~AJ~:,pii'Bro~~n I:I.air . i. The individual named',abo~e ani:ld~~6ribed:on'th~ reverse ollhis card has I"" WT: 185 :/""""'::.:.J1'~,'7"~_S.'_:.'~...r,oo.w~~n.:,~.'"",'y~?.' completed the requJrementsse{lcrth~in'_OR.S-:682 ~ and is certified as ~ ,.. _ ,/"/,,,:\;, 'In Emergency Medical T9chnlcinn' 'It 't.he 'e';"",l jfl(:i~:1,?j , . ! "" ( Gran-t-~jgginSQn\,y..~mlni$lrator Office 01 Community Health & Health Planning, EMS Director I S~~~~;~~d-;;~~-b~-s~~dd~~;d-bYlhe'h~id~~~~'d;~~~d. I I :) {!~, .1 AUDIT NO.' --' :". l STATE.QFoOREGON EMERGENCY MEDICAl'TECHNICIAN ..J;:~,.. ...;:;_~~>~;:::;:~~';..;",:~">';~ CERT # 131705 /EMT~psi~@;dfi:,,'Ex'pif~'::06l3012009 .', ....., '''.' '-":;'.~''- ....,}.:,:.: ~~," \\ -.,~.., ,.' ~,;~~t~t~i~!t;~,a~'YC.:, The Individual named:aboVe_arid:~~rib.id:on~ttie reVerse of this card has I completed the reQuirems,:,ts sat}~i1Ii.:in~OR~.:682 ~ and is certified as I an Emergency Medical TeCn~,I.~~a~~\nte~,t.~~~Y\dicated. lew~-,"""'"'' ..' I Office of Community Hea/tt1 & Heahh F'tannlng. EMS Director I m 1__ -- - - ,- - ---- ---- -- -- -- I I I. ii I~ a I~ I~ I I I I I '-..-' ---- .., STATE OF OREGON - DEPARTMENT OF HUMAN SERVICES EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEMS IDENTIfiCATION " ,- ,;.~;~\\+~ jrr~ '~:~::, .~;-::~;;/~t~:: EMT -ParD~~~~t::C;~.RT ~:\'.'t3(70~_\':' ;";~1.r Signatur~~~cate Holder o This certificate is th8 ptopetty of the Department 01 Human Services and must be summdered by the hoIderon demand. 80637 AUDIT NO. May 24, 2007 on 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 stahftes 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. 1- - - - - STAT;-OF OREGO;- - - - - - -I-STATE OF OREGON- DEPARTMENT OF HUMAN SERVICES I EMERGENCYMEOICALrEcHNlclAN 1 EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEMS I" .: ........ ... 1 IDENTIFICATION CERT #.121237 . E.~'f,~,~.~~~~~_~~ic, Ex~ire~: 06/30/2009 .1 ~ I. I Matthew E,' F~~itieit : I ~ I 49~'r~iintileb.e~ry_J"ane 1 ~ Ashland b.~'9_752Q . I ".' . If The ir,cli"idual named Rho':,,, '~:\nI1 de'3,~rihp.rl nn lr.? reV9rsn of this card has ._ I f'ornrl~ < r h~ ,-~'qLlife'l '- ), ["I'j . - r . ! I' ~11'lii;",..r , EMT-Paraf!l~~ic ~t.RT # 121237 Matthew KFrelheit.;. . .. .\'." HT: 72 WT:180 . _~A.~.:' ~Io~d~ Hair ,:'~YES:'Biu~ Eyes ~~ 78t"7~. This certificate is the property of the Department of Human n n May 23, 2007 Department of Human Services - Health'Services EMERGENCY MEDICAL SERVICES e 800 NE Oregon Street Ste. 607 Portland, OR 97232 G (971) 673-0520.. Fax (971) 673c0555 " 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/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, 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- - - - - STAT~OF 06EGO;- - - - - - -I-STAT~ 07 OREGO~ DEPARTMENT OF HUMAN SERVtCEE I EMERGENCY'~EDIC:ALi'ECHNICIAN I EMERGENCY MEDICAL SE8V.ICES & TRAUMA SYSTEMS : CERT # 124336fJ~~r~t~~:~i~~~~!?es: 06/30/2009 : . . }:,I,~~N;rl~19}TI~~" ;.' '_:' ":..:.' ::....,";,:_:,..'._ "",:",.' ,...~: '"c'; l:: EMT-Param~dl_c_,:CF:RT -#::12433,6:.,:' : '":;i~!~r;tp~::u~", . . ," . : j Jennifer Aij~~'~'1;:f:,'<,c~~;'~W' I AshlandOR975,~0' ".,'. 1 g HT: 72 ('.l...".'....HAIR. ...: UBio",." H..a.lr. cO'.', '." ~ WT: 143 "",:J;YEt'1H;m'i-W'f'" 1 The Individual named .above_:'a~d, de,scdb~~h;lIi;Jhe re:verse 01 this card has I. ~o ,./ . _.."T~._,.;)" ,1'---:. - < '-"c;'.;': completed the reqlJiram'en. Is set.fnrlli' hi OR..S,682 at- <:..n and is certified as ~ J' ,11'1 I . ~ e- - / ,".:> 1 I " C11' - . Ii""';" \. j. "...,.,'hnit'j., ..,~ 1.;'1",1 ,,;.t ( """'" ..~ ~~~nt H!9pinsQn ._ ~!nI~t~!or. Ims cerrnicatfJ IS tm:rproperTy or me ueparrmenr or Human Services and must be surrendered by the holder on demand. /'1546 May 23, 2007 Department of Human Services..:.. Health Services E}\1ERGENCYMEDlCAL SERVICES e 800NE Oregon Street Ste. 607 Portland, OR 97232.. (971) 673-0520 o 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 inunediately 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$10.00, Please be aware that you are required to be familiar with the Oregon administrative rules pertaining to your certification. These rules are available on our web site under rules and statutes at: http://www.oregon.gov/DHS/ph/ems/. You will always find the latest information from this office on the web site. We encourage you to use this tool frequently. Some items you will find there other than the Administrative Rules are: Updates from the Director, a list of available classes from the mobile training unit, continuing education requirements for all levels ofEMTs, current EMS Update (newsletter), current articles of interest, EMS hot topics, Awards Banquet information, EMS for Children, and a list of staff you can contact in our office for different prO~lams. . Again, welcome to the team. ,- - - - - STATE OEOREGO;;;- - - - - - -I-STATE 0-; OREGON- DEPARTMENT O~UMAN SERVICES - I EMERGE~CY'iIIE!iiCA,t,TECHN1CIAN I EMERGENCY MEDtCAL s!'iB.YI9ES & TRAUMA SYSTEMS I ..... .'. ..---''',. I IDENTIFICATION.,;. I- ~W~~~~Jit~1~':.',i",f':: HT: 74 The individual named"~bove:_a~a',ge~,Cr!tj~d:pn~_th'e re;;ierse of this card has WT: 245 completed the requlrem~.nts set.-Jor:th.",in_ 0135.682 ~ and is certified 8.$- ! . an Emergency Medical Tr.r.I-,rif'h"'l"81 'P13Iew!; 101;;; ~",.' . ~ Grant HigginsQn\y..~mlnistralor nt/i..." nl ('"mm, ,n;l" >4",,,11,, R. 1-I.."lIh 01"",..,;"" I:Uc;:, n1.~~.^, S;;W~~;'~~d~~;t'b;~;';~;d;~;d-b;;;;;hojd~~~~'d;~-;;~d. . II j f J May 23,2007 Department of Human Services- Health Services EMERGENCY MEDICAL SERVICES I) 800 NE Oregon Street Ste. 607 Portland, OR 97232 e (971) 673-0520 e 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 $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. 1- - - - - -STATE OE,OREGO~ - - - - - -I-STATE OF OREGO-;- DEPARTMENT OF HUMAN SERVICES - I EMERGENCY'MEOICii.btECHNICIAN I EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEMS ' i ",:m'-;~j~~i~~~"" il =;~m~~ij~i~~ I MedforijOR9?504.;.:::j/".X:: ~ I ~ HT: 6S."iiHArn~'Li:'Bi~W,n'Hair .J ,\ \..':;~">i:':_:~;;;;"::;:',-:~: ",":." :::' i: I] WT: 165 f:';":'->'~EYESrG~~e'~:Eye'1','_~ I The individual named:above.~arjd.~es~.ribe~ on llie r51verse .)1 this card hDS ,; ." -. . completad I~A requireli18 II;: set fanh in '):=:8 :" ~'L~if'J], '. ~ - " ~~'r!iFi'! ':: ....{;'", ,",i I "1i', ~~'>J ,.....~_,. tt__,____ . n'",' " !:is certifica:e is the property of the Department of Human 7 7 .4 h t:. May 23, 2007 . Department of Human Services ~ Health Services EMERGENCY MEDICAL SERVICES e 800 NE Oregon Street Ste, 607 . Portland, OR 97232.. (971) 673-0520 .. Fax (971) 673-0555 Scott M Hollingsworth 3077 EMain 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$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 r11 f'~eront p-r...... rrrn ill ~ .............:.L ..'-' I.. .l......sJ.(.O..! J..:t. Again, welcome to the team. ------------------- ,- - - - - -;'TATE O;-OREGO;- - - - - --, I EMERGENc'f!IIEOicAGTECHNICIAN I I .,f';";:,,,:-,"c}',\. I I CERT # 113607 '/'~'I~t~~a:t~~~,~~l>c::~~~p~ti;~~' ~.6/3012009 1 GJ ! '^ !~tr~~~~i;:~o~~e}~'!t'] i i I The Individual named'<;ibOVE.:,~~d~?~,.~gri.D.e_d'pn,>t/ie r~verse of ,this c~rd has -0 completed the requlreme!1ts seq~ttj.n;0I7,~;:a82 ~ and 15 certified as []2. I an..Emerl')onI;Y M(>dkal technir.i8.:1 ~J th~.t~',pl indicated. . I , STATE OF OREGON - DEPARTMENT OF HUMAN SERVICES EMERGENCY MEDICAL ?.FB'l!\iES & TRAUMA SYSTEMS IDENJIFI9.ATION " it.:;.~:_;,:;:, ;r~':'.~~~_'f~~};':f~b; EMT-ParAm~_~:jf);~~J!T' ]t{~.07j.t:,~~,. Scott M HoUip~~f'Q~t.til " . .~t ." :;;;;;'fll,.w Grant HigginsQn\Ja.Yministrator Office 01 Cammunlty Health & Health Planning, EMS Director I SeNices and must be surrendered by me nalaer an aemallu. I. "' r1j T Aui'lrpN1). U '"----" ~ I I I CERT # 131871 I I I . The IndMduaI named above and - described on the reverse of this card has I completed the requirements set forth in ORS 682 m...sA. and Is certified as \ .~~;;2~"hJ;~. 'I' Ql!lceol...........IhSysOems S1a1e......HeaJlhOllloa< ,~.. -.--- . STATE OF OREGON - DEPARTMENT OF HUMAN SERVICES I EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEMS I IDENTIACATION I. Ii I~ Ii I~ I I I I STATE OF OREGON' EMERGENCY MEDICAL TECHNICIAN EMT -Paramedic Expires: 0613012009 Ronald W Garfas--Knowles 14690 Hwy 66 . Ashland OR 97510-0000 . '-' , '-' EMT.Paramedie:.CERT k 132871' Ronald W Ga~as-Knowles' HT:70 Wf:170 HAIR: EYES: ~~~ 1316 Signature of Certificate Holder I 0 - __....._oI..._ofHumBn 750 / 5 SeMces and musI be sunend6ted by the holder 011 d8m8nd. AUDIT NO. May 24, 2007 on Department of Human Services -Health Services EMERGENCY MEDICAL SERVICES 0 800 NE Oregon Street Ste. 607 Portland, OR 97232 co (971) 673-0520 '"Fax (971) 673-0555 Brent A Knutson 5830 Havencrest Drive Klamath Falls OR 97603 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: o 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 feeof$lO.OO. Please be aware that you are required to be familiar with the Oregon administrative rules pertaining to your certification. These rules are available on our web site under rules and statutes at: http://www.oregon.gov/DHS/ph/ems/. You will always find the latest information from this office on the web site, We encourage you to use this tool frequently, Some items you will find there other than the Administrative Rules are: Updates from the Director, a list of available classes from the mobile training unit, coritinuing education requirements for all levels ofEMTs, current EMS Update (newsletter), current articles of interest, EMS hot topics, Awards Banquet information, EMS for Children, and a list of staff you can contact in our office for different programs. Again, welcome to the team. \ 1- - - - - :STATE OF,OREGO;; - - - - - -I-STATE OF OREGO;- DEPARTMENT OF HUMAN SERVICES' I EMERGENCY'MEiiICA~JECHNICIAN I EMERGENCY MEDICAL sgRVICES & TRAUMA SYSTEMS I'~..,.. ..,;" 1 IDEr-!f!fl~~Tio~." I CERT# 130961 ';:'~Ml'~.Pa:~.a:t:~~~f:~~~!~~S:,~6/30/2009 [~ ",'::~'''.:,.:,_ '~: '''~''~:'~_:'':''C~:~:~):> : ' . :;;g~1~~~';~;r~~;vlC' .... .: " : i ~~:;~~~~ft~~t~;~r'i~'~~1f,t\~;'r I . KI~,mat.~ t~il~ig,~~:,~.I~,~3.:<..._:;. to' . If HT: 65 ,-:/ -,'_~::$_ui:.'DlLij{;Qwn Hair 1 :~~~~~~d~:~ ;:~f,~~~~~:~~~o~~'f;i~~~~~~e.~e;:q~:n~ i~i;e~~;'~dh:: I ~ WT: 15~';:0H~'};;~~fKe~N t an Fn' n!ne', ~,1-! 1:;'~!T'ldlf'i~'<J' -~tt'1' I,. Il,f. I ,.~'7 ,.-, ..~ Grant HlgginsQn mlnlstrator _"'__ _. ~___.._"... .__..~ G . .__".. nl___:_~ ",..Q nl.^~,~. I ;;;~i~;;'~;d-;;~sWt'b;~-;';~;d~~~d-bY th;h~id~~ ~~. d;;;;;~. I (j () )J !} . 1 AUDIT NO. May 23, 2007 Department of Human Services - Health Services EMERGENCY MEDICAL SERVICES fJ 800 NE Oregon Street Ste, 607 Portland, OR 97232 0) (971) 673-0520 ~Fax (971)673-0555 Rod Lacoste 11525 Dead Indian Memorial Road Ashland OR 97520 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 ofEMTs, current EMS Update (newsletter), current articles of interest, EMS hottopics, Awards Banquet information, EMS for Children, and a list of staff you can contact in our office for different prOtl~i1ilS. Again, welcome to the team. 1--- - - - - ~TATEOEOREG6;:;- - - - - - -1- STAT~ OF OREGON - DEPARTMENT OF HUMAN SERVICES - I EMERGENCy'MEoicAI2rECHNICIAN I EMERGENCY MEDICAL SEIWICES & TRAUMA SYSTEMS CERT # 127119 I . c I~ l~ a I~ I~ I . an Emergency Medical TeqhnJcI~ifa't.the:levellndlcaled. I ~;:.~1. :.;:"iH -~'--, - I q '. i" ... /. '" ' ~. HT:7I \VT: ] 75 Office of Com~u~ily Health & Health Planning, EMS Director AUDIT NO. '",," '------------------1------------------- STATE OF OREGON STATE OF OREGON - DEPARTMENT OF HUMAN SERVICES EMERGENCY MEDICAL TECHNICIAN I EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEMS I IDENTIFICATION I. Ij I~ If III I I 1 I I '-../ r-.-,.T #I 132690 EMT-Par~medlc .E~pires:,0613012009 '--" '"---" Ashley L. l\1ay.' " 240 Suncrest Rd #15. . Talent OR 97540' ~ EMT-Paramedlc':CERT#:.jiz69'O' . AshleyL. Ma>:,;:.",<,,:~,",> . ;.:<>>:;-;;~ HT:68 WT: 130 ""..", . '.. ',"HAIR:'LL:Bnhvn ,.c..",- :"EvES:" Bfue',":,>~:"- 11857 This certificate Is 1M property Of 'he Department of Human 8 0 1 0 2 Stmrlcfi and must be surrendered by the hokJer on demand.. AUDIT NO. May 23,2007 Department of Human Services - Health Services EMERGENCY MEDICAL SERVICES e800 NE Oregon Street Ste. 607 Portland, OR 97232.. (971) 673-0520.. Fax (971) 673-0555 Lance W Menold 7138 Hwy 66 Ashland OR 97520 Below is your new Oregon-certified EMT-Paramedic certification card which expires 06/30/2009. 4 Please review your certificate carefully. Ifthere 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 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 --diffcrent-progla1115. . Again, welcome to the team. 1- - - - - ~TATE OF OREGO;- - - - - - -I-STATE OF OREGO-;- DEPARTMENT OF HUMAN SERVICE~ I EMERGENCY MEDiCAL TECHNICIAN I EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEMS I I IDENTlACATlON I CERT# 125954 . El\IT~Panlmedi.Eiplr~;1l613012009 I. I Lance W Menold I ~ I lo 7138 Hwy 66 I ~ Ashland OR 97520 01 .1 The IndMduaJ named above and described on the reverse of lhis card has I ~ I completed the requirements set forth in ORS 682 ~ and is certified as I ~ I . an Emergency Medical Technician at the level (ndlcated. I ~ , EMT-Paramedic CERT # 125954 Lance W Menold HT:69 W1':165 HAIR: Blonde Hair . . EYES: Blue Eyes 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 Marshall G Rasor 2500 Lindley Way Klamath Falls OR 97601 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$IO.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 d;ffcl C11t p, OS1 a,ll~,m ______n....__________n ------------------- . ----------------,...-.---- ----.---- Again, welcome to the team. 1-"--- - - - STATEOF OREGON" - - - - - -I-STATE OF OREGO-;- DEPARTMENT OF HUMAN SERVICES - I EMERGENCY M'FP1CALlECHNICIAN I EMERGENCY MEDICAL %EJi'lVICES & TRAUMA SYSTEMS I .,' .'. ,". I IDENTI ION, CERT # 126969 ..~_Mr. ~. -Para-th~dic Expires: 06/30/2009 . ini~l't;~ _ -ft~~.> I .... "." -.... I c<l> EMT-Par~'iiifd"i~/~ERT .' "'. ,.'-' I Marihaii c" Rasor' I ~ MarshaH~G1if~r~,;%~ I l~ 2so~~ri~~~ey-"V~y ," I~ "~~~~ryf~Z~';' I KJamat~,~Il.~.:9~:97~Ot 19' HT:69 _ei;~~~~'_'..~~",,:;._~_air The individual named"ab;,je' ~~d~d'~~~~be~' b~,th~ reverse 01 thIs card has I j WT: 220 -t~t;~i%:~~~~J~t~E,!~~,~~,:' I completed the requirements sei.foi'th:.in .O'R~ 682 ~ and is certified as 4~~~~1~~~'i''''--'<-~.'~'if. I an~EmergenCY. MedicaITeCh~ida~'~.~.t~'e:I,~vel.in9icated. I ~{e-~&..- ..,~.:: ~ ~1- ! _ r ~i-__+qr~-,_"'i'l ,_, I"":" 1. Offl~; ~tc;~~~~tYH~~Jih&~Health Planning, EMS Director 'AuthT I'm. - - "" ~ 00 OJ 00, 02 -..w il:.... wOO OO&; 2..: <(2 2:::> :::><( Ice . LL. I- \,-:";W::-' o g/jZ jd I-cnO,,:g m ~.~, .~ ~ ~-;~~1& I- CI:iU.-{ t.r[-o ~ w;;:-il!.<~ n.: U)-z '4l ill...JW lP Cl <( Q ,Vi~. ~-A]~ Z 0 4';i;f o ill ~'''!- t'e (!J ~ e J:::: ill >- :::t: a: U . -0: o Z [-0.;;:, LL ill ~.e; o el r.:ll::! wffi !;;:2 I-'W 00 on "'...' '::~ ~..~ N :('J !l:"--g ;.Qt\ b !l ~< ti lij lij E~ :; ~~ ''0 ,,~ . . 2--5 Q" .~ ~" ". o~ ~@ ~~ o.~ .~ ;Su; "; e ~l ~ ~ u.~ .!!.!C: ~~ ~ ... ~ ~Ull pauop fiUOle Plo_, _ ----,,- 00 . . ~~ "E.9,! ~~ 00 g; ;S~ Z ~ 'O-g <C d m <II g I-' OZ' >....:;r-o ~:-;:'~f~;:s..~>-!r!!l -fift . CI) ',-.-!<:" ,....-..~--...~~,. 0 <::._,1D W ',,~ 'i'~',~::c::r-_ -t.= .a ~'r- CJ .~ <;, . ~'elI ~<ll~E (ij a: . ~~~~..o.~.s-::'"..::i.~ =a W _ <ll ~ Eo E g.CD rii ::;:: Q!"" r.n ~~:: ~ la,! ~ _ :;:).... t: :;t: ~-g ~ t2 'gi ~ w -; ~w U ~ 8 ~ o u . 5 "' " w " < 1! . i[ ;; .. . ." ~~ .~ lii < . "EI :.- '< < ' o. ~a 81" :1:'0 - . < 0 ~.S:". __--'-___.,..,.-n.....' , Department of Human Services - Health Services ~ori EMERGENCY MEDICAL SERVICES 0 800 NE Oregon Street Ste, 607 Portland, OR 97232.. (971) 673-0520 co Fax (971) 673-0555 May 23, 2007 DerekA Rosenlund 642 Wilson Road Ashland OR 97520 4 Below is your new Oregon-certified EMT-Paramedic certification card which expires 06/30/2009. Please revIew your certificate carefuily. 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$1O.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 , d';:-;:----j-" pro""------ .u:.lJ.:aC'It... .. o..anl~. 'Again, welcome to the team. 1- - - - - STAT~O;-OREGON - - - - -, -I-STAT~-~; OREGO-;- DEPARTMENT OF HUMAN SERVI~ I EMERGENCY MEDICAL TECHNICIAN I EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEM~ - I I IDENTIFICATION ) CERT # 121067 EMT-Paramedic Expires: 06/3012009 I <u c 1 Derek A Rosenlund I ~ I " 642 Wilson Road. I ~ I Ashland OR 97520 I! The Individual named above and described on the reverse of Illis card has I completed the requirements set forth In ORS 682 et seo. and is certified as f ~ I an Emergency Medical Technician at tile level indil';atad. I ~ EMT-Paramedic: CERT# 121067 Derek A Rosenlund HT:73 WT: 202 HAIR: Dk. Brown Hair EYES: Blue Eyes / d ,/ '.or' .~ (.._' (. P-? \;lri1IHnl\JY"I:?I./"\J'IllIT\IIII~Ul1lU! Office of Community Health & Health Planning, EMS Director ~_, ,,__~ _,,_ ..._~. ~~ ~~" ~..~~._~ ~, ..._ .._.~_. _u ~~...~. .~. Ad~'r'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 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$1O.00. ..."__~~.--..::.o;,- . ..- --_.._--~ ~ . --' --,--'.~- 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 Ji[["icHllJlUtildi{l~:---'~-'---- Again, welcome to the team. - -- -- ---- -.--'-- --.- - -1- ------ ----.---~~-~.-..........,......-~-~ I STATE OF OREGON STATE OF OREGON - DEPARTMENT OF HUMAN SERVICE! 1 EMERGENCY MEDICAL TECHNICIAN I EMERGENCY MEDICAL SERViCES & TRAUMA SYSTEMS I' ' I IDENTIficATION I CERT # 116336 EMT-paiamedic Expires: 06/30/2009 1 ~ EMT_par.iii~ij[h3tRi1iij'ilii~g:\ I Dana'S Sallee I i Dana S Sall~~\: -'--".-~----; .J;>,. ---". I "'_ 1701lriern.o~d Dr I g J ,-- Talent OR 97~40 If The indi'';duaJ named above arid described on" the reverse of this card has 1 complet;d the requirements set forth In OAS 662 ~ and Is certirIed as I ~ Ian Emergency Medical Technician a,t the, level indicated. I '! ~ -I ' ' ' '1 ,~ ' HT:72 Wf:200 ,',?~tw~i ~w.~~f~,<air -Si'lw:ta.-,; .'1fG,,"'!;Fr, t) l-ldJ=F '\ (1"1 tl '. Office 01 community Ntll:UJn '" N~"lUI ....,..",,,,,\:1. ........... V""'....... May 23,2007 Department of Human Services - Health Services EMERGENCY MEDICAL SERVICES I) 800 NE Oregon Street Ste. 607 Portland, OR 97232. (971) 673-0520 . Pax (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 06/3012009. 4 Please review your certificate carefully. Ifthere 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$1O.00. HPlease be aware that you are required to be familiar with the Oregon administrative rules pertaining to your certification. These rules are available on our web site under rules and statutes at: http://www.oregon.gov/DHS/ph/ems/. You will always find the latest information from this office on the web site. We encourage you to use this tool frequently. Some items you will find there other than the Administrative Rules are: Updates from the Director, a list of available classes from the mobile training unit, continuing education requirements for all levels of EMTs, current EMS Update (newsletter), current articles of interest, EMS hot topics, Awards Banquet information, EMS for Children, and a list of staff you can contact in our office for different programs. Again, welcome to the team. 1- - - - - STATE OcOREGO;- - - - - - -I-STATE 0-; OREGO-;, DEPARTMENT OF HUMAN SERVICES- I EMERGENCY'M'EDICAtTECHNICIAN I EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEMS I ,)"" ,,' ':, ' I IDENTiFI~ATION I . CERT# 123197 ..:':~MT~par~-.~~~iC:'E~P!~~~.:"q6/3.012009 1m"'... ~ ""';"".,' '., EMT-Param~'dk~:CERi#;'-iijf9",' J Da~id_:({s~_ipi"'~~4':;~-:;';"';:',_:, ",.., I ~ . David G >Siiel;~~~~~J : ',;": :,-;.~.'-' I 3775;Colem~~' CreekRd" . I Q I Me'a.ford-OR:~i75iil ,.... ",-' Ii. HT: 72 ..,' ~;'~,~AH~_;,.pk~:~9,\v:n:J:lair The individual nameJ-abo"ve'.'ariid~s~;ibed' ~ri'~he reJ~rse of this card has WT: 175 ."' 'j <-.'ft..E,~: ~,re~n:~ye$ I completed the requirerilents set forth' in.ORS,.682 fi!:iillg. and is certified as I ~ /7\ '~/i<" -" / I <In Emeq~l ~',l \'~:diu\j --, ! ri,:i." ^.' hl I,i"lll inrll~' ,~" " ~~~;~!~'pln5Qn~~!ni~::a!O~. ,"';:, ""'''''''-'d'':'' ,;:0 "":'i'lVfJl;;"Y v, ''''''''''''f'''''''''''lJurnu,,,all ./"/ <\. !.. 2 Services and must be surrendered by the holder on demand. y ~ May 23,2007 Department of Human Services- Health Services EMERGENCY MEDICAL SERVICES. 800 NE Oregon Street Ste. 607 Portland, OR 97232 .. (971) 673-0520 ePax(971) 673-0555 Robert W Stephens 100 Alder Street Phoenix OR 97535 Below is your new Oregon-certified EMT -Paramedic certification card which expires06/30!2009. ~ Please review your certificate carefully. Ifthere 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 certificat~ 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 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. 1- - - - - -STAT~OF OREGO;- - - - ~ - -1- STAT-; OF OREGON. DEPARTMENT OF HUMAN SERVICES - I EMERGENCYMEDICALTECHNICIAN I EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEMS I"': ':> I IDENTifiCATION [ CERT # 123787 .-'~'MT-.~~r~~~di{,~~pi~~~.': ~6/3012009 I CD ", - ,t I . ".' '.':,':: ,-" .-..;:-., .. I~. EMT-par.~:~,~~).~;.:f.~~T;#.I'~~i8ir I' ~;t1ia~ ~t;;n'?ii , ' , I ~ Robert W St.~~~?ii' I The lndi~dual n:::~e:~~~~::!.~~~ibed-On'lhe reverse of this card has II "_"0= ~:~;9>{St~i~~;fm~air I completed the requirements 'se(J.orttfin OAS 682 er:-s8Cl. and Is certified as . . "5 I, an tm"genoy "eol',,' Technldan ,I th" ,;" I ;n,,,,,,,led, \ '\./ " l-uGr~ntHjgginsQn~Mmlnlstrator . .. -.- _~_h__ I I'lU:~.. "I r"n.."...."nihl 1.l""III1.ll. 1-l""lth PI"'nn;nn FM.c;: Director I Services and must be surrendered by the holder on demand. I I .;).q. 'J .1 AUDIT NO. -t~-- vJregon Department of Human Services -- Health Services EMERGENCY MEDICAL SERVICES 0 800 NE Oregon Street Ste. 607 , ,- Portland, OR 97232 " (971) 673-0520" Fax (971) 673-0555 May 24, 2007 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/DI-IS/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 foralllevels ofEMTs, current EMS Update (newsletter), current articles of interest, EMS hot topics, Awards Banquet information, gMS for Children, and a list of staff you can contact in ouroftice for different programs. Again, welcome to the team. , 1- - -- - - -STATE OFOREGO;- - - - - - -I-STATE 0-; ()REGON - DEPARTMENT OF HUMAN SERVICES I EMERGENCY MEDICAL TECHNICIAN I EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEMS I 1 IDENTIFICATION CERT # t 1891 1 F.l\'IT-l'aramcdic Expires: 06/30/2009 1 I. EWlT-Paramedlc CERT # 118911 e 1 '- Joha T Stay I ~ John T Stay I 955 Grandview Dr 1 jj Ashland OR 97520 ~ HT: 73 HAIR: Ok. Brown Hail' 1 I ~ Wf: 195 EYES: B1ac Eye, The individual named above and described on the reverse of this card has I completerJ lh~ requirements sel forth In GRS 6fl2 .t;1tJ!e:(l. S'F! I!, G€nllfied fl:, I ~ :" ' ; I . ' ;/ < -', . '~' l' '1'. . ; " ,I ~ I e \ fflM "1~ .. : GrnnIHig~illson\, _inislrator Thiscertificaieis'lfepropertyoflheOep,1rtmentofHuman / (~ 0/, :.< 'j SCNlceSSlldmustlJeSlIrrenderedbyllfeholderondamando .', ", ,. AlIDlr:"lO. May 23, 2007 Department of Human Services - Health Services EMERGENCY MEDICAL SERVICES I) 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 Oregonccertified 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 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. r - - - - - --;'TATE OF, OREGO;:;- - - - - - -I-STATE 0-;- ~-EGON- DEPARTMENT OF HUMAN SERVICES - \ ' EMERGENCy'MEOicAtTECHNICIAN I EMERGENCY MEDICAL SERVICES & TRAUMA SYSTEMS I : . . "",,)' : ' " I IDENTIFicATION I CERT # 130277 ..EMT.Pir3'medic"E~pir~s: 0.6/3012009 'I ~ ._;._ '__:-", c'. .~:_: .,.,.<,,;:.."_ I ". ." ",. I ::::.c EMT-Par:ainedk;p~~T #-~130277... .~ TOd~~.'G;~t~~~b? : ,. - " ~ Todd C Stubbs ,'-;~:,-"" :.;.}t~_.~~:-:>. I 71SGSt< ,,', " I~ ,', , : ~~~;;,~~~d~ha; ~;;;~;;l:~~1~f0~~;~i~~A;~:~;S:n~ ;~;~'~~~~dh:: : f ~; ~6o' ;~~;'~Hit~~~;:. an Em''': c . . I 'ladical ....,.. t.ni~il,l at lh~ I ~""I ini;; ',I 1 Gra~;~igginSQn\y..~inJstrator . Offlee of Community Health & Health Planning, EMS Director '''~''''''''''''''''''''''''''''''I-',vl-''''''yv,,,,..vt:y'''''''''::'''tJlnu''''''" '7' 7 -~, 1 0. Services and must be surrendered by the holder on demand. v 7 AnnTTNO June 14,2007 Department of Human Services- Health Services EMERGENCY MEDICAL SERVICES 0 800 NE Oregon Street Ste. 607 Portland, OR 97232. (971) 673-05200 Fax (971) 673-0555 Robert A Trask 415 Nugget Drive Rogue River OR 97537 Belaw is yaur new Oregan-certified EMT-Paramedic certificatian card which expires 06/30/2009. 4 Please review your certificate carefully. If there is an errar in yaur name, return yaur certificate immediately to. aur affice with the carrectians. Send the certificate to.: Emergency Medical Services, PO Bax 14450, Partland, OR 97293-0450 and a carrected certificate will be issued to. yau. Keep yaur certificate in a secure place. Duplicates can be issuedJor a fee af$1O.00. Please be aware that yau are required to. be familiar with the Oregon administrative rules pertaining to. your certificatian. These rules are available an aur web site under rules and statutes at: http://www.oregan.gav/DHS/ph/ems/. Yau will always find the latest infarmatian fram this affice an the web site. We encaurage yau to use this taal frequently. Same items yau will find there ather than the Administrative Rules are: Updates from the Director, a list af available classes fram the mabile training unit, cantinuing educatian requirements far all levels af EMTs, current EMS Update (newsletter), current articles afinterest, EMS hat topics, Awards Banquet infarmatian, EMS for Children, and a list afstaffyau can cantact in aur affice far different programs. ' Again, welcome to. the team. ,- - - -- -- - - - - - - - - - - -1- - - - - -- - - - - - - -- - - -, I STATE aE_OREGON STATE OF OREGON - DEPARTMENT OF HUMAN SERVICES 1 EMERGEt:lCY'~,~~ICA:t,jl'c:;HNICIAN 1 EMERGENCY MEDICAL <>~YJSES & TRAUMA SYSTEMS I"" ,.c"-"'-"'-;" ",,-", I ,IDENTIFICATION r~5:~J~:1Y.t~fii~~;\,,',:))"::_' The individual named:above.and,aes'd'i15ejl'ori"ttie reverse of this card has completed the reql'iremenl5 se~ fortt1,'in ORS-682 ~ '3.nd is certified as I ~ "r."~' ':'':'DCYP ....~'kj~.1l-1't'l=-I~ :"c.+k',!"I HT:6? Wf: 225 ',' """'" -. '\j;t 9~~nt H!911insQn .. . .1n1~I:a!o~. I ms cerrmcare IS me properry or Ine l.Ieparrmenr or numan 0 J::,. I I IlJ SeN/ces and must be surrendered by the holder on demand. February 2, 2007 Department of Human Services - Health Services EMERGENCY MEDICAL SERVICES. 800NE Oregon Street Ste. 607 Portland, OR 97232" (503) 731-4011 eFax (503) 731-4077 ShannonW Turner PO Box 4 Phoenix OR 97535-0000 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 issuedfor a fee of$1O.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 Bmlquet information, EMS for Children, and a list of staff you can contact in our office for different programs. Again, welcome to the team. 1- - - - - -;'TAT;-OF OREGO;; - - - - - -I-STATE OF OREGO~. DEPARTMENT OF HUMAN SERVICE~ I EMERGENCycME~JCAlTECHNICIAN ,I EMERGENCY MEDICAL SERVIE;ES & TRAUMA SYSTEMS I ,// ,r};.;.,,", I IDEN:t!jjif~TION"" I CERT # 126208 ~M!~:~r~m.~dl_cExplr~~: 06/3012009 1 "::\~~:.\:- 11,;.-".;;-: -,' ...~;;;~:'; lY'\~':/,'~"~-'::-.:~:"~-'_''''~'--''-- . ': .' \-, ~ EMT-Par~~~~HE}g~fT~{}?~3:~t:j.~\~ .1 '. Shannon .W,Turner _'~ '.' . 1 u Shannon W,Turner.',c -',,-, : ,;~.._-.'(.~:!---".." '~<' : " , ;~o:irx;t~9753~~'O~O'; :" '.' I h' :I ~~;72300'" ;!~~~~~~:J~~~:~ai;' I The indiVIdual nam~d abqve<!nd de~c_nl:!ed,ol): Ihe,/everse 0/ .1 IS c~~d has l!l ' ,'~ > ~;!r"'A_:-;:",,-:,\.;~~>/~,(1 completed lh3 reqUirements, set fN~ti in,QRS'S8'2 ~ al'"lcll<: emil/leo as (> ,~:1>' (?-". ('...r-r ,or ;:.,., , "i'flir:8IT,.,' 'I" I', ,', ",Ij(";;l.t~.j . ._~/ l...:A'r~-'t....- ",~a C <::h;hl",,, A...."'ln;"'."tnr I ,V'<l'/M "H r::r:mtHlnnin=n \ This certificate IS me property Of me ueparrmenr or Human ,'''''' Iv. 1.,...1 Services and must be surrendered by the holder on demand.