HomeMy WebLinkAboutAgenda - 06-27-2006-5vORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: June 27, 2006
Action Agenda
Item No. jj y
SUBJECT: NC State Firemen's and Rescue Squad Annual Certification Roster
DEPARTMENT: Emergency Management PUBLIC HEARING: (Y /N) No
ATTACHMENT(S):
Certification Form
Roster
Addition /Deletion Form
Training Certificates (4)
INFORMATION CONTACT:
Mike Tapp, 968 -2050
PURPOSE: To approve the certification roster for the fire marshal and assistant fire marshal to
participate in the North Carolina State Firemen's Association for the year 2006.
BACKGROUND: The North Carolina State Firemen's Association requirements are, that in
order to be eligible to participate in Association, members must attend thirty -six (36) hours of
training in the calendar year. The Fire Marshal received forty -eight (48) hours of training in
fire /arson investigations and multi hazard planning for schools. The Assistant Fire Marshal
received forty -four (44) hours of training in fire /arson investigations and clandestine drug labs
and explosives. Certificates of training are included with this agenda abstract. Former assistant
fire marshal Jerry Wagner will be deleted and current assistant fire marshal Scott Merritt will be
added to the addition /deletion form before delivery to the association.
North Carolina General Statute 58 -86 -25 requires submission of a complete and certified roster
of eligible staff annually. The governing body, the County Commissioners, must certify the
annual certification roster. The certified roster and minimum training requirements determine
eligibility for benefits through the Association, including line of duty death benefits, accidental
death and dismemberment benefits and participation in the pension fund. The certification
roster is attached and lists two individuals. As an additional point of information, individual
County fire departments submit their own certification rosters based on approval by their
respective boards of directors and signature of approval by the respective board's president.
FINANCIAL IMPACT: The County funds associated costs for staff to attend seminars to
maintain certification and membership in the NC State Firemen's Association,
RECOMMENDATION(S): The Manager recommends that the Board approve the certification
roster and authorize the Chair to sign the certification documents.
North Carolina State Firemen's Association
P.O. Box 188 2
Farmville, NC 27828
800 - 253 -4733
2005
ANNUAL CERTIFICATION OF FIREMEN
North Carolina General Statute 58 -86 -25 requires that all certified fire departments submit a complete roster of
its eligible firemen annually. This certified list determines eligibility for the $50,000 line -of -duty death
benefit as well as eligibility for Pension Fund credit. Failure to accurately and promptly report this
information is violation of G.S. 58 -86 -25 and will automatically result in a loss or reduction of benefits.
'�' : 1' 1 '• I II1
As Fire Department Chief, I have determined that the attached roster is a valid and accurate list of all eligible
firemen, within the definition contained in North Carolina General Statute 58- 86 -25.
Name of Fire Department Orange County Fire Marshal's Office
Fu e Department Mailing Address
City Hillsborough State
Zip Code 27278
Name of Fire Chief Mike Tapp, Fire Marshal
- (Please print or type)
Signature of Fire
Date June 8, 2006 Daytime Telephone _ 9( 19 ) 968 -2050
County Orange
CERTIFICATION BY GOVERNING BODY
Pursuant to G.S. 58- 86 -25, the governing body of a fire department operated by (i) a county is the county board
of commissioners, (ii) a city is the city council, (iii) a sanitary district is the sanitary district board, (iv) a
corporation, whether profit or nonprofit, is the corporation's board of directors and (v) any other entity is that
group designated by the board. Therefore, in our capacity as the governing body of the above -named fire
department, we certify and find that the attached roster is a valid and accurate list of all eligible firemen in
accordance with G S.58- 86 -25.
Name of Governing Body Orange County Board of County Commissioners
Name of Governing Body Official Barry y, Jacobs, Chair
(Please print or type)
Authorized Signature Title Chair
Date Daytime Telephone_ 919 245 -2130
11/15/200 2005 Fire Department Roster
ORANGE CO. FIRE MARSHAL
This Roster was last
updated on 9/2/2004
Mike Tapp
ORANGE CO. FIRE MARSHAL
P o Box 8181
Hillsborough, NC :27278
NCSFA Member N
SSN NAME /DOS
1
Jeny Wagner, Jr.
2/26/1964
60S
Certification Letter N
ADDRESS
P O Box 8181
Hillsborough, NC 27278
P O Box 8181
Hillsborough, NC 27278
Chief Date
ORANGE CO, FIRE MARSHAL
Page 1 of 1
NC State Fireman's Association 3
PO Box 188
Farmville, NC 27828
800 -253-4733
252 -753 -3335
Day Phone# 919 - 968 -2050
Secretary o1
Number Paid _
Number Volunteer _
Email
PHONE# / EMAIL GEN MAR P/V/R CERT
919 -968 -2050 M M P N
mtapp@co.orange.nc.us
919 -563 -2302 M M P N
jwagner @co orange.nc.us
ADDITION / DELETION FORM
To: N C State Firemen's Association
P.O. Box 188
Farmville, North Carolina 27828
From: Orange County Fire Marshal's Office
Fire Department
P.O. Box 8181
Address
Hillsborough, NC 27278
ADDITIONS:
Paul(cr3,ncsfa.com or Melissa@ncsfa.com
Telephone (252) 75.3 -2626
Toll Free 1 -800- 253- 473.3
Fax (252) 75.3- 3.335
Please add the name of David S. Merritt to our roster as a New Member for the year 2006
David S. Merritt
Neu—
Chapel Hill, NC 27516
Address
Mal )/ Female
DELETIONS:
G d Single
Please delete the name and information of
no longer a department member,
Effective Date: June 1, 2006
Chief Mike Tapp - Fire Marshal
Orange County - P.O. Box 8181
Hillsboroughi NO 27278
Address
County Orange
Social Security Number DOB
Phone Number
smerritt@co.orange.nc.us
E -mail Address
Paid Volunteer /Retired Certified (Yes No)
Wagner, Jr. from our roster, as this person is
You may add one member for each member deleted at no charge. There is a membership fee of $12.00 for all
other members added. You have 30 days to send in membership dues if you fax this information in. It is
understood that no claims will be paid against this New Member until membership dues are received in our
office. After 30 days, if no membership dues are received, this New Member will not be covered.
Department may duplicate this form.
Effective January I, 2004
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