Texas Fire Chiefs Association DOCUMENT SUBMISSION FORM. Coppell Fire Department

1 Texas Fire Chiefs Association DOCUMENT SUBMISSION FORM Candidate Department: Coppell Fire Department Best Practice Standard:2.03 EMS Provider (insert the Best Practice Standard you are working on - example 1.01 ) Proofs of Compliance Submitted: 1. DSHS EMS Provider Letter of Continuance (Page 3). 2. Texas DSHS EMS Renewal Packet (Pages 3-27). 3. Copy of organization s current members licensed to provide EMS services by DSHS (28-33). Submitted By: Gregg Loyd Date: 10/1/2013 Evaluator s Review Evaluator: Date Accepted:

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28 Coppell Fire Department Personnel Credentials Last Name First Name Status Employee Number Credential Credential Number Current Date Expiration Date ADAMS JOHN Active 325 EMT-Paramedic 884 03/21/2012 07/31/2014 ADDISON BLAINE Active ADDISON CHRISTOPHER Active ALLEN TIM Active BAIRD JAMES Active BARTOLACCI BARRY Active BAZE TAYLOR Active BEARE JAMES Active 1243 BEYER GARY Active 941 BOURLAND TODD Active BOYLES BRANDON Active 1508 BREWSTER JAMES Active Briggs Shane Active BROOM JEREMY Active BROWER MICHAEL Active 2159 BURR KELLEY Active 734 NREMT-Paramedic (NREMT-P) P0964286 11/02/2013 03/31/2014 EMT-Paramedic 34270 01/31/2012 01/31/2016 EMT-Paramedic 19539 09/30/2011 09/30/2015 EMT-Paramedic 726017 08/21/2012 08/31/2017 EMT-Paramedic 108181 09/30/2013 09/30/2017 EMT-Paramedic 135544 03/23/2011 08/31/2017 EMT-Paramedic 52245 03/23/2011 09/30/2016 EMT-Paramedic 147755 03/23/2011 01/31/2017 NREMT-Paramedic (NREMT-P) p0979118 03/26/2012 03/31/2013 EMT-Paramedic 106367 03/20/2012 07/31/2017 FLIGHT PARAMEDIC 0001884 03/19/2012 06/30/2015 NREMT-Paramedic (NREMT-P) P8001226 03/21/2012 03/31/2014 EMT-Paramedic 83362 03/23/2011 03/31/2015 EMT-Paramedic 157772 03/23/2011 10/31/2017 NREMT-Paramedic (NREMT-P) p0992717 03/27/2012 03/31/2014 EMT-Paramedic 113220 03/23/2011 04/30/2017 EMT-Paramedic 03/23/2011 EMT-Paramedic 149090 03/23/2011 07/31/2016 EMT-Paramedic 177464 01/31/2011 01/31/2015 CRITICAL CARE PARAMEDIC 0000079 03/28/2012 11/30/2014 EMT-Paramedic 106676 03/23/2011 06/30/2014

Last Name First Name Status Employee Number Credential Credential Number Current Date Expiration Date 29 BURRIS STUART Active EMT-Paramedic 110654 03/23/2011 08/31/2016 CAMPBELL ADAM Active 1725 EMT-Paramedic 170010 03/23/2011 01/31/2016 NREMT-Paramedic (NREMT-P) p8019606 03/27/2012 03/31/2013 CARTER CHARLES Active 1007 EMT-Paramedic 128707 03/23/2011 07/31/2015 NREMT-Paramedic (NREMT-P) P0956652 03/28/2012 03/31/2014 CHITWOOD CHASE Active 2154 CODY MICHAEL Active CROUCH EDWARD Active DABBS JOHN Active 1025 DAILEY JAMES Active 1315 DANIELS MARK Active DEAN JARROD Active 1622 DINGFIELD HEATHER Active ELLIOTT MARK Active 0363 FISK ROBERT Active 1623 FOSTER JOHN Active GREASER ERIC Active GREEN DAVID Active GREENBERG BRANDON Active 1695 EMT-Paramedic 709201 03/23/2013 03/31/2017 FLIGHT PARAMEDIC 0001906 03/21/2012 07/15/2015 NREMT-Paramedic (NREMT-P) p8031114 03/21/2012 03/31/2015 EMT-Paramedic 14179 03/23/2011 03/23/2015 EMT-Paramedic 720751 01/31/2013 01/31/2017 NREMT-Paramedic (NREMT-P) P0973046 03/27/2012 03/31/2014 EMT-Paramedic 21096 03/23/2011 07/31/2016 EMT-Paramedic 135580 03/23/2011 03/31/2016 NREMT-Paramedic (NREMT-P) p098862 03/28/2012 03/31/2013 EMT-Paramedic 37646 03/23/2011 03/23/2015 EMT-Paramedic 151846 03/23/2011 12/31/2015 NREMT-Paramedic (NREMT-P) 123456 03/21/2012 03/31/2013 FLIGHT PARAMEDIC 0001814 03/21/2012 03/31/2015 EMT-Paramedic 118425 03/23/2011 08/31/2017 EMT-Paramedic 43854 03/23/2011 07/31/2016 EMT-Paramedic 128104 03/23/2011 01/31/2016 EMT-Basic 48534 10/15/2013 11/30/2017 EMT-Paramedic 03/23/2011 EMT-Paramedic 38049 03/23/2011 03/23/2015 EMT-Paramedic 150780 03/23/2011 05/31/2015 NREMT-Paramedic (NREMT-P) P8017519 03/21/2012 03/31/2015

Last Name First Name Status Employee Number Credential Credential Number Current Date Expiration Date 30 CRITICAL CARE PARAMEDIC 0000080 03/21/2012 11/30/2014 FLIGHT PARAMEDIC 0001742 03/21/2012 11/30/2014 HAMILTON JOHN Active 1927 HARDIN CHAD Active 1502 HARDT BRAD Active INMAN JASON Active JOLES EVERETT Active JONES BRANDON Active 2049 KINNEY KERRY Active KNIGHT JOHN Active LEE AUSTIN Active LEECH CHRIS Active LOVELL DURL Active LOYD GREGG Active 2034 MCCRACKEN AUSTIN Active 2298 MCDOWELL MICHAEL Active MCGEE ROBERT Active MCINIS WILLIE Active 007 NREMT-Paramedic (NREMT-P) p8031500 03/27/2012 03/31/2014 EMT-Paramedic 700287 03/27/2012 12/31/2012 FLIGHT PARAMEDIC 0001794 03/21/2012 02/28/2015 NREMT-Paramedic (NREMT-P) 123456 03/21/2012 03/31/2014 EMT-Paramedic 152333 03/23/2011 06/30/2017 EMT-Paramedic 157055 03/23/2011 10/31/2013 EMT-Paramedic 106110 03/23/2011 03/23/2015 EMT-Paramedic 54800 03/23/2011 03/23/2017 NREMT-Paramedic (NREMT-P) P0942334 11/02/2013 03/31/2014 EMT-Paramedic 709069 03/27/2012 12/31/2014 NREMT-Paramedic (NREMT-P) p8040895 03/27/2012 03/31/2014 EMT-Paramedic 20424 03/23/2011 05/31/2015 EMT-Paramedic 163746 03/23/2011 03/23/2015 FLIGHT PARAMEDIC 2754 05/31/2013 05/31/2017 NREMT-Paramedic (NREMT-P) P8028720 03/31/2013 03/31/2015 EMT-Paramedic 175729 08/31/2012 08/31/2016 EMT-Paramedic 28342 03/23/2011 03/23/2015 NREMT-Paramedic (NREMT-P) P8023002 03/31/2012 03/31/2014 EMT-Paramedic 168615 03/23/2011 02/29/2016 EMT-Paramedic 21085 11/30/2012 11/30/2016 EMT-Paramedic 723139 12/31/2012 12/31/2016 EMT-Paramedic 126094 03/23/2011 03/23/2015 EMT-Paramedic 157602 03/23/2011 07/31/2015

Last Name First Name Status Employee Number Credential Credential Number Current Date Expiration Date 31 MILLER CODY Active 2051 MOON MONTY Active 484 MUSSER GARRETT Active EMT-Basic 29676 03/23/2011 11/30/2017 EMT-Paramedic 123456 10/31/2013 10/31/2017 EMT-Paramedic 12755 03/23/2011 10/31/2017 CRITICAL CARE PARAMEDIC 0000081 03/21/2012 11/30/2014 EMT-Paramedic 155356 07/31/2010 07/31/2014 NICKELSON PRESTON Active 2161 OLSON BREA Active 2160 PACE JASON Active PARR JARRETT Active 561 PARSONS JON Active PAYNE TOMMY Active PIERCE BRIAN Active PIERCE JAMES Active 2297 PORTER ERIC Active 1077 PRICE MARLIN Active 1303 RICHARDSON TY Active RIDLING ROBERT Active 1141 RINARD JAMES Active RODRIGUEZ RENE Active EMT-Paramedic 705450 04/18/2011 04/30/2015 EMT-Paramedic 700205 10/31/2012 10/31/2016 FLIGHT PARAMEDIC 2759 05/31/2013 05/31/2017 EMT-Paramedic 159147 03/23/2011 03/23/2015 EMT-Paramedic 1677 03/23/2011 05/31/2016 EMT-Paramedic 14936 03/23/2011 02/28/2014 EMT-Paramedic 707611 12/31/2012 01/31/2017 EMT-Paramedic 166556 03/23/2011 08/31/2015 NREMT-Paramedic (NREMT-P) p0988425 03/26/2012 03/31/2013 EMT-Paramedic 723300 11/30/2012 11/30/2016 NREMT-Paramedic (NREMT-P) p0900553 03/26/2012 03/31/2013 EMT-Paramedic 106670 03/23/2011 05/31/2015 EMT-Paramedic 146398 03/23/2011 12/31/2015 CRITICAL CARE PARAMEDIC 0000086 03/21/2012 11/30/2014 NREMT-Paramedic (NREMT-P) 123456 03/21/2012 03/31/2014 EMT-Paramedic 138794 03/23/2011 12/31/2016 EMT-Paramedic 135481 03/27/2012 12/31/2015 NREMT-Paramedic (NREMT-P) p0963862 03/23/2011 03/31/2014 NREMT-Paramedic (NREMT-P) p0961354 03/31/2012 03/31/2014 EMT-Paramedic 117059 03/23/2011 03/23/2015

Last Name First Name Status Employee Number Credential Credential Number Current Date Expiration Date 32 EMT-Paramedic 172026 03/23/2011 12/31/2015 RUSSELL TIM Active 562 SMITH BRAD Active 1625 SPENCER RYAN Active 1497 STACY BRIAN Active 911 STONE ROBERT Active TAYLOR STEPHEN Active TAYLOR JAIME Active 2296 THOMASON SAM Active UPPOLE MATTHEW Active 370 WHITE BRYAN Active WHITE DAVID Active WILLIAMS ROBERT Active WILLIAMSON BLAKE Active 2153 WILSON MICHAEL Active 801 EMT-Paramedic 59617 03/23/2011 07/31/2016 EMT-Paramedic 170236 03/23/2011 12/31/2015 NREMT-Paramedic (NREMT-P) 123456 03/21/2012 03/31/2014 CRITICAL CARE PARAMEDIC 0000082 03/21/2012 11/30/2014 FLIGHT PARAMEDIC 0001746 03/21/2012 11/30/2014 CRITICAL CARE PARAMEDIC 0000078 03/21/2012 11/30/2014 NREMT-Paramedic (NREMT-P) P0979134 03/21/2012 03/31/2014 Nurse 123456 03/21/2012 FLIGHT PARAMEDIC 0001149 03/21/2012 03/31/2016 EMT-Paramedic 150971 03/23/2011 12/31/2012 NREMT-Paramedic (NREMT-P) p0979190 03/26/2012 03/31/2013 EMT-Paramedic 112692 03/23/2011 12/31/2016 EMT-Paramedic 163639 03/23/2011 03/23/2015 EMT-Paramedic 77768 01/31/2013 01/31/2017 EMT-Paramedic 714585 01/31/2011 01/31/2015 EMT-Paramedic 79324 03/23/2011 03/23/2015 EMT-Paramedic 3353 03/23/2011 08/31/2015 EMT-Basic 45264 03/23/2011 03/31/2015 EMT-Paramedic 159471 03/23/2011 07/31/2017 EMT-Paramedic 153504 06/30/2013 06/30/2017 NREMT-Paramedic (NREMT-P) p0983532 03/31/2013 03/31/2015 NREMT-Paramedic (NREMT-P) P8030965 03/26/2012 03/31/2015 FLIGHT PARAMEDIC 0002181 11/01/2013 04/30/2016 EMT-Paramedic 173763 03/23/2011 10/31/2012 EMT-Paramedic 130545 03/23/2011 08/31/2017

Last Name First Name Status Employee Number Credential Credential Number Current Date Expiration Date 33 FLIGHT PARAMEDIC 0001779 03/21/2012 01/31/2015 WOLSKE JIMMY Active EMT-Paramedic 127098 03/23/2011 08/31/2014 YOWELL JON Active EMT-Paramedic 114307 03/23/2011 09/30/2016