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Home My WebLink About229810 03/12/14 r C�N.. �' �`"' CITY OF CARMEL, INDIANA VENDOR: 356912 �, � . •j, e ''r ONE CIVIC SQUARE AMERICAN SOCIETY OF CIVIL ENGINEEI$$�ECK AMOUNT: S"'""'168.75" �:, ;�Q CARMEL, INDIANA 46032 P.O.80X 79084 CHECK NUMBER: 229810 �'M,�,oN�" BALTIMORE MD 21279-0084 CHECK DATE: 03/12I14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2200 4355300 168.75 ORGANIZATION & MEMBER '� t�� ' Warltl Headquarters 1801 Alexander Bell Drive,Reston VA 20191-4382 USA �� j�� Phone:(800)54Ema 13 mem6er@ sce.org FWeh(70wwwasce org W ANiERICAN SOCIETY OF CIVIL ENGWEERS Official Membership Authorization Receipt Instructions to Recipient: �ProfessiOnal LiCensure Complete items 1-6 �Registered Engineer ❑Not licensed Q Deliver to Addressee Only 3 76�>> ❑Registered Land Surveyor ❑Engineer-in-Training Mr.Jeremy Michael Kashman �Licensure not available in ❑Land Surveyor-in-Training American Structurepoint, Inc. residence area Ste. 100 Primary state/country �D��i�l� 7260 Shadeland Sta. Reg.#: � �D1�i0�t��?'� Exa.Date:3�I:, Z-Gj� Indianapolis, IN 462�6-3977 Invitation Code: 0114CB26 � Your ASCE mem6ership includes membership in one ASCE specialty Institute. Please check the one you would like to became enrolled in. � � Yes,activate my membership! l understand my 201� dues ❑Architectural Engineering Institute(AEI) are discounted 25%,a savings of up to$56.25. Plus 1 may join ❑Coasts,Oceans,Ports and Rivers Institute(CUPRI) the specialty Institute of my choice. ❑Construction Institute(CI) Your reduced dues are shown below. Please indicate your ❑Engineering Mechanics Institute(EMI) Institute membership in section 4 of this form. ❑Environmental and Water Resources Institute(EWRI) You may also join online at www.asce.org/join and use your ❑Geo-Institute(6-I) personal invitation number—01 14CB26—when prompted. ❑Structural Engineering Institute(SEI) ❑Please remove me from your mailing list. �Transportation and Development Institute(T&DI) ❑No,I do not wish to become an ASCE member at this time,but please keep me on Signature your mailing list. If elected,I will conform to the Canstitution,Bylaws,Rules of Policy and Procedures, ❑Check here if you are already a member of ASCE.You received this mailing and Code of Ethics of ASCE as stated at www.asce.org/membergrades. Your because we were unable to match your name and address,as it appears on this membership cannnt be activated until Constitution,Bylaws,Rules of Policy, form,with your membership record.Please return this form to us and we will Procedures and Codes of Ethics is signed. correct this error.Indicate any corrections to your work or home address below. Have you ever been a member of ASCE? ❑No �jYes Signature: Date: � l� 1 Date of Birth: ►aov�� 1S 1`t.�� montn oay Year � Calcula Your Dues Gender: f�Male ❑Female ❑Prefer not to say Please calculate your dues based on the dues schedule below. Far a more complete description of ASCE mem6er grades,visit www.asce.orglmembergrades. Please send my ASCE correspondence to my ❑Residence ❑Work Place Residence Address: (1) Mem6ers,Assaciate Members,and Affiliate Members (not recent BS grads):°'n�zz"vo $168.75 Street �3I C. � �:�5c� �vz.. ��i�- 3�2 (2)Associate Members and Affiliate Members who are recent recipients of Ciry/State/Zip '-sLur-c-, T.n� `{��3� a Bachelor's degree are entitled to a sliding dues schedule.Dues are based upon the year the Bachelor's degree was granted: Phone 3t � -2$t - [`3`�1"/ Year of graduation:�§A-BA $37.50 Email First year after receipt of Bachelor's degree:�§8:8A $37.50 Employer: Second year after receipt of Bachelor's degree:$8r99 $63.75 Third year after receipt of Bachelo�'s degree:$�88 $93.75 Company Name C;� �� r+�w�, � Fourth year after receipt of Bachelor's degree:$�,r.89 $131.25 Job Title C;� �q t r1�-r Fifth year after receipt of Bachelnr's degree and thereafter: '$168.75 Street I (��c ��+r.,�-e ❑ Please charge my: ❑V'isa ❑American Express ❑MasterCard ❑Discover mers Club Ciry/State/Zip �,��,�,a� '� 1{��U.s 7 Card Numher oaoo-aooa-�000-0000 Phone 31� - �� -Zyy f Fax 3[� -5-7( -2tf-39 Expiration Date ��00 pmount$ Email '1�CccS��vi u cn C C'c.r►'K.�I.;n��v' �Signature: Date: Educational Background ❑Check here if no degree. ❑My check for$ is enclosed,payable to ASCE in U.S,dollars payable Undergraduate Degree: Major G;�!;l �Q�,��.;�n�� through a U.S.bank. College/University Q--o S.z-N-J�,;M.t;✓� � ❑ BILL ME.Please use my: ❑Residence address ❑Employer address Graduation Date(month/year) �� '?�✓�� Graduate Degree: Major For Office Use Only Educ❑ Resume❑ Date Rcvd MARC College/University Registration❑ Refs.❑ Ballot❑ Graduation Date(month/year) Date Grade 0114CB26 0114R Prescribed by State Board of Accounts City Form No.201(Rev.1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee American Society of Civil Engineers Purchase Order No. POB 79084 Terms Baltimore, MD 21279-0084 Date Due Invoice Invoice Description Date Number (or note attached invoice(s)or bill(s) Amount 1/0/1900 0 ASCE Membership-Jeremy $ 168.50 Total $ 168.50 I hereby certify that the attached invoice(s), or bill(s), is (are)true and correct and I have audited same in accordance with IC 5-11-10-1.6. ,20 Clerk-Treasurer VOUCHER NC WARRANT NO. American Society of Civil Engineers ALLOWED 20 POB 79084 IN SUM OF $ Baltimore, MD 21279-0084 � ��. o' l��?� ON ACCOUNT OF APPROPRIATION FOR Board Members PO#or �NVOICE NO. ACCT#/TITL AMOUNT �EPTa . I hereby certify that the attached invoice(s), 0 0 22oo-assssoo $ .�se� or bill(s) is (are) true and correct and that the -7 materials or services itemized thereon for `6� !�l' which charge is made were ordered and received except 3/10/2014 Signature City Engineer Cost Distribution ledger classification if Title claim paid motor vehicle highway fund