The URL can be used to link to this page

182247 02/17/2010 CITY OF CARMEL, INDIANA VENDOR: 010558 Page 1 of 1 ONE CIVIC SQUARE AMERICAN SOC OF CIVIL ENG MEMBRSHI 0 CARMEL, INDIANA 46032 PO BOX 79084 CHECK AMOUNT: $220.00 l; '-",,-,-,5,- r BALTIMORE MD 21279 -0084 CHECK NUMBER: 182247 CHECK DATE: 2117/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2200 4355300 1040813856 220.00 ORGANIZATION MEMBER AMERICAN SOCIETY OF CIVIL ENGINEERS INDIANA SECTION TDI September 9, 2009 RENE'.^ EARLY Carm Jr., P.E., M.ASCE el City of TO HELP Civic sq YOUR SECTION Carmel, IN 46032 -7569 IrlrrlrllII Irrrrrllrrrlrllrrrl ............l n Ilrrrrfrlllrrell Address Update Please note any changes in Step 4 on reverse side of form. Renew online at www.asce.org /renewal -T.,_m ��a�ntsn- your current -level of membership and services, please subm,l the "Grand Total' smount. To amend your current letieia, please circle any items you choose to pay in Step 1- Add additional items in the Step 2 "write -in" column and include them in the "Grand Total." Instructions: To continue with your previous level of membership and services, submit the "Grand Total" amount- To amend your previous levels, please circle any items you choose to pay in Step 1 and submit the amended "Grand Total" payment. Add additional items in the Step 2 "write -in" column and include them in the "write -in" "Grand Total" section. i� fi 'k`�'M+..a�+' ^.'.�7 ,3eac. `�.des� :m' l s �i w a "�%t k "o-�i�,% STEP =1 2010 MEMBER REN E WA kWr V ICE �Bas on Your )„T Year Partrcr a aF� �,a u3rordr�.. �su ,tSars- •fi wam Description Renewal Amount �l Code National Membership Dues $205.00 ND Indiana Sec -Metro Indianapolis Br Dues $15 00 SD Transportation Development Institute Membership (T &DI) $0.00 I TDMP Annual Sub total: I> $220.00 STEP 2010 ADDITIONAL TiEMS R m Description Write -in Amount I Code Engineers Without Borders Professional Membership ($60. EWBP Engineers Without Borders Supporting Membership ($40.00) EWBS Architectural Engineering Institute Membership (AEI) ($30.00) AEMS Coasts, Oceans, Ports Rivers Institute Membership (COPRI) ($30.00) i COMS Construction Institute Membership (CI) ($30 00) CIMS Engineering Mechanics Institute Membership (EMI) ($30.00) EMMS Environmental Water Resource Institute Membership (EWRI) ($30.00) EWMS Geo- Institute Membership (G -I) ($30 00) GIMS Structural Engineering Institute Membership (SEI) ($20.00) SEMS Interm: Soo-o .Solt- M, mica GcotboiiriiGc,r Eng (L.inl GE) (+y 15700.)` wJ Indiana Section Metro Indianapolis Branch Voluntary ($0.00) 1 SV National Voluntary Description See enclosed insert for descriptions Write -in Amount Write -in Code write -in description wO write -in description Qi write -in description i n z Institute Voluntary Description See enclosed insert for descriptions Write -in Amount Write -in Code v0 write-in description 0 L write-in description write-in description Annual Sub total: b GRAND TOTAL: $220.00 STEP o.3 ,4=n G JJ INFORMATION s y t, .r;.• aym Payment by Credit Card ❑AMEX ❑Discover ❑MasterCard 0 Visa Diners Club I P No. 13- 1635293. ent by Check Check must be made payable to ASCE in equivalent U S dollars Federal ID A $25 service charge applies to all International checks not payable through a U.S. bank, Payments not in U.S. dollars drawn on a U bank must be a minimum of $75 00. Please remit payment to: MEMBERSHIP DUES ARE DUE ASCE MEMBERSHIP, P.O. BOX 79084, BY DECEMBER 31, 2009. BALTIMORE; MD 21279 -0084 MEMBER 285096 Credit Card Expiration Date No CORRESPONDENCE TO ABOVE ADDRESS) or call: (800) 548 -ASCE (2723) INVOICE 1040813856 X Signature Your 2010 Membership Year began on January 1, 2010. Thank you for renewing your membership. $36 (or a pro-ration therof) of your dues payment represents the non deductible amount associated with ASCE News and Civil Engineering magazine. The balance of your dues and all voluntary contnbutions may be deductible as a chartitable contribution according to the I -R -5- We recommend you consult your tax advisor 285096 4 1 1040813856 3 TYPE C MB 54/F USA 10 STEP GONTiArCT INFORMATION: UPDATES ....A_ S.CE ORG /MAYPR,OEILE e In order to ensure the accuracy of your record, please review all the information below and make changes where needed. Currently your preferred mailing address is: Business/School Change your preferred mailing address by circling your new preference: RESIDENCE or BUSINESS /SCHOOL COMPANY NAME: Carmel City of RESIDENCE ADDRESS BUSINESS /SCHOOL ADDRESS Line 1: 11034 Palatka Court Line 1: One Civic Square Line 2: Line 2: Line 3: Line 3: City: Indianapolis City: Carmel State: IN State: IN Zip Code. 46236 i Zip Code 46032 Country: United States o Country: United States Home Phone: (317) 826 -2948 E -mail Address #1 mrpoops @comcast net Business Phone (317) 571 -2441 E -mail Address #2 Fax Phone: (317) 571 -2439 Online Account E -mail Address: gduncan @carmel.in.gov S: EP PERSONAL INVENTORY I w :�AS.CE ORG /IN >�TE 15CE Thank you for completing your Personal Interest Inventory (PII). This information helps us to tailor your ASCE membership with more focus on your professional specific needs. Fund Y To learn more about all of the ASCE member benefits available to you please refer to the 2009 -2010 a SCE o Member Resource Guide. You can also call ASCE Member Services at (800) 548 -ASCE (2723), (703) 295 -6300 (int'l) or e -mail member @asce.org. Tics x'�k a. t c The 2009 -2010 Member Resource Guide is mailed as a supplement to the September issue of Civil tiu 4.4-,„,, `7 ,i Lrs ke r Engineering Magazine. Please inform us if you need another copy of the Member Resource Guide. (41141, $t,'� tr 1 �Y rr �tl t is t 7 4041i e, m. o (BPA) C PUBLICATION AUDITORS INFORMA Current New BUSINESS TITLE Current New EMPLOYER ACTIVITIES YOUR CURRENT BPA A. Owner, President, Vice 1. Architectural, Architectural- Engineering Firm, INFORMATION IS PROVIDED. President, General Architect, Architect Engineer in Private Practice IF CORRECTIONS ARE Manager, Military Officer, C 2 Consulting Engineering Firm, engineer in NEEDED, PLEASE MAKE Private Practice THEM IN THE NEW COLUMN. B. Project Manager and Coordinator, Chief andlor 6. Commercial andlor Industrial Organization Staff Engineer (including transportation and privately owned utility companies) Your Business Title C. Staff Architect 7. Producer of Building Construction Materials D Construction (including cement, cement products, sand, Assist Eng r Superintendent and/ gravel, and other aggregates, clay products, or Supervisory Staff and other raw materials) If your Business Title Personnel 8. Manufacturer of Construction Equipment has changed, please print E. Department Manager and Supplies corrections below: and /or Department Head 14. Engineering School student F. Other titled Engineer, 15. Educator Professor, instructor X Non Titled Engineer andlor Fully Retired 16. Library, Club Professional, or Trade Association Engineer 31. Contractor specializing in building construction G. Student 33. Contractor specializing ie constructron other 0. Other Personnel, Library than buildings andlor Company Copies 34. Contractor engaged in both Please sign with or without changes 51. Federal 52. State 53. State X 54 Municipal, County, Township, andlor District Signature Date 55. Foreign 18. OTHER: If no other category applies, please advise type of organization with which you are affiliated 285096 4 1 1040813856 3 TYPE C MB 54/F USA 10 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 ASC /Membership Purchase Order No. P.O. Box 79084 Terms Baltimore, MD 21279 0084 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 09/09/09 n/a ASCE Annual Membership Gary Duncan $220.00 For 2010 year Total $22200 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 NO. WARRANT NO._ ALLOWED 20 ASCE /Membership IN SUM OF P.O. Box 79084 Baltimore, MD 21279 -0084 $220.00 ON ACCOUNT OF APPROPRIATION FOR Department of Engineering Board Members D PT INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or 1040813856 EyG 4355300 $220.00 bill(s) is (are) true and correct and that the Member 285096 materials or services itemized thereon for which charge is made were ordered and received except 21110 20 Signature C 13 M 7 nq 1 v�Q Title Cost distribution ledger classification if claim paid motor vehicle highway fund