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191540 11/10/2010 CITY OF CARMEL, INDIANA VENDOR: 356912 Page 1 of 1 ONE CIVIC SQUARE AMERICAN SOCIETY OF CIVIL ENGINEEERR O P.O. BOX 79084 CHECK AMOUNT: $225.00 CARMEL, INDIANA 46032 s ;o to BALTIMORE MD 21279 -0084 CHECK NUMBER: 191540 CHECK DATE: 11/10/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2200 4355300 090710 225.00 ORGANIZATION MEMBER r Payment by Check Check must be made payable toASCE in equivalent U.S. dollars. GRAND TOTAL $225.00 Federal ID No. 13 1635293 A 525 service charge applies to all International checks not payable through a U S- bank_ Payments not in U.S. dollars drawn on a U.S. bank must be Payment by Credit Card: AMEX IL Discover 7 MasterCard 17 Visa Diners Club a minimum of $75,00 Please remit payment to: MEMBERSHIP DUES ARE DUE Credit Card Expiration Date P. BY DECEMBER 31, 2010. MID 21279 (N O C •O MEMBER #:368926 X Signature BO INVOICE 1 041 091 626 or call: (800) 548 (2723) Thank you for renewing your membership. Your 2011 Membership Year begins on January 1, 2011. $25 (or a pro- ration thereof) of your dues payment represents the non- deductible amount associated with the Civil Engineering magazine. The balance of your dues and all voluntary contribu- tions may be deductible as a charitable contribution according to the I.R.S we recommend you consult your tax advisor. 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: Residence Change your preferred mailing address by circling your new preference: RESIDENCE or BUSINESS /SCHOOL COMPANY NAME: City of Carmel RESIDENCE ADDRESS BUSI NESS/SCHOOL ADDRESS Line 1: 14227 Turner Hollow PI Line 1: Engineering Departme Line 2 Lin 2: One Civic S quare Line 3: Line 3. City: Fortville City: Carmel State: IN State IN Zip Code: 46040 Zip Code: 46032 Country: United States Country: United States Home Phone: (317) 336 -4228 E -mail Address #1: mmcbride @carmel.in.gov Business Phone: (317) 571 -2441 E -mail Address #2: Fax Phone: Online Account E -mail. mmcbride @carmel.in.gov Current New BUSINESS TITLE Current New EMPLOYER ACTIVITIES YOUR CURRENT BRA A_ Owner, President, Vice 1. Architectural, Architectural Engineering Firm, INFORMATION IS PROVIDED. President, General Architect, Architect Engineer in Private Practice 1F CORRECTIONS ARE Manager, Military 2, Consulting Engineering Firm, engineer in Private Officer, Consultant Practice NEEDED, PLEASE MAKE B Project Manager and 6. Commercial and/or Industrial Organization rri nl Tr,rP' ern rl -inn/ /�llr rn nn, r5 rc Jl iry X Coordinator, Chief and/ including transportation anti pnvateiy owned or Staff Engineer utility companies) C. Staff Architect 7. Producer of Building Construction Materials Your Business Title (including cement, cement products, sand, D_ Construction gravel, and other aggregates, clay products, and CITY ENGINEER Superintendent and) other raw materials) or Supervisory Staff 8. Manufacturer of Construction Equipment Personnel and Supplies If your Business Title E. Department Manager 14 Engineering School student has changed, please print and/or Department 15 Educator- Professor, Instructor corrections below: Head 16. Library, Club Professional, or Trade Association F. Other titled Engineer, Non Titled Engineer 31 Contractor specializing in building construction and/or Fully Retired 33. Contractor specializing in construction other Engineer than buildings G. Student 34. Contractor engaged in both 51. Federal O. Other Personnel, Library and /or 52. Slate Company Copies 53. Slate Please Sinn ,kith r�r wiiiirnit changes X 54. Municipal, County, Township, and/or District 55. Foreign 18. OTHER If no other category applies, please t I advise type of organization with which you are Signature Date affiliated 368926 3 1 1041091626 2 TYPE A 1113 USA 11 ASCE AMERICAN SOCIETY OF CIVIL ENGINEERS P.O. BOX 79084, BALTIMORE, MD 21279 -0084 September 7, 2010 RENEW EARLY TO HELP YOUR SECTION AND TO Michael Thomas Mc Bride, P.E., M.ASCE WIN A CASH PRIZE. City of Carmel 14227 Turner Hollow PI Fortville, IN 46040 -8113 I1 111111 1111111111111I11111111111 111 111 11111111111 11 111111111111111 Renew your membership online at www.asce.org /renewal Address Update Please note any changes in Step 4 on reverse side of form. Instructions: to continue with your previous level of membership and services, submit the "Grand Total" amuunl. To amend your previous levels, please uircic ary 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. To choose or change your EWB Chapter, please call ASCE's Customer Service at (800) 548 -ASCE (2723) or (703) 295 -6300, Description Renewal Amount Code National Membershi Dues $210.00 ND indiana Section -Metro Indiana Branch Dues $15.00 SD Transportation and Development Inst Dues (TDI) $0.00 TDMP Annual Sub total: $225.00 m. Description Write -in Amount Code Engineers Without Borders National Membership $60.00 EO Engineers Without Borders Supporting Membership $40 -00 E813 Architectural Engineering Institute Dues AEI $30.00 AEMS Coasts, Oceans, Ports and Rivers Inst Dues COPRI $30.00 COMS Construction Institute Dues (Cl $30.D0 CIMS Eng ineerin g Mechanics Institute Dues (EMI) $30.00 EMMS Environmental and Water Resources Inst Dues EWRI $30.00 EWMS Geo- Institute Dues G -I $30.00 GIMS Structural Engineering Institute Dues SEI $30.00 SEMS Int'I Soc of Soil Mech Geotechnical Err ISSMGE $15.00 ISS Indiana Section -Metro Indianapolis Br Volunta $25.00 SV National Voluntary Description See enclosed insert for descriptions Wri -in Amount Write -in Code -rite-in description VJ W n -i dcF ?ion __jO Ml tunte -in description _m z Institute Voluntary Description See enclosed insert for descriptions Write -in Amount Write -in Code Z v 0 write -in descr iption write-in description write -in description Annual Sub total: D Turn Over for Payment Information 368926 3 1 1041091626 2 TYPE A MB USA 11 Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995) 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 ASCE /Membership Purchase Order No. P.O. Box 79084 Terms Baltimore, MID 21279 -0084 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 09/07/10 n/a ASCE Annual Membership Mike McBride $225.00 For year 2011 i. Y r Total 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. WAR, RANT NO. ALLOWED 20 ASCE /Mem ership IN SUM OF P.O. Box 79084 Baltimore, MID 21279-0084 $225.00 ON ACCOUNT OF APPROPRIATION FOR Department of Engineering Board Members POk or INVOICE NO. ACCT /TITLE AMOUNT DEPT, I hereby certify that the attached invoice(s), or 09/07/10 E G 4355300 $225.00 bill(s) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except 20 Sig ature vy �z Cost distribution ledger classification if Title claim paid motor vehicle highway fund