HomeMy WebLinkAbout195325 03/16/2011 CITY OF CARMEL, INDIANA VENDOR: 010558 Page 1 of 1
ONE CIVIC SQUARE AMERICAN SOC OF CIVIL ENG MEMBR
CARMEL, INDIANA 46032 PO BOX 79084 CHECK AMOUNT: $225.00
BALTIMORE MD 21279 -0084
CHECK NUMBER: 195325
CHECK DATE: 3/16/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2200 4355300 012511 225.00 ORGANIZATION MEMBER
n
N
Payment by Check: Check must be made payable toASCE in equivalent U.S. dollars.
GRAND TOTAL: $225.00 Federal ID No 13- 1635293. A $25 service charge applies to all InternationaE 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 Discover MasterCard D Visa C Diners Club a minimum of $75.00.
Please-rernit payment to: MEMBERSHIP DUES WERE DUE
Credit Card Expiration Date ASCE MEMBERSHIP BOX BY DECEMBER 31, 2010.
•08 D 00
CO MEMBER 285096
X
Signature DDI INVOICE #:1041069331
or call. :i0
Thank you for renewing your membership. Your 2011 Membership Year began on January 1, 2011.
$25 (or a pro- ration thereof) of your dues payment represents the non- deductible amount associated with the Civii 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: 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
Lin 1: 11034 P alatka Court Line 1: One Civic Square
Line 2: Line 2:
Line 3: Line 3:
cit Indianapolis City: Carmel
State: IN State: IN
Zip Code: 46236 Zi Code: 46032
Count a: United States Country: United States 22i I
Home Phone: (317 826 -2948 E -mail Address #1: nrp oop s comr ast.net
Business Phone: 317 571 -2441 E -mail Address #2:
Fax Phone: 317 571 -2439 1 Online Account E -mail 2duncan2carmel.in2v
r
P
ULL -41
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
1F CORRECTIONS ARE Manager, Military 2 Consulting Engineering Firm, engineer in Private
Officer, Consultant Practice
NEEDED, PLEASE MAKE
B. Project Manaoer and 6_ Commercial and/or industrial Organization
THEM IN THE "NEW' COLUMN. Coordinator, Chief and/ (including transportation and privately owned
or Staff Engineer utility companies)
G Staff Architect 7. Producer of Building 8 Construction Materials
Your Business Title (including cement, cement products, sand,
D. Construction gravel, and other aggregates, clay products, and
Assist Engr Superintendent and/ other raw materials)
or Supervisory Staff 8. Manufacturer of Construction Equipment
Personnel and Supplies
If your Business Title 14. En ineerin s
E. Department Manager Engineering drool 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, 31 Contractor specializing in building construction
Non Titled Engineer
X and /or Fully Retired 33. Contractor specializing in construction other
Engineer than buildings
34 Contractor engaged in both
G Student
51. Federal
O, Other Personnel, 52. State
Library and/or 53. State
Company Copies
54. Municipal, County, Township, and/or District
Please sign with or without changes 55. Foreign
18. OTHER. If no other category applies, please
advise type of organization with which you are
Signature Date affiliated
285096 4 2 1041069331 5 TYPE A MB USA 11
ASCE AMERICAN SOCIETY
OF CIVIL ENGINEERS
P.O. BOX 79084, BALTIMORE, MD 21279 -0084
I� I II II II II I I I I f II enXSiaw.FxH
January 25, 2011 2ND EFFORT NOTICE
EXPIRED MEMBERSHIP
Gary R Duncan, P.E., M.ASCE
Carmel City of
1 Civic Sci
Carmel, IN 46032 -7569
Renew your membership online at www,asce.org /renewal
Address Update Please note any changes in Step 4 on reverse side of form.
We're concerned because we haven't received your 20 i dues, and your membership has expired. To maintain your current level of
membership and services, please submit the "Grand Total" amount. To amend your current levels, 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. To choose or change your EWB Chapter, please call ASCE's
Customer Service at (800) 548 -ASCE (2723) or (703) 295 -6300.
e o s M amma=
Description Renewal Amount Code
National Membership Dues $210.00 ND
Indiana Section -Metro Indianapolis Branch Dues $15.00 SD
Transportation and Development Inst Dues TDI) $0.00 I TDMP
Annual Sub total: $225.00
A
Description Write -in Amount Code
Engineers Without Borders National Membership $60.00 EO
Engineers Without Borders Supporting Membershi $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 CI $30.00 CIMS
Engineering Mechanics Institute Dues EMI $30.00 EMMS
Environmental and Water Resources Inst Dues EWRI $30.00 EWMS
Geo- Institute Dues (Gd) ($30.00 GIMS
Structural Engineering Institute Dues (3[I) '$30.00' SEMS
Int'I Soc of Soil Mech Geotechnical En ISSMGE $15.00 ISS
Indiana Section -Metro Indianapolis Br Voluntary $25.00 Sv
National Voluntary Description See enclosed insert for descriptions Write Am ount Write in Code
LUZ w� °tt.£•ia� description
JO writ: An descrion
Q vtrite -in descript "scan
Lm
a 01 Institute Voluntary Description See enclosed insert for descriptions Write in Amount Write in Code
z
00 �rst• desesiptici�
;Fa�;trr -in descriptor;
description
Annual Sub- total:
Turn Over for Payment Information
285096 4 2 1041069331 5 TYPE A MB USA 11
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 207 (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, MD 21279 -0084
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
1125/11 n/a ASCE Annual Membership Gary Duncan $225.00
For year 2011
Total $225.00
1 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
$225.00
ON ACCOUNT OF APPROPRIATION FOR
Department of Engineering
Board Members
Po# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1125111 El 4G 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
Signatur
City r- A
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund