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Home My WebLink About195325 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