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Home My WebLink About202458 10/11/2011 CITY OF CARMEL, INDIANA VENDOR: 010558 Page 1 of 1 ONE CIVIC SQUARE AMERICAN SOC OF CIVIL ENG MEMBRSH� CARMEL, INDIANA 46032 PO BOX 79084 CHECK AMOUNT: $225.00 BALTIMORE MD 21279 -0084 CHECK NUMBER: 202458 CHECK DATE: 10/11/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2200 4355300 1041566295 225.00 ORGANIZATION MEMBER 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 Currently your actual business title is: CITY ENGINEER if this is not correct please mark through this and write in your changes here RESIDENCE ADDRESS BUSINESS /SCHOOL ADDRESS Line 1: 14227 Turner Hollow PI Line 1: En ineerin Department Line 2: Line 2: One Civic S quare Line 3: Line 3: Cam: Fortville Cit Carmel State: IN State: IN Zip Code: 46040 Zi Code: 46032 Count !y: United States Country: United States Home Phone: 317 747 -7025 E -mail Address #1: mmcbride @carmel.in.gov Business Phone: 317 571 -2441 E -mail Address #2: Fax Phon Online Accoun t C inaii: mm.cbrid6Cw�CaiiTlei.iri.gOv 0 Please place a check (X) in the box that best describes your business title and industry classification. This helps ASCE to better filter the most appropriate business information to you. X Standardized Business Title X Industry Classification Engineer in Training, Engineering Intern, Assistant Engineer, Junior 1 Consulting Firm (a) Engineer, Staff Engineer, Engineering Instructor 2 Architectural Firm Civil Engineer, Associate Engineer, Project Engineer, Resident (d) Engineer, Assistant Professor 3 Federal (e) Senior Engineer, Project Manager, Associate Professor 4 State, County, Township and District (f) Principal Engineer, District Engineer, Engineering Manager, Professor GOVERNMENT 5 Municipal Director, Program Manager, City Engineer, County Engineer, Division (g) Engineer, Department Head, Vice President 6 Military Bureau Engineer, Director of Public Works, Dean, President, Owner, 7 Engineering Schools (h) CEO (i) Other non engineer, non technical, non sciences 8 Specializing in Highway and Heavy Construction Q) Retired 9 Specializing in Building Construction CONTRACTOR 10 Engaged in Both 8 and 9 ried38 Sign with Of WitilOUi changes. Producers of Building and Construction Materials and Manufacturers of 11 Construction Equipment and Supplies W 'r'7�I vE I Professional and Trade Associations, Libraries, Clubs and Others Allied to the Signature Date 12 Field Payment by Check: Check must be made payable to ASCE in equivalent U.S. dollars. GRAND TOTAL: $225.00 Federal ID No. 13- 1635293. 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.S. bank must be Payment by Credit Card: AMEX Discover MasterCard Visa Diners Club a minimum of $75.00. Please remit payment to: MEMBERSHIP DUES ARE DUE Credit Card Expiration Date ASCE MEMBERSHIP, BOX BY DECEMBER 31, 2011. C MEMBER #:368926 MID 21279-0084 X Signature INVOICE 1041566295 or call: :00 Thank you for renewing your membership. Your 2012 Membership Year begins on January 1, 2012. $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 contributions may be deductible as a charitable contribution according to the I.R.S. We recommend you consult your tax advisor. 068926 3 1 1041566295 6 TYPE A MB USA 12 A SI C AMERICAN SOCIETY OF CIVIL ENGINEERS P.O. BOX 79084, BALTIMORE, MD 21279 -0084 IIII III III) III II September 6, 2011 RENEW EARLY TO Michael Thomas Mc Bride, P.E., M.ASCE WIN CASH City of Carmel 14227 Turner Hollow PI FOR THE HOLIDAYS Fortville, IN 46040 -8113 Renew your membership online at www.asce.org /renewal Address Update Please note any changes in Step 3 on reverse side of form. To maintain your current love! of membership and services, please submit the "Grand Total" amount. To amend your current !evels, 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." s Descriptio 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 1 TDMP Annual Sub total: D $225.00 Description Write -in Amount Code En gineers Without Borders National Membershi $60. 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) $30.00 CIMS Engineering 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 En ISSMGE $15.00 ISS Indiana Section -Metro Indianapolis Br Voluntary $25.00 SV Nat Funds Description See enclosed insert for descriptions !Trite -in Amount Write -in Code w m� _m Institute Funds Description Seeenclosed insert for descriptions !Trite -in Amount Write -in Code Z 00 rite-:n dsscrip'iicn U vrite dvt:crip on Annual Sub total: Q Turn Over for Payment Information 1 368926 3 1 1041566295 6 TYPE A MB USA 12 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 '0 Kyjr' 0 Purchase Order No. 4 Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) CQ CD l 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. WARRANT NO. ALLOWED 20 IN SUM OF ruD 21 ON ACCOUNT OF APPROPRIATION FOR Board Members PO# or INVOICE NO. ACCT #!TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 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/j ,A I f- V Title Cost distribution ledger classification if claim paid motor vehicle highway fund