HomeMy WebLinkAbout202458 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
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Institute Funds Description Seeenclosed insert for descriptions !Trite -in Amount Write -in Code
Z
00 rite-:n dsscrip'iicn
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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