The URL can be used to link to this page

Home My WebLink About202905 10/25/2011 CITY OF CARMEL, INDIANA VENDOR: 356912 Page 1 of 1 �f ONE CIVIC SQUARE AMERICAN SOCIETY OF CIVIL ENGINEE&ECK AMOUNT: $225.00 CARMEL INDIANA 46032 P.O. BOX 79084 BALTIMORE MD 21279 -0084 CHECK NUMBER: 202905 CHECK DATE: 10/25/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2200 4355300 1041546909 225.00 ORGANIZATION MEMBER ASCE AMERICAN SOCIETY OF CIVIL ENGINEERS P.O. BOX 79084, BALTIMORE, MD 21279 -0084 September 6, 2011 RENEW EARLY TO Gary R Duncan, P.E., WASCE WIN CASH Carmel City of 1 Civic Sq FOR THE HOLIDAYS Carmel, IN 46032 -2584 Renew your membership online at www.asce.org/renewal Address Update Please note any changes in Step 3 on reverse side of form. -To of membership and please s-_,limit- the- "Crand Total" ".__r,t. TO amend y„_ rurrent !eve!^ please Cirrm amt items v choose to pay in Step 1. Add additional items in the Step 2 "write -in" column and include them in the "Grand Total." Description R enewal Amount Cod 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: J> $225.00 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) 30.00 CIMS Engineering Mechanics Institute Dues EMI $30.00 EMMS Environmental and Water Resources Inst Dues EWRI $30.00 EWMS Geo- Institute Dues G -1 ($30.00) GIMS Structural Engineering Institute Dues SEI $30.00 SEMS Intl Soc of Soil Mech Geotechnical En ISSMGE $15.00 ISS Indiana Section -Metro Indianapolis Br Voluntary $25.00 SV National Funds Description See enclosed insert for descriptions Write -In Amount /rite -in Code C0 Q •fie i.s i��t"rt .c9t m Institute Funds Description See enclosed insert for descriptions Write-in Amount Write -in Code v0 t t:ri U Annual Sub total: Turn Over for Payment Information 285096 4 1 1041546909 5 TYPE A MB USA 12 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 Currently your actual business title is: Assist Engr if this is not correct please mark through this and write in your changes here RESIDENCE ADDRESS BUSINESS /SCHOOL ADDRESS Line 1: 11034 Palatka Court Line 1: One Civic S quare Line 2: Line 2: Line 3: Line 3: CCU: Indianapolis Cit Carmel State: IN State: IN Zip Code: 46236 Zi Code: 46032 Count a: United States Country: United States Home Phone: 317 826 -2948 E -mail Address #1: gduncan @carmel.in.gov Business Phone: 317 571 -2441 E -mail Address #2: �,.,F._. I tlh \J I rlililiG. I :JI 1 LYJS V iiG /1l.�JU ill i ii: y lAllal.prIIICI.II i.gJv 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 0) Retired 9 Specializing in Building Construction CONTRACTOR 10 Engaged in Both 8 and 9 r ieaSe Sign with Or wi[hoUt charlyes. Producers of Building and Construction Materials and Manufacturers of k 6 'liv Construction Equipment and Supplies Professional and Trade Associations, Libraries, Clubs and Others Allied to the nature Date 12 Field GRAND TOTAL: $225.00 Payment by Check Check must be made payable to ASCE in equivalent U.S. dollars. 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 f MEMBERSHIP DUES ARE DUE Credit Card Expiration Date ASCE MEMBERSHIP BOX BY DECEMBER 31, 2011. •0 00 MEMBER 285096 X Signature ABOVE AD D_ INVOICE 1041546909 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. 28509L 4 1 1041546909 5 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 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)) 9/6/11 1041546909 ASCE Annual Membership Gary Duncan $225.00 2012 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 1 1546909 ENG 4355300 $225.00 bill(s) is (are) true and correct and that the rn tuber #285096 materials or services itemized thereon for which charge is made were ordered and received except 0 74 20 Signatu e Title Cost distribution ledger classification if claim paid motor vehicle highway fund