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Home My WebLink About178031 10/14/2009 CITY OF CARMEL INDIANA VENDOR: 356912 Page 1 of 1 s 0 ONE CIVIC SQUARE AMERICAN SOCIETY OF CIVIL ENGINEF&ECK AMOUNT: $220.00 CARMEL, INDIANA 46032 P.O. Box 79084 BALTIMORE MD 21279 -0084 CHECK NUMBER: 178031 CHECK DATE: 10/14/2009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION ;'2200 4355300 MCBRIDE 220.00 ORGANIZATION MEMBER s >r INDIANA SECTION TDI AMtRICAN SOCIETY OF CIVIL ENGINEERS September 9, 2009 RENEW EARLY Michael Thomas Mc Bride, P.E., M.ASCE TO City of Carmel 14227 Turner Hollow PI Fortville, IN 46040 -8113 YOUR SECTION Irlr�lrll�rlll��rl�rlllrrrlr�l�r��ll�r�llrrllrrrl�ll��rl�lr�ll Address Update Please note any changes in Step 4 on reverse side of form. Renew online at www.asce.org /renewal To maintain your current level of membership and services, please sub it ,he "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. Description Renewal Amount Code National Membership Dues $205.00 ND Indiana Sec -Metro Indianapolis Br Dues $15.00 SD Transportation Development Institute Membership (T &DI) $0.00 TDMP I UUL9J�C /(7]� ry Annual Sub total: $220.00 W% D C5 f D 0 c Description Write -in Amount Code Engineers Without Borders Professional Membership ($60.00) EWBP Engineers Without Borders Supporting Membership ($40.00) EWBS Architectural Engineering Institute Membership (AEI) ($30.00) AEMS Coasts, Oceans, Ports Rivers Institute Membership (COPRI) (S30.00) COMS Construction Institute Membership (CI) (S30.00) CIMS Engineering Mechanics Institute Membership (EMI) ($30.00) EMMS Environmental Water Resource Institute Membership (EWRI) ($30.00) EWMS Geo- Institute Membership (G -1) ($30.00) GIMS Structural Engineering Institute Membership (SEI) ($20.00) SEMS En (I c) (v1 0) Indiana Section Metro Indianapolis Branch Voluntary V ($0.00) SV Nat Voluntary Description See enclosed insert for descriptions Write -in Amount Write -in Code I write -in description wp write -in description co gin ite -in description D t Z m Institute Voluntary Description See enclosed insert for descriptions Write -in Amount Write -in Code Z v0 descrirfion :e in i^r_::rip}iiC L!riie Ill dB�,criptini! Annual Sub total: D GRAND TOTAL: $220.00 Payment by Check: Check must be made payable to ASCE in equivalent U.S. dollars. Federal ID Payment by Credit Card: AMEX Discover MasterCard Visa Diners Club 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 a minimum of $75.00. Please remit p a y ment MEMBERSHIP DUES ARE DUE ASCE MEMBERSHIP, BOX 79084 BY DECEMBER 31, 2009. BALTIM 08 MEMBERM 368926 Credit Card Expiration Date or call: :00 INVOICE #:1040846068 X Signature Your 2010 Membership Year began on January 1, 2010. Thank you for renewing your membership. $36 (or a pro-ration therof) of your dues payment represents the non deductible amount associated with ASCE News and Civil Engineering magazine. The balance of your dues and all voluntary contributions may be deductible as a chartitable contribution according to the I.R.S. We recommend you consult your tax advisor. 368926 3 1 1040846068 8 TYPE A MB 54/B USA 10 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 RESIDENCE ADDRESS BUSINESS /SCHOOL ADDRESS Line 1: 14227 Turner Hollow PI Line 1: Engineering Department Line 2: Line 2: One Civic Square Line 3: Line 3: City: Fortville City: Carmel State: IN State: IN Zip Code: 46040 Zip Code: 46032 Countrv: United States Countrv: United States Home Phone: (317) 336 -4228 E -mail Address #1 mmcbride @carmel.in.gov Business Phone: (317) 571 -2441 E -mail Address #2 Fax Phone: Online Account E -mail Address: mmcbride @carmel.in.gov Your professional needs and interests are important to us. Please complete the following personal interest inventory to help us tailor the programs and services ASCE offers to you. I do not have interest in the technical specialities of civil engineering and do not choose to receive technical information from the Society. The following is a list of broad technical areas currently offered by ASCE. To indicate your level of interest, past experience, or willingness to participate, please place a number in the corresponding box. Please complete only the Area of Interest(s) relative to your personal interest. Thank you! Interest Level: Past experience in this area: Willingness to participate: Want more information: WS W UN 1 for high interest 1 for a lot of experience 1 for very likely Y Yes rVallu 2 for some interest 2 for some experience 2 for somewhat likely N No 3 -for no interest 3 for no experience 3 for not likely Area of Interest Interest Level Past Experience Willingness to Participate More Information A. Architectural Engineering B. Coasts, Oceans, Ports, Rivers C. Construction D. Environmental Water Resources E. Geotechnical Engineering Geotechnology F. Infrastructure Security and Emergency Preparedness Response G. Structural Engineering H. Transportation Land Development I. Other Civil Engineering Areas 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 IF CORRECTIONS ARE Manager, Military Officer, Consultant 2. Consulting Engineering Firm, engineer in NEEDED. PLEASE MAKE Private Practice THEM IN THE "NEW' COLUMN. B. Project Manager and X Coordinator, Chief and /or 6. Commercial and/or Industrial Organization Staff Engineer (including transportation and privately owned utility companies) Your Business Title C. Staff Architect 7. Producer of Building &Construction Materials CITY ENGINEER D. Construction (including cement, cement products, sand, Superintendent and/ gravel, and other aggregates, clay products, or Supervisory Staff and other raw materials) If your Business Title Personnel 8. Manufacturer of Construction Equipment has changed, please print E. Department Manager and Supplies Corrections below: and /or Department Head 14. Engineering School student F. Other titled Engineer, Non Titled Engineer 15. Educator Professor, Instructor and /or Fully Retired 16. Library, Club Professional, or Trade Association Engineer 31. Contractor specializing in building construction G. Student 33. Contractor specializing in construction other O. Other Personnel, Library than buildings and /or Company Copies 34. Contractor engaged in both 51. Federal Please sign with or without changes 52. state 53. State X 54. Municipal, County, Township, and /or District 55. Foreign Signature T2_ to v 18. OTHER: If no other category applies, please advise type of organization with which you are affiliated. 368926 3 1 1040846068 8 TYPE A M8 54/13 USA 10 2 Prescribed by State Board of Accounts City Form No. 201 (Re ACCOUNTS PAYABLE VOUCHER 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)) 09/09/09 n/a ASCE Annual Membership Mike McBride $220.00 For year 2010 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. 1 20 Clerk- Treasurer I VOUCHER NO. WARRANT NO. ALLOWED 20 ASCE /Membership IN SUM OF P.O. Box 79084 Baltimore, MD 21279 -0084 $220.00 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 09/09/09 E G 4355300 $220.00 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 2 Signature Cost distribution ledger classification if Title laim paid motor vehicle highway fund