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Home My WebLink About210860 07/17/2012 CITY OF CARMEL, INDIANA VENDOR: 359978 Page 1 of 1 ` ONE CIVIC SQUARE GOLF COURSE SUPER.ASSOC OF AMER I CARMEL, INDIANA 46032 1421 RESEARCH PARK DR CCK AMOUNT: $340.00 LAWRENCE KS 66049-3859 CHECK NUMBER: 210860 CHECK DATE: 7117/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1207 4355300 164825 340 . 00 ORGANIZATION & MEMBER GCSA GOLFCOUPMSUKPJ SOCAMNOFAMERiG REMIT TO: 164825 1421 Research Park Dr, Lawrence, KS 66049-3859 Call: (800)472-7878 Fax: (785)832-3643 FINAL NOTICE-RENEW ONLINE TODAY @ WWW.GCSAA.ORG DUES INVOICE 276710 Your preferred mailing address: 7/1/2012-6/30/2013 164825 A Robert D. Higgins Other Address: 024887 16133 Hymera Grn Westfield,IN 46074-8418 UNITED STATES Brookshire Golf Course 12120 Brookshire Pkwy Carmel,IN 46033-3314 UNITED STATES Your Class A Renewal Cycle is: 04/06/2011-04/05/2016 Would you like to continue to receive OYESONO Golf Course Management magazine? CHAPTER MEMBERSHIP Use the spaces below to update your home and/or golf course information. NEW Home Mailing Address: (Provide ONLY if changed address.) Indiana GC5A,M/chlana GCSA Pd & :lc kE) Street or P.O. Box(1) Vote is with: None Street or P.O. Box(2) City,State,Zip IF YOU WOULD LIKE TO CHANGE YOUR VOTE, I,I,),-S` pp t ii e.l PLEASE CONTACT MEMBER SOLUTIONS @ 1-800- Country 472-7878 FOR AN AFFIDAVIT. 31 ' Phone Fax Current E-mail Information: If possible,please provide a mailing address that includes a street address. Fed Ex will not deliver to a PO Box. (GCSAA does not rent or sell email addresses.) NEW Golf Course Information: Date started (Provide ONLY if you have changed positions.) bhiggins @carmel.in.gov Golf Course Name Street or P.O. Box(1) Please update below,if needed: Street or P.O. Box(Z) City,State,Zip Preferred E-mail(To be used for all GCSAA correspondence) Country PUBLISH E-mail address in the [PYESONO Fax Membership Directory? Phone GOLF COURSE MANAGEMENT GIFT SUBSCRIPTION(S) You may,as a professional courtesy,send a maximum of two Goff Course Management(GCM) subscriptions to your club president,green chairman, employer or other appropriate party. To send complimentary subscriptions to a new/or different person,go to http://www.qcsaa.ora/profile/giftsub.asi)x r RE" 164825 A Robert D. Higgins . 276710 7%1/2012-6/30%2013 $340.00 ® 0 0 To continually improve membership programs and resources, please provide the following information. Your participation will enable your association to build the most comprehensive database in the golf course management industry. 1. What is your annual maintenance budget?(circle one) a.Less than$250,000 d. $750,000- $999,999 g. $1,500,000 and over b.$250,000-$499,999 e. $1,000,000 - $1,249,999 c $500,000-$749;999 f. $1,250,000- $1,499,999 2. What percentage of your annual maintenance budget is spent on the following categories?If necessary, provide an estimate. (Total must add up to 100%) a. )L % Labor(include all payroll expenses: salaries, hourly wages and labor contracts) b. %Water(include all water costs) c. 5 %Other(include all remaining items in your maintenance budget) 3. How many golf holes are maintained through your annual maintenance budget? Enter number of holes 1 4. How much do you spend annually on maintenance equipment purchases and leases? 5,What is your predominant turf type on: tees fairways_T(.t greens_, , 6.What percentage of your maintenance fleet is owned vs. leased? Own ')-' % Lease % (Total must add up to 100°/x) What is your gender? Male Female Which of the following best describes your ethnicity? k. White Black/African American a ^5"11L1e�IGo The EIFG fosters sustainabib(y through Hispanic/Latino Asian research, awareness, education,programs Multiracial Amercan Indian/Native Amertcan/Alaskan Native and scholarships for the benefit of golf course management professionals, golf faolities and the game. Birthdate '71,- J-7 i " (mm/dd/yyyy) Are you a citizen of the United States 7 IN y ❑N For more information regarding the life insurance benefit, go to www.gcsaa.org and search for Affinity Programs. GCSAA Bylaws require that the following information be confirmed and returned with your annual dues remittance. Your current job title or position is: If your position/responsibilities have changed and you have not contacted us, please visit www.gcsaa.org/membership and complete a reclassification form. Golf Course Superintendent Title I hereby certify that my information is correct. J Semi private 18 X Member's Signaturer..� y' Date /. 't��: Facility Type # Holes Please Make A Copy For Tax Purposes: GCS.AA dues are not deductible as a charitable contribution for federal income tax purposes;but may be deductible as an ordinary and necessap'business expense GCSAA estimates that 0%of your membership dues are not deductible as this portion will be used for advocatine positrons on 11-emme1-11 issues.as—11 as for the payment of dues term life insurance for all member's excluding students,affiliate companies,technical assistance nernvrk,International The Em'ironmental Institute for Golf is exempt from taxation under Code Section 501(c)(3)of the Internal Revenue Set"%ice. Yourvoluntary Lift is deductible as a charitable contribution for federal tax purposes to the extent proN tded by Inw. METHOD OF PAYMENT ❑ Membership Dues $340.00 Check Encosed ❑American Express []MasterCard❑MasterCard Visa U.S. Funds Only(U.5. dollars draivn on U.5. bank) Prepaid Amount $0.00 TOTAL DUES OWED 5340.00 Credit Carte _——— ——`` Voluntary Contribution to The Environmental Institute for Golf $50.00 120_` TOTAL DUES and CONTRIBUTION $390.00 Expiration Date Card Holder Name (please print) ��// Join or renew the Golden Tee Club by contributing an additional X Signature $50 here. Make checks payable to: GCSAA TOTAL AMOUNT ENCLOSED REMIT TO: 1421 Research Park Dr, Lawrence,KS 66049-3859 - Call:(800)472-7878 Far.(783)832-3643 a, 3- M 21 112111 -01 REN 164825 A Robert D. Higgins 276710 7/1/2012- 6/30/2013 $340.00 VOUCHER NO. WARRANT NO. ALLOWED 20 GCSAA U`l /!d, , IN SUM OF $ 1421 R1 esearch Park Drive D(J> Lawrence, KS 66049-3859 $340.00 ON ACCOUNT OF APPROPRIATION FOR Brookshire Golf Club PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1207 I 164825 I 43-553.00 I $340.00 1 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 Thursday, July 12, 2012 Director, Brookshir off Club Title Cost distribution ledger classification if claim paid motor vehicle highway fund Prescribed by State Board of Accounts City Form No.201 (Rev.1995) 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 Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 07/01/12 164825 Dues $340.00 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