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Home My WebLink About225734 11/05/2013 i CITY OF CARMEL, INDIANA VENDOR: 356912 Page 1 of 1 ONE CIVIC SQUARE i AMERICAN SOCIETY OF CIVIL ENGINEER CARMEL, INDIANA 46032 RO.Box 79084 CHECK AMOUNT: $240.00 BALTIMORE MD 21279-0084 CHECK NUMBER: 225734 CHECK DATE: 11/5/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2200 4355300 240 . 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: 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: 13129 Foster Ct Line 1 One Civic Square Line 2. Line 2' Line 3: Line 3: Cit : Carmel City: Carmel State: IN State: IN Zip Code:46033-4615 Zip Code:46032 Country: United States Country: United States Home Phone: (317)669-2373 E-mail Address#1: gduncan@carmel.in.gov Business Phone: 317 571-2441 E-mail Address#2: Fax Phone: /7(317)5571-2439 p fOnline A/c-c/ounyt�E-�ymaii�: .9dduncan @carrymyeyl.i�n.gov �p V 0.� D D 0 D 0 0 (l1 A:-1/O J(/ll.�/l�(�.�U7J �•/l•,l o h 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. Note This information must be updated annually. 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 GOVERNMENT (F) Principal Engineer,District Engineer,Engineering Manager,Professor 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 (1) Other non-engineer,non-technical,non-sciences,student 8 Specializing in Highway and Heavy Construction (J) Retired 9 Specializing in Building Construction CONTRACTOR 10 Engaged in Both 8 and 9 Please sign ,,r� Producers of Building and Construction Materials and Manur a rs of 11 Construction Equipment and Supplies Professional and Trade Associations,Libraries,Clubs and Others Allied to the Si a e Oad 12 Field eU U l5lr✓� try' ( 1� � Payment by Check:Check must be made payable to ASCE in equivalent U S.dollars GRAND TOTAL: $240.00 Federal ID No.13-1635293 Checks not in U S dollars drawn on a U S.bank will be returned Payment by Credit Card ❑AMEX ❑Discover ❑ MasterCard ❑Visa ❑Diners Club Please remit payment to: MEMBERSHIP DUES ARE DUE MEMBERSHIP,ASCE •• BOX BY DECEMBER 31,2013. Credit Card# Expiration Date 0" _• •�• D 27 79-0084 MEMBER#:285096 X ABOVE ADDRESS) INVOICE#: 1042497023 Signature :00 Thank you for renewing your membership. Your 2014 Membership Year begins on January 1, 2014. $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 Please consult your tax advisor. 285096 4 1 1042497023 1 TYPE A - MB USA 14 Azc�AMERICAN SOCIETY OF CIVIL ENGINEERS PO BOX 79084, BALTIMORE, MD 21279-0084 September 3, 2013 RENEW EARLY FOR A Gary R Duncan,Jr., P.E., M.ASCE CHANCE TO WIN CASH Carmel City of AID/OR A 50" TV 1 Civic Scl Carmel, IN 46032-2584 �IIIIJIIIIIIIIII"1111111'1'11111'I'llllllllllllllllllll�l�lllll ' Renew your membership online at www.asce.org/renewal Address Update - Please note any changes in Step 3 on reverse side of form. Instructions: To maintain your current level of membership and services, please submit the "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." To choose or change your EWB Chapter, please call ASCE's Customer Service at (800) 548-ASCE (2723) or(703) 295-6300. U�° MW &ggg go TaF ftftg MW it o o Description Renewal Amount Code National Membership Dues $225.00 ND Indiana Section-Metro Indianapolis Branch Dues $15.00 SD Transportation and Development Inst Dues(TDI) $0.00 TDMP Annual Sub-total: $240.00 Description Suggested Amount write-in Amount Code Engine rs Without Borders National Membership $60.00 E0 Engineers Without Borders Supporting Membership $40.00 E813 Architectural Engineering Institute Dues AEI 530.00 AEMS Coasts,Oceans,Ports and Rivers Inst Dues COPRI $30.00 COMS Construction Institute Dues CI $30.00 CIMS Engineering Mechanics Institute Dues EMI 530.00 EMMS Engineers Without Borders National Membership ($60.00) EO Environmental and Water Resources Inst Dues EWRI ($3000) 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 ($1500) ISS Indiana Section=Metro Indianapolis Br Voluntary — ----$25.00 SV National Funds Description seeencosed insert for descriptions Write-in Amount Write-in Code U) write-in description JO write-in description 00�:: write-in description F Z) —CO QE Institute Funds Description See enclosed inseri for descriptions Write-in Amount Write-in Code _~ Up write-in description write-in description write-in description Annual Sub-total: D Turn Over for Payment Information 285096 4 1 1042497023 1 TYPE A - M8 USA 14 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 American Society of Civil Engineers Purchase Order No. POB 79084 Terms Baltimore, MD 21279-0084 Date Due Invoice Invoice Description Date Number (or note attached invoice(s)or bill(s) Amount 9/3/2013 0 asce membership $ 240.00 Total $ 240.00 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 NC WARRANT NO. American Society of Civil Engineers ALLOWED 20 POB 79084 IN SUM OF $ Baltimore, MD 21279-0084 $ 240.00 ON ACCOUNT OF APPROPRIATION FOR Board Members PO#or INVOICE NO. ACCT#/TITL AMOUNT DEPT# I hereby certify that the attached invoice(s), 0 0 2200-4355300 s 240.00 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 1/4/2013 Signature City Engineer Cost Distribution ledger classification if Title claim paid motor vehicle highway fund