REDACTED-FOR AGENDA ATTACHMENT - 3010198326 - LINCOLN PROPERTY COMPANY .PDF

‘

MARICOPA
COUNTY

Office of Budget & Finance
301 W. Jefferson St, 9" Floor
Phoenix, Arizona 85003

P: 602-506-3561
F: 602-506-4451

Marlcopa.gov

To: Clerk of the Board

From: Office of Budget & Finance, Accounts Payable
Date: 06.26.26

Subject: Affldavit - LINCOLN PROPERTY COMPANY

Please find attached one Affidavit for a Stale Dated warrant to be included on the
next available Board Agenda.

e The attached item has been researched to ensure the warrant in question has not
been cashed or previously re-issued.

e The original warrant Is presumed lost.

Please call Marcia Anderson at 506-7291 if you have any questions. Please return the
approved Affidavit to my attention in the Office of Budget and Finance, 9"" Floor.

Thank you.

Re: FUND 640-TRANSPORTATION-FUND 232-GAX1D 25*8521-RELEASE OF CASH BOND
TC202101845

MA R) COPA . Application for a Duplicate or Stale Dated
- COUNTY Warrant/Check Affidavit/Claim Form
This application is for L} Duplicate or Stale-Dated (definitlons are on page 2)

STATE OF ARIZONA Note: Numbers on this form correspond to the numbers
COUNTY OF MARICOPA on the Instruction sheet which is page 2 of this form

LINCOLN PROPERTY COMPANY (1), being first sworn, upon oath deposes and says:
Name/Clalmant

On or about .21-NOV-2024 (date) (2) a warrant/check was Issued to the above named
person/entity in the amount stated below. Such warrant/check was either never received or
was subsequently inadvertently lost or destroyed and-there is no reasonable probability of its
being found or presented for payment, or it was not presented for payment within one year
after the date of issuance.

Therefore, under penalty of perjury, claimant hereby affirms that thls claim Is correct and the
amount shown is due and owing, and the applicant requests that a replacement warrant/check
be Issues to im/her in the sur) of $48,265.27 (3)

Signed:

Print Name: (required) \ v\anfoe.

Note: Please atfach a copy of the warrant/check if available and/or any other evidence that a
warrant/check was originally Issued. .

6) 2a me this 2-2 day of UWIC. 202

NOTARY PUBLIC
ly commission expires: z COMMISSION # at
’ \ My Comm Expires November 8, 2027 (seal)
a

Warrant/Gheck Number 3010198326

iginal ff |
Original Dateoflssue 194. NOV-2024

Reason for original issue of Warrant/Check (8):
O Payroll
For Services or Goods furnlshed

Treasurer's refund/payment
Other: 0840 - TRANSPORTATION- FUND 232-GAX1D 268521-RELEASE OF GASH BOND TC202101845

SAPROCESSES\Warrants - Duplicate or Stale\02 Forms\Current Clalm Form\100518 Warrants Checks notice of clalm.doc Revised
100518

ARS, 11-632 & 11-644