STAMPED & REDACTED ACERO ESTRELLA PARKWAY.PDF

MARICOPA COUNTY BOARD OF SUPERVISoR's
ee
Office of Budget and Finance
301 West Jefferson 202] JUN Nl 24. Jo:
PM 26
Phoenix, Arizona 85003 Hand veny
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INTEROFFICE MEMORANDUM
Date: June 24, 2021
To: Clerk of the Board
From: Walter Chang
Office of Budget and Finance
Subject: Affidavits — Replacement of Lost Warrants
Please find attached 1 Affidavits for lost warrants to be included on the next available
Board Agenda.
e The attached items have been researched to ensure the warrant in question
have not been cashed or previously re-issued.
e The original warrants have a void/stale date/stop payment done.
Please call me at 506-8747 if you have any questions. Please return the approved
affidavits to my attention in the Office of Budget and Finance.
Thank you.
Re: Fund: 200 /Dept: Human Services / Company : ACERO ESTRELLA PARKWAY

Application for a Duplicate or Stale-Dated Warrant/Check
Affidavit/Claim Form
This application is for: Duplicate or L] Stale-Dated (definitions are on page 2)
STATE OF ARIZONA Note: Numbers on this form correspond to
COUNTY OF MARICOPA numbers on the Instruction sheet which is
page 2 of this form.
ACERO ESTRELLA PARKWAY LLC (1) being first sworn, upon oath deposes and says:
Name/Claimant
On or about 26-Mar-2021 (date)(2) a warrant/check was issued to the
above named person/entity in the amount as 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 this claim is correct
and the amount shown is due and owing, and the applicant requests that a replacement
to him/her/inythe sum of ¢ 4,500.00 (3)
———_
ba
Signed: _ AT A227 LLLthk? (4)
Note. Please attach a copy of the warrant/check if available and/or any other
evidence that a warrant/check was originally issued.
(5) Subscribed and sworn to before me this__/5 _day of J es 204( .
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Warrant/Check Number =| 0085344 Varese?
394
(if known) (6)
Original Date of Issue
26-Mar-2021
Date of is
Reason for original issue of Warrant/Check (8):
1 Payroll
For Services or Goods furnished / COVID rental payments
O Treasurer’s refund/payment
/ Original check presumed lost in the mail
Other:
06/25/2021

June 15, 2021
|, Tony Doan, authorize Teresa Fenimore, Accountant, to execute an affidavit on behalf of Acero
Estrella Parkway LLC.
Yours truly,
ae
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“Tony Doan
Director of Finance
David Ce Macdouale
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4	1	9	1	5	0	642	1550	1174	76	-1	
5	1	9	1	5	1	642	1564	126	49	27.891541	eS
5	1	9	1	5	2	993	1555	72	65	26.234669	“US
5	1	9	1	5	3	1093	1570	20	40	33.624634	4
5	1	9	1	5	4	1398	1550	202	76	0.000000	Voter
5	1	9	1	5	5	1638	1556	178	41	0.106649	Paubleen
4	1	9	1	6	0	638	1591	482	58	-1	
5	1	9	1	6	1	638	1608	110	38	0.000000	exif
5	1	9	1	6	2	799	1591	173	53	22.168312	NOIR,
5	1	9	1	6	3	1013	1602	107	47	51.238037	4-3
4	1	9	1	7	0	636	1637	998	45	-1	
5	1	9	1	7	1	636	1638	102	44	35.987297	405
5	1	9	1	7	2	808	1650	142	17	46.526314	meme
5	1	9	1	7	3	1021	1637	103	44	35.652321	103
5	1	9	1	7	4	1425	1672	11	6	32.328243	.
4	1	9	1	8	0	639	1659	1075	69	-1	
5	1	9	1	8	1	639	1680	19	46	77.566559	4
5	1	9	1	8	2	727	1675	56	53	8.716288	nis,
5	1	9	1	8	3	804	1674	154	50	26.300350	PUB
5	1	9	1	8	4	975	1681	57	44	27.835155	97
5	1	9	1	8	5	1098	1672	26	51	10.817137	2
5	1	9	1	8	6	1393	1659	321	43	25.346546	ee
4	1	9	1	9	0	648	1710	1168	67	-1	
5	1	9	1	9	1	648	1711	161	59	50.892353	(RWG
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5	1	9	1	9	3	1047	1716	68	61	60.078442	FF
5	1	9	1	9	4	1336	1710	173	52	1.784363	Conrmis
5	1	9	1	9	5	1522	1733	89	25	94.545540	sion
5	1	9	1	9	6	1637	1719	81	52	34.551765	Exp
5	1	9	1	9	7	1738	1723	78	29	34.551765	wes
4	1	9	1	10	0	668	1756	434	66	-1	
5	1	9	1	10	1	668	1765	110	46	34.480228	(OR
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5	1	9	1	10	3	1009	1763	93	32	48.325672	OE
4	1	9	1	11	0	694	1786	389	58	-1	
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3	1	10	1	0	0	709	1813	259	71	-1	
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5	1	10	1	1	3	849	1820	119	54	67.292641	was’
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5	1	11	1	1	1	783	1869	204	39	0.000000	Vananes®?
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3	1	12	1	0	0	243	2984	351	35	-1	
4	1	12	1	1	0	243	2984	351	35	-1	
5	1	12	1	1	1	243	2987	178	31	96.311890	Vancouver,
5	1	12	1	1	2	432	2985	61	29	94.833504	WA
5	1	12	1	1	3	503	2984	91	35	96.950478	98683
2	1	13	0	0	0	32	2895	71	155	-1	
3	1	13	1	0	0	32	2895	71	155	-1	
4	1	13	1	1	0	32	2895	71	155	-1	
5	1	13	1	1	1	32	2895	71	155	95.000000	 
2	1	14	0	0	0	132	2878	2384	168	-1	
3	1	14	1	0	0	132	2878	2384	168	-1	
4	1	14	1	1	0	132	2878	2384	168	-1	
5	1	14	1	1	1	132	2878	2384	168	95.000000