STAMPED & REDACTED RUGGIERO'S ACE HARDWARE.PDF

INTEROFFICE MEMORANDUM
- =
Maricopa County Schools Superintendent Office
TO: CLERK OF THE BOARD
FROM: Terri Ysaguirre
SUBJECT: Affidavits — Replacement of Lost Warrants
DATE: 3/2/2021
Please find attached 1 Affidavit/Notice of Claim(s) for lost warrants for inclusion on the next
available Board agenda
Vv The attached item(s) have been researched to ensure that the warrant(s) in question have
not been cashed or previously re-issued.
vV The original warrant(s) have had a stop payment done.
If you have any questions, please contact Terri Ysaguirre at 602-372-1245 or via e-mail at
terri.ysaguirre@maricopa.gov. Approved Affidavits may be routed back to the Superintendent
of School Finance Division at 4041 N. Central Avenue #1200, (12th Floor)
Thank you.
#95 Queen Creek Unified Ruggiero’s Ace Hardware $9.21
oS,
RECEIVED"
MAR 08 2021
MARICOPA COUNTY
CLERK BOARD OF SUPERVISORS

Schools Affidavit/Claim Form
Application for a Duplicate Warrant/Check (definitions are on page 2)
STATE OF ARIZONA Note: Numbers on this form correspond to numbers on the
COUNTY OF MARICOPA Instruction sheet which is page 2 of this form.
Ruggiero's Ace Hardware - Queen Creek (1) being first sworn, upon oath deposes and says:
Name/Claimant
On or about _ !5 [ ta{2oao (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
warrant/check be issued to of $9-21 (3)
win
Signed: WM auopust Th (4)
ae
(5) to before me this _ © day of Feloruars 20.2'.
wy
NOTARY PUBLIC
ANDREA KRIS SHACKELFORD
My commission expires: NOTARY PUBLIC » ARIZONA
is MARICOPA COUNTY
NWA jie 202) Ay it My Commission Expires (seal)
om May 16,2027
Note. Please attach a copy of the warrant/check if available and/or any other
evidence that a warrant/check was originally issued.
Warrant/Check Number We ZTSODTIETY
(if known) (6) eK= FT5 6%000 2
Original Date of Issue ul«2z[2zazo
(if known) (7)
Reason for original issue of Warrant/Check (8):
O) Payroll
03/03/2021
@ For Services or Goods furnished /
1 Other:
S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Schools\Schools-Warrants Checks notice of claim.doc
Revised June 2015 A.R.S. 11-632 & 15-999

G [] Fy [Re © °S Ruggiero’s Ace Hardware Stores
ACE tarware” Gilbert, AZ 85233 Phone:
To Whom It May Concern:
Margaret Graham, Accounts Receivable Specialist for Ruggiero’s Ace Hardware Stores has my authority
to sign the affidavit for missing check from the Queen Creek Unified School District. Her job
responsibilities include handing all payments, invoices, statements and questions for our internal house
accounts.
For further questions, please feel free to reach out to me via email:
Kind Regards,
Joshua Ruggiero
President, Ruggiero’s Ace Hardware Stores
Cell:
Email:
Neighborhood Store Locations:
Gilbert, AZ ¢ Chandler, AZ e Phoenix, AZ ¢ Queen Creek, AZ @ Peoria, AZ
Santa Fe, NM e Spokane, WA e Spokane Valley, WA