SIGNED & REDACTED JANCO & WINNEX INC DBA JANMARTUSA.PDF
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MARICOPA COUNTY Office of Budget and Finance 301 West Jefferson Street Ste 960 , Phoenix, Arizona 85003 ‘ INTEROFFICE MEMORANDUM rm oo mM or Date: February 25, 2021 2 \ To: Clerk of the Board Y on 7 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 Suite 960. , Thank you. Re: Fund:100 / Dept: Treasurer / Company: JANCO & WINNEX INC DBA Janmartusa Application for a Duplicate or Stale-Dated Warrant/ Check Affidavit/Claim Form This application is for: Duplicate or (-] 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 pade 2 of this form. JANCO & WINNEX INC DBA Janmartusa (1), being first sworn, upon oath deposes and says: Name/Claimant On or about 28-Jan-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 warrant/check be issued to him/her in the sum of $ 954.75 .(3) Signed: Jy ae wa =] (4) Note: Pleasé attach a copy of the warrant/check if available and/or any other evidence that a warrant/check was originally issued. (5) Subscrjbed and to before me this 14 day 5 1 17 1 1 11 1627 1753 43 41 78.948227 of 5 1 17 1 1 12 1715 1756 224 50 0.000000 Fepeuney 5 1 17 1 1 13 2011 1754 53 40 26.516800 20 5 1 17 1 1 14 2094 1759 86 47 26.516800 27. 2 1 18 0 0 0 1213 1871 271 41 -1 3 1 18 1 0 0 1213 1871 271 41 -1 4 1 18 1 1 0 1213 1871 271 41 -1 5 1 18 1 1 1 1213 1871 171 41 0.000000 EmMpee 5 1 18 1 1 2 1403 1878 81 34 28.138641 CE 2 1 19 0 0 0 1406 1407 658 6 -1 3 1 19 1 0 0 1406 1407 658 6 -1 4 1 19 1 1 0 1406 1407 658 6 -1 5 1 19 1 1 1 1406 1407 658 6 95.000000 2 1 20 0 0 0 493 1522 1362 10 -1 3 1 20 1 0 0 493 1522 1362 10 -1 4 1 20 1 1 0 493 1522 1362 10 -1 5 1 20 1 1 1 493 1522 1362 10 95.000000 2 1 21 0 0 0 287 1705 1029 18 -1 3 1 21 1 0 0 287 1705 1029 18 -1 4 1 21 1 1 0 287 1705 1029 18 -1 5 1 21 1 1 1 287 1705 1029 18 95.000000 2 1 22 0 0 0 1316 1705 932 16 -1 3 1 22 1 0 0 1316 1705 932 16 -1 4 1 22 1 1 0 1316 1705 932 16 -1 5 1 22 1 1 1 1316 1705 932 16 95.000000 2 1 23 0 0 0 1681 1793 490 7 -1 3 1 23 1 0 0 1681 1793 490 7 -1 4 1 23 1 1 0 1681 1793 490 7 -1 5 1 23 1 1 1 1681 1793 490 7 95.000000 2 1 24 0 0 0 388 1909 1547 10 -1 3 1 24 1 0 0 388 1909 1547 10 -1 4 1 24 1 1 0 388 1909 1547 10 -1 5 1 24 1 1 1 388 1909 1547 10 95.000000 2 1 25 0 0 0 392 1810 699 169 -1 3 1 25 1 0 0 392 1810 699 169 -1 4 1 25 1 1 0 392 1810 699 169 -1 5 1 25 1 1 1 392 1843 376 124 12.739210 rae 5 1 25 1 1 2 767 1810 324 169 32.489128 LZ} 2 1 26 0 0 0 392 2000 1742 148 -1 3 1 26 1 0 0 392 2000 1742 148 -1 4 1 26 1 1 0 1083 2005 341 74 -1 5 1 26 1 1 1 1083 2005 58 74 87.787964 ce 5 1 26 1 1 2 1382 2006 42 39 49.382137 om 4 1 26 1 2 0 392 2000 1149 93 -1 5 1 26 1 2 1 392 2047 59 46 96.841995 My 5 1 26 1 2 2 468 2047 243 37 96.323456 commission 5 1 26 1 2 3 730 2047 161 46 96.868729 expires: 5 1 26 1 2 4 1047 2011 31 39 75.613045 LEE 5 1 26 1 2 5 1177 2000 196 49 61.296223 ATTACH 5 1 26 1 2 6 1424 2006 117 53 54.848679 MEAT 4 1 26 1 3 0 498 2090 1636 58 -1 5 1 26 1 3 1 498 2092 119 52 38.101608 o8(t| 5 1 26 1 3 2 638 2090 200 54 0.000000 |2022— 5 1 26 1 3 3 2036 2107 98 41 60.735191 cay 2 1 27 0 0 0 388 2142 607 7 -1 3 1 27 1 0 0 388 2142 607 7 -1 4 1 27 1 1 0 388 2142 607 7 -1 5 1 27 1 1 1 388 2142 607 7 95.000000 2 1 28 0 0 0 2232 1721 15 487 -1 3 1 28 1 0 0 2232 1721 15 487 -1 4 1 28 1 1 0 2232 1721 15 487 -1 5 1 28 1 1 1 2232 1721 15 487 95.000000 2 1 29 0 0 0 288 2164 1945 51 -1 3 1 29 1 0 0 288 2164 1945 51 -1 4 1 29 1 1 0 288 2164 1945 51 -1 5 1 29 1 1 1 288 2164 1945 51 95.000000 2 1 30 0 0 0 296 2308 1201 6 -1 3 1 30 1 0 0 296 2308 1201 6 -1 4 1 30 1 1 0 296 2308 1201 6 -1 5 1 30 1 1 1 296 2308 1201 6 95.000000 2 1 31 0 0 0 296 2211 5 207 -1 3 1 31 1 0 0 296 2211 5 207 -1 4 1 31 1 1 0 296 2211 5 207 -1 5 1 31 1 1 1 296 2211 5 207 95.000000 2 1 32 0 0 0 893 2211 5 208 -1 3 1 32 1 0 0 893 2211 5 208 -1 4 1 32 1 1 0 893 2211 5 208 -1 5 1 32 1 1 1 893 2211 5 208 95.000000 2 1 33 0 0 0 321 2195 1862 224 -1 3 1 33 1 0 0 321 2195 1862 224 -1 4 1 33 1 1 0 321 2195 499 75 -1 5 1 33 1 1 1 321 2195 317 75 91.805038 Warrant/Check 5 1 33 1 1 2 653 2215 167 55 96.605072 Number 4 1 33 1 2 0 472 2238 801 128 -1 5 1 33 1 2 1 472 2273 58 87 65.922325 iG 5 1 33 1 2 2 529 2249 127 117 27.821798 knw) 5 1 33 1 2 3 661 2275 46 36 86.936234 (6) 5 1 33 1 2 4 910 2238 363 53 95.770180 3010080636 4 1 33 1 3 0 321 2324 459 47 -1 5 1 33 1 3 1 321 2324 146 47 96.240585 Original 5 1 33 1 3 2 500 2325 95 42 95.855286 Date 5 1 33 1 3 3 613 2335 24 26 96.925835 of 5 1 33 1 3 4 668 2325 112 36 96.647812 Issue 4 1 33 1 4 0 487 2341 1696 78 -1 5 1 33 1 4 1 487 2380 37 33 88.594940 (if 5 1 33 1 4 2 533 2380 115 34 88.594940 known) 5 1 33 1 4 3 662 2380 45 34 96.469650 (7) 5 1 33 1 4 4 908 2341 363 52 96.499809 28-Jan-2021 5 1 33 1 4 5 1654 2399 3 2 53.775024 | 5 1 33 1 4 6 1890 2345 293 74 73.915115 02/26/2021 2 1 34 0 0 0 296 2410 1201 10 -1 3 1 34 1 0 0 296 2410 1201 10 -1 4 1 34 1 1 0 296 2410 1201 10 -1 5 1 34 1 1 1 296 2410 1201 10 95.000000 2 1 35 0 0 0 322 2485 993 49 -1 3 1 35 1 0 0 322 2485 993 49 -1 4 1 35 1 1 0 322 2485 993 49 -1 5 1 35 1 1 1 322 2487 150 36 96.393250 Reason 5 1 35 1 1 2 489 2485 61 40 96.092560 for 5 1 35 1 1 3 564 2485 151 49 96.974274 original 5 1 35 1 1 4 734 2487 103 36 96.155243 issue 5 1 35 1 1 5 853 2485 43 39 93.033836 of 5 1 35 1 1 6 908 2485 318 46 92.055969 Warrant/Check 5 1 35 1 1 7 1242 2485 73 49 96.686249 (8): 2 1 36 0 0 0 392 2581 1674 127 -1 3 1 36 1 0 0 392 2581 1674 127 -1 4 1 36 1 1 0 392 2581 211 49 -1 5 1 36 1 1 1 392 2584 37 36 59.693558 C1 5 1 36 1 1 2 465 2581 138 49 92.729485 Payroll 4 1 36 1 2 0 465 2645 1601 63 -1 5 1 36 1 2 1 465 2669 68 39 96.226784 For 5 1 36 1 2 2 548 2669 171 39 96.661911 Services 5 1 36 1 2 3 736 2680 43 28 96.915283 or 5 1 36 1 2 4 793 2668 130 40 96.623505 Goods 5 1 36 1 2 5 939 2668 197 40 93.246437 furnished 5 1 36 1 2 6 1159 2645 21 46 90.862305 / 5 1 36 1 2 7 1186 2645 227 48 96.948296 Souvenirs: 5 1 36 1 2 8 1432 2652 269 43 96.669052 Promotional, 5 1 36 1 2 9 1718 2651 254 47 96.869019 Advertising, 5 1 36 1 2 10 1989 2653 77 37 94.933601 etc. 2 1 37 0 0 0 1136 2707 942 8 -1 3 1 37 1 0 0 1136 2707 942 8 -1 4 1 37 1 1 0 1136 2707 942 8 -1 5 1 37 1 1 1 1136 2707 942 8 95.000000 2 1 38 0 0 0 391 2755 871 127 -1 3 1 38 1 0 0 391 2755 871 127 -1 4 1 38 1 1 0 391 2755 664 50 -1 5 1 38 1 1 1 391 2758 37 34 76.493439 O 5 1 38 1 1 2 462 2755 237 40 32.820702 Treasurer's 5 1 38 1 1 3 715 2755 340 50 89.858047 refund/payment 4 1 38 1 2 0 432 2822 830 60 -1 5 1 38 1 2 1 391 2833 43 46 41.918724 fd 5 1 38 1 2 2 463 2842 133 40 74.912537 Other: 5 1 38 1 2 3 637 2822 16 45 92.433144 / 5 1 38 1 2 4 669 2824 233 53 94.550110 presumed 5 1 38 1 2 5 922 2824 82 43 95.484589 lost 5 1 38 1 2 6 1020 2824 40 42 95.484589 in 5 1 38 1 2 7 1078 2824 72 42 96.764526 the 5 1 38 1 2 8 1169 2823 93 43 96.655914 mail 2 1 39 0 0 0 1066 2794 1022 8 -1 3 1 39 1 0 0 1066 2794 1022 8 -1 4 1 39 1 1 0 1066 2794 1022 8 -1 5 1 39 1 1 1 1066 2794 1022 8 95.000000 2 1 40 0 0 0 613 2880 1495 10 -1 3 1 40 1 0 0 613 2880 1495 10 -1 4 1 40 1 1 0 613 2880 1495 10 -1 5 1 40 1 1 1 613 2880 1495 10 95.000000 2 1 41 0 0 0 2535 8 15 3278 -1 3 1 41 1 0 0 2535 8 15 3278 -1 4 1 41 1 1 0 2535 8 15 3278 -1 5 1 41 1 1 1 2535 8 15 3278 95.000000 paw WELLS FARGO Jurat Certificate California only A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of LOS ANGELES Subscribed and sworn to (or affirmed) before me on this 19th day of FEBURARY 20 21, by__ CHIN YU JUAN proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. waa aK Place Seal Here Signature ] 7 v a ARUATOCOREROCSSOSECORARR SRA ROTEERRECES. = AE KIMBER LEE = x Kale COMM. #2253610 B S394) NOTARY PUBLIC - CALIFORNIA = \Sae LOS ANGELES COUNTY = 5 eM OCRTRDURATORUESOBEGUORGGE ission Expires 08/14/2022 z PUMUEReE Description of Attached Document Type or Title of Document | | APPLICATION FOR A DUPLICATE OR STALE DATED WARRANT/CHECK Document Date Number of Pages | 02/19/2021 | ONE ONLY Signer(s) Other Than Named Above | NA DSG 3018 CA (Rev 02-2/15) JANCO & WINNEX INC dba JANMARTUSA PO Box CA 91715 Tel: Fax : Email: Date : 02/19/2021 I Jennifer Renshaw , authorize Janice, Chin Yu Juan Accounting to execute an affidavit on behalf of Janco & Winnex Inc dba Janmartusa Yours truly President — Maricopa County Office of Budget and Finance Accounts Payable Suite | Phoenix, AZ 85003