SIGNED & REDACTED SODEXO INC & AFFILIATES ORIGINAL.PDF

INTEROFFICE MEMORANDUM
Office ===
Maricopa County Schools Superintendent
TO: CLERK OF THE BOARD
FROM: Terri Ysaguirre
SUBJECT: Affidavits — Replacement of Lost Warrants
DATE: 2/10/2021
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.
#98 Fountain Hills Unified Sodexo Inc & Affiliates $11,220.84
RECE| \ i ED TO Hayy
FEB 1 1 29 PS >
MARICOPA ce,
LERK BOARD
OF SUPERVISORS

Application for a Duplicate or Stale-Dated Warrant/Check
Affidavit/Claim Form
This application is for: Duplicate or C stale-Dated (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.
500Ex%o jWe (1), being first sworn, upon oath deposes and says:
Name/Ciaimant
On or about (Q2.3 [2020 (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 ar destroyed and there is
no reasonable probability of its being found or presented fer 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 $._(/, 220-5 o (3)
|
Mag Ze
Signed: levee cal)
Note: Ph Lr ao of) the warrant/check if available and/or other
any
that
evidence a warrant/check was originally issued.
(5) Subscribed and sworn to before me this | l day of December 2022.
oo
NOL - SARIN S VARTAK
UBC
Lic. #01VAG330397
- wee neo en sf - NOtary Public - State of New: Yorke | --—- ——
My commission expires: ‘ Qualified i in Broome
gun
ogists eee vere COMM: EXP pres say =
J
Warrant/Check Number
(if known) (6) 3B7OCOBET3SI3Z
Original Date of Issue
10 (2-3 [2020
(if known) (7)
Reason for original issue of Warrant/Check (8):
02/12/2024
1 Payroll :
(1 For Services or Goods furnished
C1) Treasurer's refund/payment
X) Other: LOST (nw THE metic
S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Warrants Checks notice of claim - Copy.doc
Revised April 2015 A.R.S. 11-632 & 11-644

sodexo
QUALITY OF LIFE SERVICES
February 2, 2021
Fountain Hills Unified School District
Attn: Karen Popowicz, Accounts Payable
Fountain Hills, AZ 85268
Dear Ms. Popowicz:
Please accept this letter as acknowledgment that Mary Beth Riley, a Senior Manager in Sodexo’s
Credit and Collections Department is authorized to sign the Application/Claim form
for Maricopa
County in the state of Arizona.
The missing warrant 3700367393 for $11 ,220.84 has not been received Sodexo.
by
Please contact me at: - co If have
, you any questions or
concerns.
Sincerely,
(y]
Mare Blass
Vice President & Treasurer
Sodexo
Tel.:
.
www.godexoUSA.com