Extracted text (via pymupdf_layout)
2976 characters
INTEROFFICE MEMORANDUM Maricopa County Schools Superintendent Office TO: CLERK OF THE BOARD FROM: Terri Ysaguirre SUBJECT: Affidavits — Replacement of Lost Warrants DATE: 8/27/2019 Please find attached 1 Affidavit/Notice of Claim(s) for lost warrants for inclusion on the next available Board agenda V The attached item(s) have been researched to ensure that the warrant(s) in question have not been cashed or previously re-issued. V 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. #17 Tolleson Elementary HD Supply Facilities Maint $266.34 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. Li 56 VIES Minn), ,,,_ being first sworn, upon oath deposes and says: ametuialinan On or about tit..1.11e. II, 2019 (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, gt 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 $ 2.40.34 43) Signed: \NA i(L/ (4) (5) Subscribed and sworn to before me this day of ar.,(5.L.5 74- 2O/ 7. GC_ /lin/ e a, NOTARY PUBLIC ''''' RENE E RODRIGUEZ '71.1iNotaly Public, Stole al Texas My cornmissiopiexpires: Comm. Expires 02-15-2020 , /c; Of-,2 Notary ID 130538685 feleal) 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 Of known) (6) 3100 jC1 1446 Original Date of Issue (If known) (7) 00.11.2011 Am" 0 A 9nio DATE Reason for original issue of Warrant/Check (8): 0 Payroll I111/1-• 100 N.-07 V For Services or Goods furnished MARICOPA GOUT, Other: SAPROCESSES\Warrants -Duplicate or Stale\02 Forms\Schools\Schools-Warrants Checks no tice of dalm.doc Revised June 2015 A.R.S. 11-632 & 15-999 • SUPPLY Customer Support Center Correspondence 10841 Scripps Summit Court P.O. Box 509055 San Diego, CA 92131 San Diego. CA 92150 FACILITIES MAINTENANCE 858-831-2000 hdsupplysolutions.corn To Whom It May Concern, Michelle Warneke (Senior Credit Manager) is an authorized signer for HD Supply. Shelly Warneke Senior Manager, Credit and Collections HD Supply Facilities Maintenance Ltd. 1511 E Common St NB Tx 78130