TCS.PDF

MARICOPA COUNTY
Department of Finance
301 West Jefferson, Ste 960
Phoenix, Arizona 85003 2019 AUG 13 AN IC: 2c-
INTEROFFICE MEMORANDUM
Date: August 13, 2019
To: Clerk of the Board
From: Nadine Higuera
Department of Finance
Subject: Affidavits — Replacement of Lost Warrants
Please find attached 1 Affidavit for lost warrant to be included on the next available
Board Agenda.
• The attached items have been researched to ensure the warrant in
question have not been cashed or previously re-issued.
• The original warrants have a void/stale date/stop payment done.
Please call me at 506-1354 if you have any questions. Please return the approved
Affidavits to my attention in the Department of Finance, Suite 960.
Thank you.
Re: Fund 222: / Dept :D220 / TCS SVC LLC

Application for a Duplicate or Stale-Dated Warrant/Check
Affidavit/Claim Form
This application is for: Duplicate or El Stale-Dated (definitions are on page 2)
r.A-1-.
STATE OF ARIZONA- Note: Numbers on this form correspond to
COUNTY OF-MARIGGPA-1,..io-ice_ numbers on the Instruction sheet which is
cape 2 of this form.
TCS SVC LLC (1), being first sworn, upon oath deposes and says:
Name/Claimant
On or about 10-May-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, gl 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 $ 345 -36 .(3)
Signed: (4)
Note: Please a 4-0)1: copy of the warrant/check if available and/or any other
evidence that a warrant/check was originally issued.
(5) Subscribed and fr9 sworn-to ri=;) before me this / day of /2(-)6us r 20 /P.
en=
JOSEPH ZAMBO
My commission expires: Notary Public
oc-i- 7o23 My Commission Wake Co., Expires North Carolina Oct. 17, 2023 (seal)
Warrant/Check Number 3010033426
(if known) (6)
Original Date of Issue 10-May-2019
(if known) (7) APPROVEL
Reason for original issue of Warrant/Check (8):
El Payroll CLERK, BOARD OF SUPERVISORS
CI For Services or Goods furnished MARICOPA COUNTY
CI Treasurer's refund/payment
111 Other:

) TotalConstruction
TC S Services
8.1.19
RE: Brandy York Controller for TCS
Brandy York is authorized to sign on behalf of TCS SVC LLC dba Total Construction Services as the controller of the
organization on all matters relating to accounts receivable and accounts payable.
Thank you
/ (
17tittly 7 .4iNt i.
Timothy Wilson
Manager and Owner
1615 W. University Drive Suite 131 Tempe, AZ 85281 480.391.8828 www.tcs365.com

Automated Disbursement(AD) Page 1 of 1
Automated Disbursement(AD) Dept: D180 ID: WAR000089353 Ver.: 1 Function: New Phase: Final
Modified by batchadm , 05/10/2019
I Header
General Info Consolidation Object Payee Cancellation Additional Amounts Document Information
Document Name: Bank Account: Stub Detail Line Count:
1000 3
Check/EFT Number: Check Exported For Printing:
Record Date: 000003010033426
05/10/2019 Routing ID Number:
Budget FY:
2019 Transit Routing Number:
Fiscal Year:
2019 Check/EFT Amount:
$345.36
Period:
Check/EFT Issue Date:
11 05/10/2019
Print Status Indicator:
Printed
Disbursement Category:
Internal Reconciliation:
N/A
Run ID:
362677
Check Printed Date:
https://azdom.hostams.com:1443/webapp/PRDFIN1X1/advantage/Advantage/document_t.. . 8/13/2019