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INTEROFFICE MEMORANDUM Maricopa County Education Service Agency (aka Maricopa County Superintendent of Schools Office) RECEIVED DEC 2 1 2018 TO: CLERK OF THE BOARD MARICOPA COUNTY SUPERVISORS CLERK BOARD OF FROM: Terri Ysaguirre SUBJECT: Affidavits — Replacement of Lost Warrants DATE: 12/20/2018 (#2) 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.vsaguirre@mcesa.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. #65 Littleton Elementary Valley Schools Benefits Trust $16,736.85 RECEIVED MAR 07 2019 MARICOPA COUNTY CLERK BOARD OF SUPERVISORS Appncation reor Ovpr.licate Stale-Date6 Warrant/Check AM-NAT/MIR-A Penh This application N for: 0 Duplicate or 0 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. 144/4.4 Name/Claimant de-haS-6. 5np/001), being first sworn, upon oath deposes and says: e neflAr 71-1.4 I /- On or about December. /W. 020/7 (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 $ /10, 7.a , .(3) Signed: - (4) Mote; Please attach a copy of the warrant/check if available and/or any other evidence that a warrant/check was originally issued, (5) Subscribed and sworn to before me this 12 th day of aci,. al be R 20 i sb . *W.& OkultAialkA r NOTARY PUBLIC - • OFFICIAL SEAL ' My commission expires: Notary Lisa A. Public Desaanberger - Arizona 01 / t5i2oz2- Marioopa County My Commission ExOrA (seal) Warrant/Check Number (if known) (6) LIFOO5-Q,30 Original Date of Issue (if known) (7) latit-4orl Ralson for original issue of Warrant/Check (8): Payroll 11 For Services or Goods furnished El Treasurer's refund/payment 111 Other: Revised SAPROCESSES\Warrants April 2015 - Duplicate or Stale\02 Forms\Warrants Checks notice of claim - Copy.doc A.R.S. 11-632 & 11-644 VALLEY SCHOOLS VALLEY SCHOOLS WORKERS" VALLEY SCHOOLS VALLEY SCHOOLS --_NEATION POOL INSURANCE TRUST EMPLOYEE BENEFITS TRUST January 25, 2019 Maricopa County — Office of the Clerk of the Board of Supervisors Attn: Ms. Maria Ceaglske 301 West Jefferson Street, 10th Floor Phoenix, AZ 85003 RE: Signed Affidavit Dear Ms. Ceaglske, In response to your email to Cinnamon Swayzee, dated December 27, 2018, please accept this letter as formal notification that Dan Davison, Valley Schools Management Group Chief Financial Officer, is authorized to sign on behalf of the Valley Schools Employee Benefits Trust/Group. Effective July 1, 2017, Valley Schools Employee Benefits Trust had an official name change and is now Valley Schools Employee Benefits Group. Please update your records. If you have questions or need further information, contact me at (623) 594-4370. Sincerely, Tom Boone Chairman/CEO PO HCA /1 76( ' L ,or9