102517 DUPLICATE WARRANTS 7.PDF

INTEROFFICE MEMORANDUM
Maricopa County Education Service Agency (aka
Maricopa County Superintendent of Schools Office)
TO: CLERK OF THE BOARD
FROM: Terri Ysaguirre
SUBJECT: Affidavits — Replacement of Lost Warrants
DATE: 10/3/2017
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@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.
#08 Osborn Elisabeth Judd #170023917 $873.16
#65 Littleton Adventure Inc. dba Epic Health #470092892 $2,707.76
#65 Littleton Adventure Inc. dba Epic Health #470090781 $11,598.02

AFFIDAVIT
STATE OF ARIZONA
COUNTY OF 1VIARICOPA
e[isabe-th Judd , being first duly sworn, upon oath deposes and says:
That on the2,Y1( cy_ la of0dmAkr_apja, he presented to W--jah &„inn
District of Maricopa County, Arizona, for payment, a claim for services rendered
or supplies furnished during the
month of DC-Vb \,0v 20 t_k, said claim being in the sum of
ek V\oocivrici Ceve,rihi Dollars, (L5:13.,=Li(o,) in payment of which the
v-ec or)
Superintendent of Schools caused his/her Warrant Number 11002911 to be
issued on Ock.tbcv 2j31-k , 20110 , drawn on the 30, Fund of CL;V:(1\( 1/1 C.,1,4661
District of Maricopa County, Arizona.
Affiant further says that although he/she was informed and believes that the above
mentioned warrant was regularly issued, the same has never been received, or has
been lost.
WHEREFORE, affiant prays that the Board of Supervisors order and the
Superintendent of Schools issue to him/her a duplicate of said Warrant Number
n 0 02:39 11 in the sum of $ (i\-13
(
Signed: (
Subscribed and sworn to before me this 0Z- day iZc ;2o /7 /7
VALERIE County Notary of C ANDERSEN alarkopa Publk
My CotonYaslon Commission AA uu IMMO 1110722 Expires
46.18.1I•I••I••II NOTARY PUBLIC
My commission expires: ..,21)I
Following approval please return this affidavit to the Maricopa County School Superintendents Office.

A
,ss'i LE To4, Stop Payment
O N,
. 444#0-4A Affidavit
Business Resources
STATE OF ARIZONA APPT:3VED
OCTIO5
COUNTY OF MARICOPA DAT
CLERK, BOARD OF SUPERVISORS
MARICOPA COUNTY
Andventure Inc. DBA Epic Health , being first duly sworn, upon oath deposes and states:
That on the 21 day of March , 20 17 , he/she presented to Littleton Elementary
School District No. 65, of Maricopa County, for payment, a claim for services rendered or supplies furnished during
the month of March , said claim being in the sum of Two thousand seven hundred and seven 11.
Dollars ($ 2,707.76 ) in payment of which Littleton Elementary School District No. 65 caused warrant/check
number 470092892 to be issued on 27 day of April , 20 17
drawn on the warrant/check fund of Littleton Elementary School District No. 65 of Maricopa County, Arizona.
Affiant further states that although he/she was informed and believes that the above mentioned warrant/check
was regularly issued, the same has never been received, or has been lost.
Wherefore, affiant requests that the Governing Board order and the Littleton Elementary School District No. 65 issue
to him/her a replacement of said warrant/check number470092892 in the sum of $ 2,707.76
kavid 7/
do,
Signature 4"47
Subscribed and sworn before me this (67) day of , 20
2* 4.0 . , Sonya Latrice Bradford 411.1I1
:;;, My Commission Expires
12/05/2018
Signature •f N49ary Public
ip_/5-hr
My Commission Expires
03/2013

A Stop Payment
n
..A.R.„•,s-A,.
sc, Affidavit
Business Resources
STATE OF ARIZONA APPROVED
ON 05 2ay
COUNTY OF MARICOPA
RK, BOARD OF SUPERVISORS
MARICOPA COUNTY
1ndv8n-hArelic. Epi614-eal+31 , being first duly sworn, upon oath deposes and states:
That on the 07P-9- day of MO roll , 20 / 1/47 , he/she presented to Littleton Elementary
School District No. 65, of Maricopa County, for payment, a claim for services rendered or supplies furnished during
the month of jR,19 ra nor 1/41 , said claim being in the sum of Elevercf-hou inci-A •tetturrinvitill'a e+y
Dollars ($ I 598. °21 ) in payment of which Littleton Elementary School District No. 65 caused warrant/check
number )-1 7ooqp---)s) to be issued on .20 day of 4er, I ,20
drawn on the warrant/check fund of Littleton Elementary School District No. 65 of Maricopa County, Arizona.
Affiant further states that although he/she was informed and believes that the above mentioned warrant/check
was regularly issued, the same has never been received, or has been lost.
Wherefore, affiant requests that the Governing Board order and the Littleton Elementary School District No. 65 issue
to him/her a replacement of said warrant/check number LI 700 tiO1S/ in the sum of $
'
401a/va 744,1
Signature /
Subscribed and sworn before me this dayof ,20 17
de ' ct Sonya LatriCe Bradford
My Commission Expires
12/05/2018
My Commission Expires
03/2013