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INTEROFFICE MEMORANDUM liaricopa County School" Superintendent's Office TO: CLEWKOT BOAXD RECEIVED FROM: Willie Thompson MAR 1 6 2017 SUBJECT: Affidavits CLERK MARICO PA COUNTY DATE: 3/15/2017 BOARD OF SUPER VtSORS Prease find attached 2Affidavit/g\rotice of Claim(s)for Cost warrants for inclusion on the ne.xt avadaffe Ooard agenda The attached item(s) have 6een researched to ensure that the warrant(s) in question have not 6een cashed or previously re-issued The originalwarrant(s) have had a stop payment done. _Thou have any questions, please contact Millie Thompson at 372-1244 or via e-mail at mthompson@mcesa.maricopa.gov . Approved Affidavits may 6e routed back to the Superintendent of School 'Finance Division at 4041 9V: Central - Avenue #1200, ( 12 th 'Floor) Thankyou. #79 LITC.71EIELD AWROWirEAD REERIGERATIOX $1047.49 #214 TOLLESON VNION LASER comprunx0P710.71r $493.21 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. Laser & Computer Option, Inc. (1), being first sworn, upon oath deposes and says: Name/Claimant On or about April 5, 2016 (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 $ 493.21 .(3) Signed: (4) (5) Subscribed and sworn to before me this VC) day of 0(k&rth 20 I---1 . NOTARY PUBLIC KRISHNA M LUSIAN \Notary Public,State of Arizona My commission expires: (i-a M My Commission Maricopa County Expires /...2_2 February 22, 2020 ...... (seal) mar-loon 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 460089025/214728498 (if known) (6) Original Date of Issue 4/5/16 (if known) (7) Reason for original issue of Warrant/Check (8): 111 Payroll K,BOARDO r= uU For Services or Goods furnished MARICOPA COUNTY El Other: Food Service toner S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Schools\Schools-Warrants Checks notice of claim.doc Revised June 2015 A.R.S. 11-632 & 15-999 Lass Options Connecting Lean Technology with Business To Whom It May Concern: Kylie Kupfer is an authorized signer on behalf of the Accounts Receivable Department for FlexPrint Intermediate, LLC, Laser Options. Sincerely, FlexInfoGroup Document Management Systems I Business Proccess Management I Managed Print Services I Copiers, Printers, Faxes and Scanners 3758 E Grove St Tel: 480-968-84 TiI rev 877-9 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. ARROWHEAD SUPERIOR REFRIGERATION SERVICE •- (.1.) I being first sworn, upon oath deposes and says: Name/Claimant On or about 11/17/2016 (clate)(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/checbe issued to him/her in the sum of $ 1, 047. 49 .(3) Signecl: (4) (5) Subwibed and sworn to before me this /0 -1-31`' . day of AkyciI 20 /7: NO Y aUBLIC OFFICIAL SEAL DIXON PETERSON My commis ion expires: Notary MARICOPA Public - State COUNTY ol Arizona 311 cP.600 My Comm Expires March 14,202q ea I) 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 470043064/79709391 (if known) (6) Original Date of Issue 11/17/2016 (if known) (7) Reason for original issue of Warrant/Check (8): ▪ Payroll MAIM 7 TR DAT • For Services or Goods furnished eir AIME /AV/ 0 111,7 P"" porzn 111 Other: 5: \PROCESSES \Warrants - Duplicate or Stale \02 Forms \Schools\Schools-Warrant Checks notice of claim.doc Revised June 2015 A,R.S. 11-632 & 15-999 ARROWHEAD SUPERIOR REFRIGERATION SERVICE LLC ARROWHEAD SUPERIOR BEVERAGE LLC ALMA GRIEGO PAYMENTS MANUEL GRIEGO ARROWHEADSUPERIOR@GMAIL.com PO Box 82783 MANGRIEGO@COX.NET 602-510-6613 PHOENIX, AZ 85071 602-368-5191 LICENSED * INSURED * BONDED * ROC ASR #304717 * ROC ASB #304718 To whom it may concern, I Manuel Griego owner of Arrowhead Superior Refrigeration here by grant Alma Griego full authorization to sign on my behalf on all legal matters pertaining to Arrowhead Superior Refrigeration. If you have any questions, please feel free to contact me.