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INTEROFFICE MEMORANDUM Maricopa County Education Service Agency (aka Maricopa County Superintendent of Schools Office) TO: CLERK OF THE BOARD FROM: Denise Weihe SUBJECT: Affidavits — Replacement of Lost Warrants DATE: 3/7/2017 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 Denise Weihe at 602-372-1245 or via e-mail at denise.weihe@mcesa.maricopalgov. Approved Affidavits may be routed back to the Superintendent of School Finance Division at 4041 N. Central Avenue #1200, (12th Floor) Thank you. #201 Buckeye Union Constellation Solar $85942.27 RECEIVED MAR 0 7 2017 CLERK M4RIC0P4 COUNTY BOARD OF SUPERVISORS 1.10 (4e. 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. Constellation Solar AZ LLC (I), being first sworn, upon oath deposes and says: Name/Claimant On or about 1541 0.01..sr (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 $ 85,942.27 .(3) Signed: (4) (5) Subscribed and sworn to before me this -7-- day of -ge--6416(IR,10/„. 20 / (inlejaiYA_ iLl-- 6iiz-k/u v N, /0, 0„.. e'.., i„ co * .....• NOTARY PUBLIC ri :-.. ... 44 4 fit. 1Cd • 0 SOLAR ),. = : ` • • 411I My commission ission t expires: F. S .5-'. .. (-1 / L9 I 04; ' iiiiiiiii i l‘t° 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 470022758 (If known) (6) Original Date of Issue 09/15/2016 (if known) (7) 4,-, c 1% 1 ..-,..A :.--7 Reason for original issue of Warrant/Check (8): O Payroll O For Services or Goods furnished Solar O Other: Solar S:\PROCESSES\Warrents - Duplicate or 51210\02 Forms \Schools \Schools-Warrants Checks notice of dalm.doc Revised June 2015 A,12.5. 11-632 & 15-999 Constellation Solar, LLC Admon,-- 1310 Point St A—PP- Constellation. Baltimore, MD 21231 An Exelon Company 27 February 2017 Buckeye Union High School District 1000 E. Narramore Ave. Buckeye, AZ 85326 Attn: Laura Blake, Accounts Payable Dear Ms. Blake, Please reissue a check in the amount of $85,942.27 related to the August 2016 invoice for Constellation Solar Arizona, LLC and Buckeye Union High School District of Maricopa County, Arizona. The new check should be remitted to the following address: Constellation Solar Arizona, LLC PO Box 65124 Baltimore, MD 21264-5124 Sincerely, 4.7 er.iva j te, Suzanne Eagles Supervisor, Wholesale Operations INTEROFFICE MEMORANDUM Waricopa County School-Superintendent's Office TO: CLERK OF DirE (BOAW9) FROM: fMiliie 7nompson SUBJECT: Affidavits DATE: 3/7/2017 Prease find attached 1 Affidavit/Wotice of Craim(s)for Cost warrants for incrusion on the ne_Kt avada6Th amrd agenda The attached item(s) have 6een researched to ensure that the warrant(s) in question have not 6een cashed or previous ry re-issued The original. warrant(s) have had a stop payment done. .11. you have any questions, pase contact Millie Thompson at 372-1244 or via e-mad at mthompson@mcesa.maricopa.gov. Approved Affidavits may 6e routed hack to the Superintendent of Schoor 'Finance Division at 4041 .9V: Centrar Avenue #1200, ( 12 th ECoor) Thankyou. #90 SADDLE morUNTAIN . (BETTY WILLER $95.45 RECEIVED MAR 07 2017 MARICOPA COUNTY CLERK BOARD OF SUPERVISORS q 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. ke-4±-/ N,HJIIr' (1), being first sworn, upon oath deposes and says: Nameaaimant On or about Apili /1/ 1 21))40 (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 $ (-15 • '15 .(3) Signed: (5) Subscribed and sworn to before me this 241.jt day of ,./ViovrVlei 20 IV • NballtDUBLIC MER LINDA AVILA My commision expires: NOTARY PUBLIC —111Y012.0 STATE OF ARIZONA (seal) MARICOPA COUNTY Ex ir 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 JL1 b 152t7 (if known) (6) Original Date of Issue (if known) (7) 7 Reason for original issue of Warrant/Check (8): Payroll 0 For Services or Goods furnished 0 Other: S:\PROCESSES\Warrants - Duplicate or Stale\02 Fonns \Schools \Schools-Warrants Checks notice of clalm.doc Revised June 2015 A.R.S. 11-632 Et 15-999 INTEROFFICE MEMORANDUM Maricopa County Education Service Agency (aka Maricopa County Superintendent of Schools Office) TO: CLERK OF THE BOARD FROM: Denise Weihe SUBJECT: Affidavits — Replacement of Lost Warrants DATE: 3/8/2017 Please find attached 2 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 Denise Weihe at 602-372-1245 or via e-mail at denise.weihe@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. #95 Queen Creek Ed. Services for Hearing Impaired $1162.50 #75 Morristown Safeguard $46.31 #75 Morristown Safeguard $43.50 ECEIVED MAR 0 9 2017 CLERK MARICOPA COUNTY BOARD OF SUPERVISORS /o Application for a DupEicate or Stale-Dated iarrntICheck Affidavit/Claim Form This application is for: , puplieate , or o Stale .0 at ed (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, , re 0 r (1), being. first sworn, upon oath deposes and says: —WrefuL:..yriLrif-f On or about r--5ehrwr,/ ----;20/7 (date)(2) a warrant/check was issued to the above named personientIty 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 er 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/c „be issued to / n the su of $ 4,1 / ,(3) Signed: ib/(9/(Le. (4) Note; Please attach copy of thewartant/Check if availaWs and/or any other evidence that a warrant/check was. originally issued.. (5) Subscrpeiri and sworryt :before' me this 3 day of L4A 2042 OFFICIAL F.AL NOTARY Puil-Lic Khafld E3 yd My commission expires; , NOTARY P LIC STATE Qfiat)IEW EXICO Warrant/Check Number (if knox0,161_____ Vs5 Original Date of Issue • (if known) (7) Reason for original issue of Warrant/Check (8): ,f2'/For Services or Goods furnished OAr K f"--00.14 0 Treasurer's refund/P yment 0 Other: SAPROCESSES \Warrants - Duplicate of St:ale \02 Vorms1Warrants Checks notice of daim - Copy.doc Revised April 2015 AiR,S, 11-632 & 11-644 Applicatioñ. for a uplicate or Stale-Dated Warrant/clwcic Affidavit/Claim F4 rin This applicatioo is fon 0 Duplicate or 0 Stale-Dated (definitions are on pogo 2) STATE OF ARIZONA Note: Numbers on this form correspond to numbers on the COUNT OF MARICOPA Instruction sheet which is page 2 of this form. C) (1), being first Sworn, upon oath deposes and says: Name! arm On or about /-1, facv 4 -7--rr,al 7 (clate)(2) a warrant/check was issued to the above named person/e tity In the amount as stated below. Such warrant/check was either never received or was subsequently inadvertently lost or destnyed•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 perjuty, claimant hereby affirms that this claim is correct and the amount shown is due and owing, and the applicant requests that a replacement warrant/cpercil ibe issued to/frri/1- er of $ 4/3 .(3) Signed; (4) Note; Please attach a copy of the Warrant/check if avalla4le and/or any other evidence that a warrant/check was originally Issued and swor'n to before me this day of _EL-K-0,14 204. 7. OFFICIAL SEA KJaHd Boy( NOTARY PUBLI My ommission expires; STATE OF NAME i cti 7-o KA•• e'rIeesrraccit-tr, gvriiroc. Warrant/Check Number jillknovvnig.1 Original Date of Issue knqwn) (7) Reason for original issue of;Wa'rrant/Check . (a): 0 Payroll •.1 • ct- -F-or Services or Goods furnished. 1.4).) /GI A (;AJ - aa.S D Treasurer's refund/Payment CI Other: . SA,PRoCESSES\Warrants- Duplfcate or swe\02 frorms\warranm Checks notice of claim Copy.doc Revised April 2015 • A,R,3, 11-632 & 11-614 SafeciLO:rd 219 Central AvenUarnw, Suite 152 Albuquerque, NM 87102 Phone; Albuq. (505) 797-84901 Fax: (505)797:8951 • March 2, 2017 MARICOPA CTY REGIONAL SCHOOL 3409W WHITTON AVE PHOEND;, AZ 85017-4418 .(602) 4524700 Dear lVlarlcopa City Regional School, This letter is an authorization for Ana Biblano to sign the Application for a Duplicate or Stale-Dated Warrant/Check Affidavit/ Claim Form. i.s of March 2, 2017, we have not received any check at our office Or our . corporate location. Please update our vendor address to the one listed below. Safeguard Business Systems 219 Centrat Ave "NW, Suite 152 • Albuquerque, NM 87102 • Thank You __ 3b Mike Dell Bleyker • Distrib Date 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. TIONAL. Ccekva CAS ft/ H 6, Ari pAlao (1), being first sworn, upon oath deposes and says: ame/Cfaimant On or about ciS <31) (date)(2) a warrant/check was issued to the above named peon rs 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, pi 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 $ 6 0 .(3) A-tet.--- (4) i (5) Su scribed and sw to before me this 03 day of `r-'2 6'"-40( 20 t 7 . NOTARY PUBLIC NOTARY PUBLIC STATE OF ARIZONA My commission expires: Pinal County / 2 WALTER A. GRANT (seal) 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 GI 009 Jq ODiO.) 9 (if known) (6) Original Date of Issue (if known) (7) Reason for original issue of Warrant/Check (8): 0 Payroll 1 0 ,=SU , L tviARICOPA COUNTY For Services or Goods furnished Other: S: WROCESSESAWarrants - Duplicate or Stale \02 Forms\Schools\Schools-Warrants Checks notice of clairn.doc Revised June 2015 A,11.5. 11-632 & 15-999 6)(kca//ofia/tirpoirr,i' op- d/.e 51-Gray g-nAaatea/ 10607 E. Knowles Ave. Mesa Az, February 16, 2017 Queen Creek School District 20217 E. Chandler Heights Rd. Queen Creek, Az 85124 To Whom it may concern, This letter is to verify that Jennifer Castillo is the president of "Educational Services for the Hearing Impaired", as is able to sign for the company on any business transactions. Sincerely, Jennifer Castillo Teacher of the Hearing Impaired • .JA(19.595 ic drnilv tarnv not