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INTEROFFICE MEMORANDUM Ilarkopa County School-Superintendent's Office TO: CLERK, OE WE 00.)1X9 FROM: %Lillie 'Thompson SUBJECT: Affidavits DATE: 10/20/2016 Please _find attached 1Affidavit/Notice of Claim(s)for lost 'warrants for inclusion on the next available &)ard agenda The attached item(s) have been researched to ensure that the warrant(s) in question have not been cashed or previously re-issued 'The original warrant (s) have had a stop payment done. fyou have any questions, please contact Willie Thompson at 372-1244 or via e-mail at mthompson@mcesa.maricopa.gov. Approved Affidavits may be routed 6ack to the Superintendent of School Finance (Division at 4041 X. Central Avenue #1200, ( 12 th Tibor) 'Thankyou, #214 TOLLESON - V.Tr10.1 I1 XENNETIfi DALT $918.86 RECEIVED OCT 2 0 Z016 MARICOPA COUNTY CLERK BOARD OF SUPERVISORS /1/4 cja ) 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. Kenneth J. Daly (1), being first sworn, upon oath deposes and says: Name/Claimant On or about August 19, 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 $ 918.86 .(3) Signed: (4) (5) Subscribed and sw to before me this ciTilday of OetObtl) 20 1G2 . KRYSTAL D. MITCHELL Notary Public- SW of Arizona My commission expires: My MARICOPACOUNTY Commission &pima September 13, 2010 (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 214731172/170010265 (if known) (6) Original Date of Issue 8/19/16 (if known) (7) — 4, t ita 14 1 Reason for original issue of Warrant/Check (8): DA Payroll 0 For Services or Goods furnished ERK, MARICO BOARD PA OF Lucim SUPERVISORS 0 Other: S: \PROCESSES \Warrants Duplicate or Stale \02 Forms\Schools \Schools-Warrants Checks notice of clalm.doc Revised June 2015 A.R.S. 11-632 & 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: 10/20/2016 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. #401 EVIT US Cutter $19049.00 #60 Higley Vertical Fix $1472.50 RECEIVED OCT 2 0 2016 MARICOPA COUNTY CLERK BOARD OF SUPERVISORS Application for a Duplicate or Stale-Dated Warrant/Check Affidavit/Claim Form This application is for: (Duplicate or 0 Stale-Dated (definitions are on page 2) STATE OF ARIZONA Note: Numbers on this form correspond to numbers on the COUNTY OF MARICOPA Instruction sheet which is page 2 of this form. US Cutter (1), being first sworn, upon oath deposes and says: Name/Claimant On or about June 7,2016 (clate)(2) a warrant/check was issued to the above named person/entity in the amount as stated below. Such warrant/check was either never received or was subsequently inadvertently lost or destroyed and there is no reasonable probability of its being found or presented for payment, or it was not presented for payment within one year after the date of issuance. Therefore, under penalty of perjury, claimant hereby affirms that this claim is correct and the amount shown is due and owing, and the applicant requests that a replacement warrant/check be issued to him/her in the sum f$ 19049.00 .(3) Signed: (4) Note: 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 cti.-4\-' day of OCkbP( 20 kraal .c -tw-cuuts NOTARY PUBLIC Notary Public State of Washington My commission expires: OKSANA P EDWARDS -JOQ MY COMMISSION EXPIRES (seal) March 25, 2018 Warrant/Check Number 460109810 (if known) (6) Original Date of Issue 6/7/2016 (if known) (7) APPROVE la Reason for original issue of Warrant/Check (8): n AT 5 111 Payroll For Services or Goods furnished 111 Treasurer's refund/payment El Other: S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Warrants Checks notice of claim - Copy.doc Revised April 2015 A.R.S. 11-632 & 11-644 L 3 Cutter/ 17945 NE 65th St., Ste. 200, Redmond, WA 98052 October 4, 2016 East Valley Institute of Tech. Re: Authorization to sign As the Office/HR Manager at USCutter Inc, I have authority to sign for USCutter Inc. Please accept my signature on the application for a duplicate check to replace check #460109810 dated 6/7/16. Thank you. Sue Karraker — Office/HR Manager 425-902-1305 EXT 7106 suek@uscutter.com 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. Vertical Fix LLC (1), being first sworn, upon oath deposes and says: Name/Claimant On or about May 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 $ 1472.50 .(3) Signed: (4) (5) Subscribed and sworn to before me this /7 /7" day of VA-0 20 /6— . NOTARY_PCJBLIC JESSE HIATT My commission expires: Notary Public - Arizona MariCopa County (seal) 4441Y-2.646 My Comm. Expires Sep 25, 2017 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 460102519 (if known) (6) Original Date of Issue 5/17/16 l 1 i9- 0)(-P (if known) (7) t _ RK. BOARD OF SUPERVISORS Reason for original issue of Warrant/Check (8): MAICODA COUNTY El Payroll 111 For Services or Goods furnished Ticket Sales for Event at Higley Theater Other: Ticket Sales for Event at Higley Theater S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Schools\Schools-Warrants Checks notice of claim.doc A.R.S. 11-632 & 15-999 Revised June 2015 I I_VIZIRT ICA_ 17IX aerial ads imp To whom it may concern, My name is Jeff Dorsey and I am the Business Manager and a Member of Vertical Fix LLC. I am authorized to conduct business on behalf of our company and I have signed the attached affidavit for your review. Please let me know if you have any questions or require any additional information. Thank you, Jeffrey Dorsey Business Manager/Member Vertical Fix LLC 7425 S Hart Ave, Tempe, AZ 85283 623-850-8155 info@theverticalfix.com www.theverticalfix.com