062216 DUPLICATE WARRANTS - 2 - SCHOOLS.PDF

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: 5/26/2016
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 602-506-7121 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.
#60 Higley Amber Soto $150
#90 Saddle Mtn. Michael George $2904
MAY 2 7 nib
MARICOPA
CLERK BOARD OF SUPER VISORS
0

4t(eo Page 1 of 1
APPROVED
Ambet Soto.pdf 1 / 1 DAT
K, BOARD OF SUPERVISORS
SChOODS Affidav6t/ C FooTa MARICOPA COUNTY
Applicatkno Vow a Duphcate Wanrant/ 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.
Amber Soto (1), being first sworn, upon oath deposes and says:
On or about a9 (date)(2) a warrant/check was r>cued to the
above named per on/entity in the amount as stated below. Such warrant/check was
either never received or was subsequently inadvertently lost or destroyed arid 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 iss to him/h thnum of $150.00 .(3)
Signed: (4)
cif
MONICA BINFORD
E .47*.fe-s-Norsiv-FrtibTfa7S • : : •E fife-a Texas
sN., ...."4.: Comm. Expires 02-22-2018
complission- Notary ID 12413057-3
a ll
22-FEB 42Nes
Note: Please attach a copy of the warrant/check if available and/or any other
evidence that a warrant/check was originally issued.
Wurant/ChEack Nurnbu 460077931
III known) I5)
Orfgirtal Date of i SRI& 02/29/2016
Reason for original issue of Warrant/Check (8):
0 Payroll
0 For Services or Goods furnished Refund for Science Camp
Other: Refund for Science Camp
SAPROCESSES1Warrants - Duplicate or Stale\ 02 Fcrms‘Schools\ ScPools-Warrants Checks notice of claim.doc
Revised Jure 2015 A.R.S. 11-632& 15-999
hups://us-mg5.mail.yahoo.com/neo/i eblank 4/26/2016

APPROVPD
Schools Affidavit/Claim Form
K BOARD OF SUPER.
MARICOPA COUNTY
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.
(1), being first sworn, upon oath deposes and says:
On or about RV L 5 .1 3(....),1(.==' (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 $ (DiCA".GO .(3)
Signed: /ii' aie (4)
(5) Subscribed and sworn to before me this I day of )t\ 20 .
t M"clIgNtEALTH
NOTARY PUBLIC NOTARIAL OF SEAL PtNNsYLVANIA
Juanita L. Hultz, Notary Public
My commission expires: Uwchlan Twp,, Chester County
My Commission Expires Oct. 8, 2018
1 ) NEVEIER, PENNSYLVANIA ASSOCIATION OF NOTARIES (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
(if known) (6) 63,05SkFicoOLaiZ75-4-V3
Original Date of Issue
(if known) (7) gcsi
Reason for original issue of Warrant/Check (8):
0 Payroll
For Services or Goods furnished
0 Other:
SAPROCESSESMarrants - Duplicate or Stale\02 Forms\Schools\Schools-Warrants Checks notice of claintdoc
Revised June 2015 A,R.S. 11-632 & 15-999

FRONTLINE° 1400 Atwater Drive p: 610.722.9745
•TECHNOLO( Malvern, PA 19355 1: 610.363.3710
www.frontlinetechnologies.com
May 13, 2016
Saddle Mountain Unif Sd 90
38201W Indian School Rd
Tonopah, AZ 85354
Attn.: Diane Warren! Accounts Payable
Dear Valued Customer,
Pursuant to the Application for a Duplicate Warrant I Check form (the "Form") numbered 90551961/460087543
requested by Saddle Mountain Unit Sd 9o, pertaining to Frontline Technologies' ("Frontline") invoice numbered
INVUS47520, Michael George is authorized to sign the Form in his capacity of Collections Specialist for Frontline.
If you have any questions, please call me at 484-328-4138.
Thank you for your business.
Sincerely,
Rob Viola
Sr Contracts & Revenue Manager
Frontline Technologies
Frontline Mission:
Serving the education community with integrated tools, best practices and caring people to
support their pursuit of excellence

INTEROFFICE MEMORANDUM
911aricopa County School Superintendent's Office
TO: CLERK OE VIE BOARD
FROM: Willie 'Thompson
SUBJECT: Affidavits
DATE: 5/25/2016
Pase,_find attached 1 Affidavit/Notice of Craim(s)for Cost warrants for incrusion on
the noct avaifabfe Board agenda
The attached item(s) have been researched to ensure that the warrant(s) in
question have not been cashed or previousCy re-issued
The original warrant (s) have had a stop payment done.
If you have any questions, please contact Millie Thompson at 506.3898 or via e-mail at
mthompson@mcesa.maricopa.gov . Approved Affidavits may be routed back to the
Superintendent of School 'Finance Division at 4041 X. Central- Avenue #1200, ( 12 th
Eloor) Thankyou.
#5 ISAAC EL E14 EWAN -CISCO SANC.VEZ $1063.25
lAY 2 7 20'i6
MAR
CLERK 90,,2 ER VISORS

a
MAN 1 2016
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.
FartC < s co c_WIC ke (1), being first sworn, upon oath deposes and says:
Name/rairn
On or about /? ?C- 7 Z. 3, Z0/Go ( ,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 is_qued to him/her in the sum of $ 106)3 Z .(3)
Signed: (4)
(5) Subscri d and swor to before me this day of M aA1 20 \ IQ.
NOTARY PUBLIC OFFICIAL SEAL 1
SANDRA APONTE
My commission expires: Notary MARICOPA Public - State COUNTY cfArizcoa
\ 1 .1+1A "IMP (41,ileb'' PO 0.111111MIMINE My Comrn. am• Expires April • • 11, ••I•• 2020 I• I ; (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 (if known) Number (6) hP 60 5. q 5-41
Original Date of Issue
(if known) (7) 0 L/10 q/ZO/(a
Reason for original issue of Warrant/Check (8):
t5i( Payroll
I=1 For Services or Goods furnished
El Other:
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

Wt Number 1-6-0058954 Wt Amount $1,063.25
Wt Status OUTSTANDING Wt Interest 0
Acct Num 33-030-005 Issue Date 2/4/2016
Paid Date Register Date
Voucher 020 Claim Number 000020
PO Num 000000 Fund Number 030
Dept Num 3700 Low Orig 00000
Payee SANCHEZ, FRANCISCO Sub Fund 000
View Audit History 1
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