050416 DUPLICATE WARRANTS - 5.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: 4/12/2016
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 602-506-7121 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.
#1 Phoenix El National HOSA $240.00
?V b
MANCL.
CLERK BOARD ,r,C)

APPRO VED
AFFIDAVIT TR 1 3 nib
DPJE 17- —
STATE OF ARIZONA
COUNTY OF MARICOPA
, being first duly sworn, upon oath deposes and says:
That on the /, / day of//';- 20p; he presented to
District of Maricopa County, Arizona, for payment, a claim for services rendered
or supplies furnished during the
month of / 1 — 20 / said claim being in the sum of
/ je-'e ,az?‘-k/Ji 77-/ Ai-, Dollars, ($ ) in payment of which the
./
Superintendent of Schools caused his/her Warrant Number 3 ?7/7 to be
issued on /7: , 20 ;drawn on the Fund of
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
in the sum of
Signed: ApAizikga
Subscribed and sworn to before me this
,,,,, KELLI NICOLE FRAZIER
Notary PuItC. Stole of Texas
<...14.4 Comm. Explies 02-05-2018
, Notary 10 12970077-8 -acie
commission expires : O2i9
Following approval please return this affidavit to the Maricopa County School Superintendents Office.

5LI8 Silicon Driue. Suite 101
Southlake. TX 76092
(800) 321-HOSR • (972) 87LI-0062
Faye Claridge
EVIT
1601 West Main Street
Mesa, AZ 85201
Our records do not indicate receiving check 460033717 in the amount of $240.
Sincerely,
/ / —
Dennis Van Peeren
hosa.org

Fro 017Corporate Eductation Resouroes 9728740003 04/11/2016 12:07 #260 P.001/001
April 11,2016
Faye Claridge
EVIT
1601 West Main Street
Mesa, AZ 85201
This letter is to inform you that National HOSA has not received check number
460033717 in the amount of $240. M y name is Dennis Van Peeren, Finance
Director and should you need further authorization, I can be reached at
972-874-0062 or via email, dvp@hosa.org .
Sin erely ,
Dennis Van Peeren
Finance Director
HOSA — Future Health Professionals
hosa,org