050416 DUPLICATE WARRANTS - 7.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: 4/15/2016
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.
#25 Liberty Kimberly Bertel $18.39
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CLERK SUPERVISORS

Affidavit
STATE OF ARIZONA T6"-ATIJiTRKIKINP5%7
COUNTY OF MARICOPA )
/Lim be{-11 181e4--k_ being first duly sworn, upon oath deposes and says:
That on thela day of , 2015-* 4he presented to the
,
ds of Maricopa County, for payment, a claim for services
../
rendered or supplies furnished during the month of Lii.A6, , said claim being
in the sum of efih-tee4A AAA, 3-X10, Dollars ($ tg, 31 )
in payment of which the Superintendent of Schools caused his/her Warrant No. 4-15-o 1 0 ico
to be issued on J/4\e. ,A3 , 20 / 6- , drawn on the Fund of
I Maricopa County, Arizona.
Affiant further says that although he 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 a duplicate of said warrant number 116-0101 9eC( in the sum of
$
Subscribed and sworn before me this .1 day of , 20 16
AA., _AIL_ .I•I AM. 41.
,r CONNIE KROGULECKI
Notary Public - Arizona Notary Public
seal)Maricopa County
icr My Comm. Expires Nov 18, 2018 1
ir-w-w-NPWNIPWRFNIP•I•I•I•I My Con; /a* ission Exp res
Following approval please return this affidavit to the Maricopa County School Superintendent's Office.
H:\WorklAffidavfldoc 07/14/05