042016 DUPLICATE WARRANTS - 1.PDF

INTEROFFICE MEMORANDUM
Waricopa County School -Superintendent's Office
TO: CLERK OE D-PE WARD
FROM: Wiffie Thompson
SUBJECT: Affidavits
DATE: 3/24/2016
Pkase find attached _1 Affidavit/Notice of Craim(s)for Cost warrants for incrusion on
the next avada6k 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, pkase contact Male 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 N. Central *Avenue #1200, ( 12 th
(Floor) Thankyou.
#33 VOCKETE EL NORTICERNAZ CATERING $758.00
#79 LITC7ITIELD 1-1ENN2(914CCM(W $528.34
#90 SADDLE 11.NT URSYLI( $827.63
#201 OVCKETE 7.),NION TROT K,S.7{ERVAN $364.54
rr„14,k,9,5
nrotc
RECEIVED
MAR 2 5 2015
MARICOPA COUNTY
CLERK BOARD OF SUPERVISOFIS
L/YYL-a-L)

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.
Northern AZ Catering/Sodexho (1), being first sworn, upon oath deposes and says:
Name/Claimant
On or about May 07, 2015 (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 $ 758 .90 43)
Signed: - (4)
(5) Subscribed and sworn to before me this 4 day of Febrcta.r el 20 lip.
• PAULA LOCItE
Notary Public -Arizona
Coconino County
My Commission Expires
October 6.2017
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 450086220
(if known) (6)
Original Date of Issue 05/07/2015
(if known) (7)
Reason for original issue of Warrant/Check (8):
0 Payroll
For Services or Goods furnished
0 Other:
S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Schools\Schools-Warrants Checks notice of cialm.doc
Revised June 2015 A.R.S. 11-632 & 15-999

NORTHERN
ARIZONA
UNIVERSITY
Dining Services Northern Arizona University 928-523-2372
PO Box 5736 928-523-6153 fax
Flagstaff, AZ 86011-5736 wvywnau.edu/dining
March 5, 2016
Hello Laura Blake,
I am the Catering Director at Northern Arizona University. Linda Carter is my Event Coordinator. She is
responsible for billing catered events. She is authorized to sign and process charges that catering has
executed in the name of Northern Arizona Catering at Northern Arizona University. If you have any
further questions or need any further varifacation please feel free to contact me.
Thank you
James A. Graves
Operations Director
Catering and Conferences
Campus Dining
Northern Arizona University

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.
Penny McCraw (1), being first sworn, upon oath deposes and says:
Name/Claimant
On or about ‘3//o /:Q0/6, (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 $528.34 .(3)
t .
Signed: LS-N\AirIJv\) -Y- (v‘_A,A- (4)
(5) Subscribed and sworn to before me this day of March 20 16
NOTAR PUBLIC BRITTANY CARTER
Notary Public
My commission expires: Maricopa County, AZ
:1 H :4( [(--, My Commission Expires (seal)
April 29, 2019
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 160067317
if known 6
Original Date of Issue 03/10/2016
if known 7 "74 A
Reason for original issue of Warrant/Check (8):
*I Payroll
0 For Services or Goods furnished
111 Other:
S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Schools \Schools-Warrants Checks notice of claim.doc
Revised June 2015 A.R.S. 11-632 & 15-999

APPROVED
DAT u I 2016
AFFIDAVIT 1011Min
..Br..r-tK, BOARD 0 SUP ISOR
STATE OF ARIZONA MARICOPA COUNTY
COUNTY OF MAR1COPA
* ,- rn. , being first duly sworn, upon oath deposes and says:
(name and title of person )*
That on the 22 day of 20 l , he/she presented to
District of Maricopa Couilty, Arizona, for payment, a claim for services rendered or sup II furn,Ahed
during the month of J 20 15 , said claim being in the sum of (
CLLA (o in payment of
Which the Superintendent of Schools caused his/her Warrant Number to be
Issued on the...Uri-I ,20 15, drawn on thalqfund orrftlxDR(..1S...11C-S
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 NumberCb6ECZ.515=, in the sum of $9' -7 iS •
Signed:**
(Name & title of authorized personneir •
Subscribed and sworn to before me this (9 D- day of
NOTARY PUBLIC :
My commission expires:
Following approval please return this affidavit to the Maticopa County Education Service Agency Office,
ARLYES DETTMANN
Notary Public
State of North Dakota
My Commission Expires Sep 29, 2021

CenturyLink TM
To Whom It May Concern;
Ann Geiger is the assigned Credit Analyst assigned to County of Maricopa. She has the authority
to sign affidavit to replace check in question.
Sincerely
Arlyes Dettmann
Finance Supervisor Credit/Collections
701 333-1001

AFFIDAVIT
APPROVED
STATE OF ARIZONA M ATI 2 5 7016
COUNTY OF MARICOPA MARICO BOARD PA 0' "
Troy K. hexman , being first duly sworn, upon oath deposes and says:
That on the <304-hday of April 2015 , he presented to 6OCKE-YE U/\110N. H. S.
District of Maricopa County, Arizona, for payment, a claim for services rendered
or supplies furnished during the
month of Apri 20 15 , said claim being in the sum of
HuNDRED FOURIxDollars, ($3L 5 q ) in payment of which the
Superintendent of Schools caused his/her Warrant Number I S 0075,558 to be
issued on Apr) I 80 , 2015 , drawn on the 001 Fund of 13ucKoe UNION WS ,
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
1500755 53 in the sum of $ 3Coq .
'CD
Signed:
‘1A-
N10419.0] before me this / day of //(avv-- 20 1 Co
Notary Public
Maricopa County, Arizona
My Comm. Expires 09-30-17
OTARY PUBLIC
My commission expires:
Following approval please return this affidavit to the Maricopa County School Superintendents Office.