Extracted text (via pymupdf_layout)
3997 characters
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: 10/29/2015 Please find attached 7 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 Schools Finance Division at 4041 N. Central Avenue #1200. #60 Higley Marissa Ames $100.64 #33 Buckeye Elem Maria Del Carmen Espino $268.55 RECEIVED OCT 2 9 2 015 MARICOPA COUNTY CLERK BOARD OF SUPERVISORS j1D inct; iotsicj_, AFFIDAVIT APPRovED 0130 2015 STATE OF ARIZONA .7SK BOARD j Suw'L'AVISORS COUNTY OF MARICOPA MARICOPA COUNTY Maria Del Carmen Espino , being first duly sworn, upon oath deposes and says: That on the 15THdav of October20 15 , he presented to BESD#033 District of Maricopa County, Arizona, for payment, a claim for services rendered or supplies furnished during the month of October 20 , said claim being in the sum of Two Hundred Sixty Eight 55/100Doilars, (L268.55 ) in payment of which the Superintendent of Schools caused his/her Warrant Number 160025798 to be issued on October 15 , 2015 , drawn on the 030 Fund of BESD#033 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 160025798 in the sum of $268.55 Signed: I ift-Ca Subscribed and sworn to before me this 7# day of Ocf019ee ,20 APRIL A. RHODES Notary PubHc - Arizona Maricope County My Comm. Expires Dec 3, 2018 NOTARY PUBLIC phssl Dec. 3, .1018 Following approval please return this affidavit to the Maricopa County School Superintendents Office. 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. MARISSA AMES (1), being first sworn, upon oath deposes and says: Name/Claimant On or about 1.)/91000 I 5- (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 $ 100.64 .(3) Signed: 1 e. (4) (5) Subscribed and sworn e before me this ,-)/ day of 20 NOTARY' PUBLIC OFFICIAL SEAL JILL L. OLIVAS j Notary Public - State of Arizona My commissior) expires: MARICOPA COUN1Y /-2A3/ . I••I ••I•••I••• My I Comm. ••I•••I Expires •• I ••I Dec. ••I•••I 31, 2017 ••••••• 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 Number 460024180 (if known) (6) Original Date of Issue 09/15/2015 (if known) (7) Reason for original issue of Warrant/Check (8): 0 Payroll 0 For Services or Goods furnished REIMBURSMENT Other: REIMBURSMENT 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