072215 DUPLICATE WARRANTS.PDF

Memo
To: Fran McCarroll, Clerk of the Board
From: Wanda Childers
Date: June 19, 2015
Re: Replacement of Lost Payroll Warrants
Please find attached I Affidavit/Notice of Claim(s) for lost
payroll warrants for inclusion on the next available Board agenda.
The attached item(s) have been researched to ensure that the
warrant(s) in question have not been cashed or previously re-
issued. The original warrant(s) have had a stop payment done.
Please call Wanda at ext. 60409 for any questions. Please route
approved Affidavits back to County Payroll, Suite 220.
Stale Dated Warrant Duplicate Warrant
Thank you.
RECEIVED
Repfacement Lost Warrant Form ihN 1 9 2015 02/25/2015
MARICOPA COUNTY
CLERK BOARD OF SUPERVISORS
I n46,/idoa q


Maricopa County
Human Resources
Memo
To: Fran McCarroll, Clerk of the Board
From: Wanda Childers
Date: June 22, 2015
Re: Replacement of Lost Payroll Warrants
Please find attached I Affidavit/Notice of Claim(s) for lost
payroll warrants for inclusion on the next available Board agenda.
The attached item(s) have been researched to ensure that the
warrant(s) in question have not been cashed or previously re-
issued. The original warrant(s) have had a stop payment done.
Please call Wanda at ext. 60409 for any questions. Please route
approved Affidavits back to County Payroll, Suite 220.
Stale Dated Warrant Duplicate Warrant
Thank you.
RECEIVED
Replacement Lost Warrant Form JUN 2 2 015 02/25/2015
MARICOPA COUNTY
CI,ERK BOARD OF 0,03, SUPERVISORS
V)X110 6ua


Maricopa County
Human Resources
agi,„, 4c,
RECEIVED
JUN 2 2 2015
Memo MARICOPA COUNTY
CLERK BOARD OF SUPERVISORS
To: Fran McCarroll, Clerk of the Board
From: Lisa Platek
Date: June 22, 2015
Re: Replacement of Lost Payroll Warrants
Please find attached I Affidavit/Notice of Claim(s) for lost
payroll warrants for inclusion on the next available Board agenda.
The attached item(s) have been researched to ensure that the
warrant(s) in question have not been cashed or previously re-
issued. The original warrant(s) have had a stop payment done.
Please call Lisa at x 6-3619 for any questions. Please
route approved Affidavits back to County Payroll, Suite 220.
Stale Dated Warrant (Over 1 Year) ( Duplicate Warrant
Thank you.

Application for a Duplicate or Stale-Dated Warrant/Check
Affidavit/Claim Form
This application is for: g Duplicate or 1=1 Stale-Dated (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.
Khalif H Sulub (1), being first sworn, upon oath deposes and says:
Name/Claimant
On or about June 17, 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 $ 1959 . 91 .(3)
Signed: (4)
Note: Please attach a copy of the warrant/check if available and/or any other
evidence that a warrant/check was originally issued.
(5) Subscribed and sworn to before me this Da day of 3 6"eN 6 20 V.
GO go",-)
NOTARY PUBLIC
My commission expires:
11 .01-aok
Warrant/Check Number 22285995
(if known) (6)
Original Date of Issue 06/17/2015
(if known) (7)
Reason for original issue of Warrant/Check (8):
IT Payroll
1=1 For Services or Goods furnished
I=1 Treasurer's refund/payment rAg0
LI Other:
1
%.at ATED
Revised April 2015 JU 3 2 5
DAT
ERK, BOARD OF COUNTY SUPERVISORS
MARICOPA

INTEROFFICE MEMORANDUM
Maricopa County Education Service Agency (aka
Waricopa County Superintendent of Schoo(. Office)
TO: CLERK OE TOE WARD
FROM: Millie Thompson
SUBJECT: Affidavits — WcpCacement of Lost Warrants
DATE: 6/22/2015
T&ase find attached 2 AffidavitNotice of Craim(s)for Cost warrants for inclusion on
the next avaiCah Ooard agenda
The attached item(s) have heen researched to ensure that the warrant(s) in
question have not heen cashed or previously re-issued.
The original-warrant(s) have had a stop payment done.
If you have any questions, please contact MiIrw Thompson at 506,3898 or via e-mail at
miNe.thompson@mcesa.man'copa.gov. .ApprovedAffidavits may he routed hack to the
Superintendent of School Finance Division at 4041 X Central Avenue #1200, i2th
ECoor) Thankyou.
#214 TOLLESON `09VIOX SCI1OLASTIC BOOKFAM $2455.62
781 Gfivasy-imEwTs PATSTMXER $496.57
781 GAmsY-1 -94Egsfirs SAWIANDIA BAILErY $1113.35
/46/up 6ie/1,57AL 14) .i ceiLA4L __ $.3113 t13
,cd?
RECEIVED
JUN 23 2015
MARICOPA COUNTY
CLERK BOARD OF SUPERVISORS
I A-IJIC 04-tt'(-4-

AFFIDAVIT vff4'
K, OAR) OF 6=_A
MARICOPA COUNTY
STATE OF ARIZONA
COUNTY OF MARICOPA
S cc. c-II\ts, being first duly sworn, upon oath deposes and says:
That on the I CI day of Haj 20l . , he presented to okkr,\N„-, GylEty-) trepy._
\DZ -kf•
District of Maricepa County, Arizona, for payment, a claim for services rendered
or supplies furnished during the
month of Fe, brucwn 2-- 20 ‘5, said claim being in the SUM of
-hue, Jor,c2,,ys,„ Dollars, ($2/ 4-rj5 .64 in payment of which the
VtuY-w--1 ruE=k, ICIV1 (36
Superintendent of Schools caused his/her Warrant Number L4Db(M to 02.. to be
issued on Cyr 20 drawn on the CD1 Fund of -C-blk-e-Sur) L.)r) LtsI \-k - %\t\
District of Maricopa County, Arizona.
Athant 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
1.-k5)t)LQ,1 • in the sum of $ 2) (-1 6 .b2
Sig SWI Alit Al
GiN Ek As p
Subscribed and sworn to before me this day of in,;.3 , 20 /:,-)
Lt T 65/17X-1—- -t-7
NOTARY PUBLIC
My commission expires:
Following approval please return this affidavit to the Maricopa County School Superintendents Office.
--MARIA R. STOCKMAN
Notary Public - Notary Seal
State of Missouri
Commissioned for Osage Cou
My Commission Expires: September 18,2017
Commission Number: 13401824

ovED
UN '21.41 201
STATE OF ARIZONA
IL,Envisons
COUNTY OF MARICOPA MAFIV-1-; ,INTY
SAMANTHA BAILEY being duly sworn, upon oath deposes and says;
That on the 17TH day of APRIL 2015 he/she presented to the
Treasurers of Maricopa County, for payment, a claim for services rendered or
supplies furnished during the month of MARCH , said claim being in the sum of
ONE THOUSAND ONE HUNDRED THRITEEN AND 35/100 dollars ($ 1 ' 113 '35 ) in payment of which the
150067495
Superintendent of Schools caused his/her Warrant Number to be issued on
MARCH 26TH , 2015 , drawn on the 781 Fund of Treasurers of
Maricopa County, Arizona.
Claimant further says that although he/she was informed and believed that the above-
mentioned warrant was regularly issued, the same has never been received or has been lost.
Under penalty of perjury, claimant hereby affirms that this claim is correct and the amount
shown is due and owing.
Wherefore, claimant requests that the Board of Supervisors order and the Superintendent
150067495
of Schools issue him/her a duplicate of said Warrant Number in the sum of
1,113.35 A.
Claimant Signature
Subscribed and sworn before me this cRq. day of IngY , c(D
KIM BRIMIE
Notary Public - State of Arizona Notary Public
MARICOPA COUNTY
My Commission Expires
April 20, 2016 y commission expires -a0/‘‘)
Following approval please return this affidavit to Maricopa County Education Service Agency.

API
STATE OF ARIZONA
JU 2,4 U15
COUNTY OF MARICOPA
Patsy Baker being duly sworn, upon oath deposes and says;
That on the 5 day of June 2015 he/she presented to the
Treasurers of Maricopa County, for payment, a claim for services rendered or
supplies furnished during the month of September , said claim being in the sum of
four hundred ninety six dollars & 57/100 dollars ($ 496.57 ) in payment of which the
Superintendent of Schools caused his/her Warrant Number 150011843 to be issued on
September 18 2014 , drawn on the 781 Fund of Treasurers of
Maricopa County, Arizona.
Claimant further says that although he/she was informed and believed that the above-
mentioned warrant was regularly issued, the same has never been received or has been lost.
Under penalty of perjury, claimant hereby affirms that this claim is correct and the amount
shown is due and owing.
Wherefore, claimant requests that the Board of Supervisors order and the Superintendent
150011843
of Schools issue him/her a duplicate of said Warrant Number in the sum of
496.57
Claimant Signature I
Subscribed and sworn before me this Vic7 day of cgok‘-5-
Notary ublic
OFFICIAL SEAL
Notary KAREN Rdbfic Sbate BENNETT of Arizona : My commission expires
MARICOPA COUNTY I
ilnli4,0,1.4•10116aMINI m,y Comm Exta rats 114,......:". Feb, 11, 2018 I •• I••••• j
Following approval please return this affidavit to Maricopa County Education Service Agency.

AFFIDAVIT
STATE OF ARIZONA M A IC ),
COUNTY OF MARICOPA
Li Liz) -iCi /11 (t 1 c( , being first duly sworn, upon oath deposes and says:
I (Name and Title.Af Person) 1- ra-e-kLe - , / 1--
, / ,-)
That on (4. / n ,20 15 , he/she presented to /VI I CL-7-21i- ( &I-4- i l el/ 1511
(School District Nam6)
Maricopa County, Arizona, for payment, a claim for services rendered or supplies furnished during the
month of --Li ikne 20 I c:), said claim being in the sum of ($ 3 l 73 ,
ji 1_, ertAA ( C DJ/ (L-D-eolifrs in /3 pm /c een)t of which
the Superintendent of Schools caused his/her Warrant Number )5 DD go 78 (-1 to be issued
on LJe I. 7, 20 I (5, drawn on the --)C Fund of lUle 6 ri3OCT of
(School District Name)
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 15 ooqc7,79 inthesumof$ 3j73 1 3.
Signed: k1/4 )
(NarLainV tho'fiZed-Wersonnel )
Subscribed and sworn to before me this day of I,_\ v-1 , 20 I 5
d
NOTARY PUBLIC:
My commission expires: \ 1°1 (ce
Following approval please return this affidavit to the Maricopa County Education Service Agency Office.

INTEROFFICE MEMORANDUM
Ilaricopa County Education Service Agency (aka
Yfriaricopa County Superintendent of Schoo(s Office)
TO: CLERK OF THE (BOARD
FROM: 914iffie Thompson
SUBJECT: Affidavits — Wcpfacement of Lost Warrants
DATE: 6/25/2015
PThase find attached 7 AffidavitOotice of CCaim(s)for Cost warrants for inclusion on
the noct avaifable (Board agenda
The attached item(s) have fieen researched to ensure that the warrant(s) in
question have not heen cashed or previously re-issued
The original warrant(s) have had a stop payment done.
If you have any questions, please contact Aliffie 'Thompson at 506.3898 or via e-mail at
miffie.tfiompson@mcesa.maricopa.gov . _Approved _Affidavits may be routed back to the
Superintendent of School Einance Division at 4041 X Central Avenue #1200, ( 12tfi
(Floor) Thankyou.
#781 GAVVIS.7 -014ENT DORTJfETBROADOENT $832.71
#45 FOWLER PRI14.A.VEM TOLKLORICO DANCE $720.00
#95 QUEEX CREEK ANA NALDOXADO $123.59
#59 LAVEEN CRITICAL VaglIKIWG CO $81.43
#68 ALIC,49110X4 911AWILOr0 GAWCIA $88,16
#68 AL11BM WIARIZ SOSA-11fiCac $285.44
#401 E1Y1T NATIONAL AVID TEM ED $750.00 RECEIVF'
JUN 2 6 :5
MARICOPA ,,OUNTY
CLERK BOARD OF SUPERISORS
.A°A,K, (*Kt, Alettlie

APPROVED
STATE OF ARIZONA
JUN IQ 20
COUNTY OF MAR1COPA
CLERK t BOARD OF SUPERVISORt-
MARICOPA COUNTY
Dorthey Broadbent being duly sworn, upon oath deposes and says;
That on the 17th day of June 2015 he/she presented to the
Treasurers of Maricopa County, for payment, a claim for services rendered or
supplies furnished during the month of May , said claim being in the sum of
eight hundred thirty two & 71/100 dollars ($ 832.71 ) in payment of which the
Superintendent of Schools caused his/her Warrant Number 150079715 to be issued on
May 14 2015 drawn on the 781 Fund of Treasurers of
Maricopa County, Arizona.
Claimant further says that although he/she was informed and believed that the above-
mentioned warrant was regularly issued, the same has never been received or has been lost.
Under penalty of perjury, claimant hereby affirms that this claim is correct and the amount
shown is due and owing.
Wherefore, claimant requests that the Board of Supervisors order and the Superintendent
of Schools issue him/her a duplicate of said Warrant Number 150079715 in the sum of
832.71
Claimant Signature oc144,..4 ie-81Dad6,4,6--
Subscribed and sworn before me this 1 7 day of
,117e,„,
Notary Public
My commission expires
Plotery Public 0. - Arizona
Risrloopa CornmIssion County Expires
JUME 30, 2010
Following approval please return this affidavit to Maricopa County Education Service Agency.

AFFIDAVIT
STATE OF ARIZONA MAR iCOPA COUN1 Y
COUNTY OF MARICOPA
y Le:city/Di reclor
A- F,1k4e,l or ,‘,,,j76-1,/rtce. Cf) .
"igi , being first duly sworn, upon oath deposes and says:
(Name Ind Title of Person)
That on June 3 al , 2015 , he/she presented to Fowler Elementary
(School District Name)
of Maricopa County, Arizona, for payment, a claim for services rendered or supplies furnished during the
months of March, April and May , 2015 , said claim being in the sum of ($720.00_) Seven
hundred twenty dollars and 00/100 Dollars in payment of which the
Superintendent of Schools caused his/her Warrant Number 450043496 to be issued on
December 12 th , 2014 , drawn on the _164_ Fund of Fowler Elementary_ of
(School District Name)
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 _450043496 in the sum $720.00 .
,
(/er tor'
Signed://*/
(N e and Title of Autiorized Personnel)
Subscribed and sworn to before me this / • ') -/L-- day of , 20 /
NOTARY PUB,LC1L
My commisiorKei(pires: 0-0 /
Following approval please return this affidavit to the Maricopa County Education Service Agency Office.
AL. sEAL
JANIS A. MUNOZ
Notary Pulgio - State of Arizona
MARICOPA COUNTY I
1j Comm. Expin3s Oct. 12, 2018
'

APPRO1C
or2b_JUiIIX6
Affidavit
STATE OF ARIZONA
COUNTY OF MAR1COPA )
Ank M ALinC0 being first duly sworn, upon oath deposes, and says:
That on the / 7 I ',lay of , 20/5 he presented,to the
aloon ()leek 5 ./r491S of Maricopa County, for payment, a claim for services
rendered or supplies furnished during the month of 07ô/5 , said claim being
in the sum of Wilailied_11/1/P,OA r 59, ej_ Dollars ($_/4 3 57 )
in payment of which the Superintendent of Schools caused his/her Warrant No. / --5- e68y73
to be issued on , 20/5 , drawn on the 7130 Fund of
of 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, athant prays that the Board of Supervisors order and the Superintendent of
Schools issue to him a duplicate of said warrant number /-5-c91? 73 7 in the sum of
$ la? 3 , 52
[-JIG( MCqi-6( 0.06 eN 010
Subscribed and sworn before me this jelday of , 20 /5—
,F1.ATTS
Watery Pao 4this c4Adrois
MARICOPA COUNTY
My Commission Exp9es My Comniissioh Expires
May 2, 2019
Following approval please return this affidavit to the Maricopa County School Superintendent's Office.
11:1Work1Afficiavitcloc 07114105

Affidavit
,
State of Arizona , J1102,8 2Q
(County of Maricopa)
The Critical Thinking Company being first duly sworn, upon oath deposes and says: That on the
Second day of March, 2015 he/she presented to the Laveen Elementary School District #59 of
Maricopa County, for payment, a claim for services rendered or services to be furnished during the
month of March, said claim being in the sum of $ Eighty-one and 43/100 dollars
($ 81.43) in payment of which Superintendent of Schools caused his/her
Warrant No. 450071395 to be issued on March 17, 2015, drawn on the 40/30 fund of Laveen
Elementary School District #59 of Maricopa County, Arizona.
Affidavit 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, affidavit prays that the Board of Supervisors order and the Superintendent of
Schools issue him/her a duplicate of said Warrant No. 450071395 in the sum of $ 81.43.
Vendor Signature
Printed name:S- irs10.11)?e ,r&c ItAxic ilie with the company:4-e_IA-, r
rs, Ct,h,
Subscribed and sworn before me this 1 7 day of
(notary public signature and stamp)
NAOMI ORONA
Notary Maricopa Public Courtly - Arliona my commission expires Arril `7/ --0)/ 6
Expires Apr 272016
Following approval please return this affidavit to Maricopa County Schools.

AFFIDAVIT
STATE OF ARIZONA
COUNTY OF MARICOPA
* , being first duly sworn, upon oath deposes and says:
(name and title of person )*
That on the ) 1-'6 day of 5LcQ 20 1`) , he/she presented to
-SC-\\GrA
District of Maricopa County, Arizona, for payment, a claim for services rendered or supplies furnished
during the month of \ -.1 -\ 4.-z) 20 45- , said claim being in the sum of ($ 5$8 •1(0 )
Dollars in payment of
Which the Superintendent of Schools caused his/her Warrant Number ()S(2X59 (-) to be
Issued on the ,20S, drawn on the C ,L IC, Fund of (4\\tIc-A-N-\6c--%
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 t_. I 0,37-e 1c) in the sum of $ 1Qo
Signed:*,* 7,4
(Name & title of adthorized personnel)**
Subscribed and sworn to before me this day of ,20 5-
.....I , * arya.111mmy
OFFICIAL SEAL
MONICA LOPEZ f
Nosily Public- Sista diatom
NOTARY PUBLIC : MARICOPA COUNTY
My Cam. Expkas July 14' 2018 i
My commission expires:
Following approval please return this affidavit to the Maricopa County Education Service Agency Office.

AFFIDAVIT
STATE OF ARIZONA
COUNTY OF MARICOPA
* Okri - 11?0 IC S , being first duly sworn, upon oath deposes and says:
(name and title of person )*
That on the Z7. day of a) fir 20/5 , he/she presented to
1-iihoo koc, Ab,a
District of Maricopa Count y, Arizona , for pa yment, claim for services rendered or supplies furnished
during the month of --501‘.y, 20 15 , said claim being in the sum of ($ ag.5. 4-1 q )
ILY) I-LAW F.; km) 6e) lo a,vj 411 0(--) Dollars in payment of
tr
Which the Superintendent of Schools caused his/her Warrant Number / --5- 602'463 `g to be
Issued on the ih19 -:Yuik 0 ,206-, drawn on the CO Fund of 4 ih.C.1-ril bfiCi
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 1-,5-nCAc9 in the sum of $ 92c) .1 ("(
Signed:*
(Name & title of authorized personnel)**
Subscribed and sworn to before me this (9c)ock day of , 20)
24/
NOTARY PUBLIC :
702/o OFRCIAL BEAL
CHERYL CARDER
My commission expires: Nor/ Pubft - Stab ameccon.
MARIGGPA COUNTY .
my corm ExPlium1. 12.2°17 .1
Following approval please return this affidavit to the Maricopa County Education Service Agency Office.

\\\04,& ok.e\-,,of ctL
MARICOPA COUNTY RECEIVED
Department of Finance
301 West Jefferson, Ste 960 JUN 2 9 2015
Phoenix, Arizona 85003 MARICOPA COUNTY
RS
INTEROFFICE MEMORANDUM
Date: June 29, 2015
To: Clerk of the Board
From: Beth Brown
Department of Finance
Subject: Affidavit — Replacement of Lost Warrant
Please find attached affidavit for lost warrant to be included on the next available Board
Agenda.
• The attached item has been researched to ensure the warrant in question
has not been cashed or previously re-issued.
• The original warrant has a void/stale date/stop payment done.
Please call me at 506-1329 if you have any questions. Please return the approved
Affidavit to my attention in the Department of Finance, Suite 960.
Thank you.
Re: US Collections West Inc.

Application for a Duplicate or Stale-Dated Warrant/Check
Affidavit/Claim Form
This application is for: 1 Duplicate or El Stale-Dated (definitions are on page 2)
STATE OF ARIZONA Note: Numbers on this form correspond to
COUNTY OF MARICOPA numbers on the Instruction sheet which is
Dade 2 of this form.
US Collections West Inc. (1), being first sworn, upon oath deposes and says:
Name/Claimant
On or about 18 -May-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 $ 1 57.1 6 .( 3 )
Signed: (4)
Note: Please atfach a copy of the warrant/check if available and/or any other
evidence that a warrant/check was originally issued.
(5) Subscribed and sworn to before me this s n 04 vot day of 3-Live_ 20 15 .
E OFFICIAL SEAL II
i KATHY ARMSTRONI$
My commi ion expires: Notary Public -State of Arizoffa
1-(.•s atAS My MARICWOUN Comm. Obc.26,2 16; I
••• II
Warrant/Check Number 350029292
' (if known) (6)
Original Date Of Issue I 8-May-2015
(if known) (1)
Reason foi-, otinal issue of Warrant/Check (8):
▪ Payroll
0 For Services or Goods furnished
O Treasurer's refund/payment
Other: Creditor check vendor payment/Garnishment

MARICOPA COUNTY
Department of Finance
301 West Jefferson, Ste 960
Phoenix, Arizona 85003
INTEROFFICE MEMORANDUM
Date: July 1, 2015
To: Clerk of the Board
From: Beth Brown
Department of Finance
Subject: Affidavit — Replacement of Lost Warrant
Please find attached affidavit for lost warrant to be included on the next available Board
Agenda.
• The attached item has been researched to ensure the warrant in question
has not been cashed or previously re-issued.
• The original warrant has a void/stale date/stop payment done.
Please call me at 506-1329 if you have any questions. Please return the approved
Affidavit to my attention in the Department of Finance, Suite 960.
Thank you.
Re: ACE PARKING MANAGEMENT, INC
RECEIVED
JUL 0 1 2015
MARICOPA COUNTY
CLERK GJAND OF SUPERVISORS
,finik, 444, ,44,4tie

Application for a Duplicate or Stale-Dated Warrant/Check
Affidavit/Claim Form
This application is for: Duplicate or U Stale-Dated (definitions are on page 2)
STATE OF ARIZONA Note: Numbers on this form correspond to
COUNTY OF MARICOPA numbers on the Instruction sheet which is
page 2 of this form.
ACE PARKING MANAGEMENT, INC (i) being first sworn, upon oath deposes and says:
Name/Glaimant
On or about 21May2015 -- (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
him/her in the sum of $ 3,225.00 43)
Signed: 1,0)cli (4)
Note: Pleas- attach a copy of the warrant/check if available and/or any other
evidence that a warrant/check was originally issued.
(5) Subscribed and sworn to bekre me this day of 20
ac-Ke 0(.
NOTARY PUBLIC
My commission expires:
(seal)
Warrant/Check Number 350029628
if known) (6)
Original Date of Issue 21-May-2015
(if known) (7)
Reason for original issue of Warrant/Check (8):
0 Payroll
For Services or Goods furnished during the month of June, 2015
III Treasurer's refund/payment
111 Other:
APPROVED
DATM JUCi.12O
H:IK, BOARD OF SUPERVISORS
MAR ICOPA COUNTY

CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189
"TN.< q.,1'..{ 46.4 41.4 vvt cv.
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the
document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of Califor la
County of cj Die00
On 2(...0 Join 201C before me, Sfr\a-&V- I eqi
Date /) . Hem Insert Name and Title of the Offic
personally appeared
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the personH whose name* is/.e
subscribed to the within instrument and acknowledged to me that he/514€1414ey executed the same in
hisAlerftheif authorized capacity(ies); and that by his/hor/thcir signature(&) on the instrument the person.(,
or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph
co... #2057453 o is true and correct.
NOTARY PUBUC-CAUFORMA
SAN DIEGO COUNTY IT nd and official seal.
My ssto Ainomme Eros
MARCH 1 2018
Sig
Place Notary Seal Above
OPTIONAL
Though this section is optional, completing this information can deter alteration of the document or
fraudulent reattachment of this form to an unintended document.
Description of Attached Docile t. t'zi
Title or Type of Document: /-'\ eta. r Document Date: I #t- 26
Number of Pages: t Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name: Signer's Name:
Corporate Officer — Title(s): 'H Corporate Officer — Title(s):
L Partner — LII Limited LI General Fl Partner — ri Limited 0 General
H Individual LI Attorney in Fact 71 Individual L Attorney in Fact
7 Trustee 1-1 Guardian or Conservator 11 Trustee LI Guardian or Conservator
Li Other: 111 Other:
Signer Is Representing: Signer Is Representing:
e, d4 -d4'd4 "d4 . d4 -45/4 'A/CAW-5,4 d4l.S• ao,4 d. 4 • d ..egd d4 WOLd,cd4
©2014 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907

Maricopa County
Human Resources
Memo
To: Fran McCarroll, Clerk of the Board
From: Linda Greinke
Date: July 1,2015
Re: Replacement of Lost Payroll Warrants
Please find attached t Affidavit/Notice of Claim(s) for lost
payroll warrants for inclusion on the next available Board agenda.
The attached item(s) have been researched to ensure that the
warrant(s) in question have not been cashed or previously re-
issued. The original warrant(s) have had a stop payment done.
Please call Linda G. at ext. 63770 for any questions. Please route
approved Affidavits back to County Payroll, Suite 220.
Stale Dated Warrant Duplicate Warrant
Thank you.
RECEIVED
JUL 01 2015
MARICOPA COUNTY
CLERK BOARD OF SUPERVISORS
kete





MAR1COPA COUNTY
Department of Finance
301 West Jefferson, Ste 960
Phoenix, Arizona 85003
INTEROFFICE MEMORANDUM
Date: July 7, 2015
To: Clerk of the Board
From: Beth Brown
Department of Finance
Subject: Affidavit — Replacement of Lost Warrant
Please find attached affidavit for lost warrant to be included on the next available Board
Agenda.
• The attached item has been researched to ensure the warrant in question
has not been cashed or previously re-issued.
• The original warrant has a void/stale date/stop payment done.
Please call me at 506-1329 if you have any questions. Please return the approved
Affidavit to my attention in the Department of Finance, Suite 960.
Thank you.
Re: James Grace
RECEIVED
JUL 0 7 2015
MARICOPA COUNTY
CLERK BOARD OF SUPERVISORS
i40 et I abi.

Application for a Duplicate or Stale-Dated Warrant/Check
Affidavit/Claim Form
This application is for: Duplicate or 0 Stale-Dated (definitions are on page 2)
STATE OF ARIZONA Note: Numbers on this form correspond to
numbers on the Instruction sheet which is
COUNTY OF MARICOPA Dade 2 of this form.
JAMES GRACE (1), being first sworn, upon oath deposes and says:
Name/Claimant
12-Feb-2015 (date)(2) a warrant/check was issued to the
On above or about 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/cp t ck be issued to him/her in the sum of $ 147.00 .(3)
Signed: qct,,, iii A.Acp (4)
Note: Pjt9ase attach a copy of the warrant/check if available and/or any other
evidence that a warrant/check was originally issued.
(5) Subscribed and sworn to before me this L__day of (,)Likki 20 /S—.
iliiallh=a 111r11111r116.10wilirilbrO
DYLLAN HERMAN
NOTARY PUBLI Notary Public - Arizona
Marlcopa County
IV commission expires: My Comm. Expires Jun 2, 2019
(seal)
Warrant/Check Number 350020338
(if known) (6) 1
Original Date of Issue 12-Feb-2015
(if known) (7)
Reason for original issue of Warrant/Check (8):
Li Payroll
LI For Services or Goods furnished
El Treasurer's refund/payment
Other: refund of Writ of Restitution fees
APPROVZD
JU11 7 2015
DATE,
IDARCY-O'F S
MAFIICOPA COUNTY


Maricopa County
Human Resources
Memo
To: Fran McCarron, Clerk of the Board
From: Linda Widner
Date: July 6, 2015
Re: Replacement of Lost Payroll Warrants
Please find attached 1 Affidavit/Notice of Claim(s) for lost
payroll warrants for inclusion on the next available Board agenda.
The attached item(s) have been researched to ensure that the
warrant(s) in question have not been cashed or previously re-
issued. The original warrant(s) have had a stop payment done.
Please call Linda Widner at ext. 6-8051 for any questions. Please
route approved Affidavits back to County Payroll, Suite 220.
Stale Dated Warrant
Thank you.
RECEIVED
JUL 0 7 2015
MAR ICOPA COUNTY
CLERK BOARD OF SUPERVISORS,
611414e- V)41A4Aj

Application for a Duplicate or Stale-Dated Warrant/Check
• Affidavit/Claim Form
11 JUL -0-I PA ?:
This application is for: Duolica e or a e- ated (definitions are on page 2)
STATE OF ARIZONA NoNIANeg§ggggorrespond to numbers on the
COUNTY OF MARICOPA Instruction sheet which is page 2 of this form.
Christopher P Rufo (1), being first sworn, upon oath deposes and says:
Name/Claimant
On or about 7/1/2015 (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 bQissued himTher in th m of $1,516.88 .(3)
Signed: "Y2)---- - (4)
Note: Please attach., a copy of the wartant/check if available and/or any other
evidence that a warrant/Check was.originaily issued.
(5) Subscribed and sworn to before me this 7 day of jUA_,\ 20 15 .
.
03Cogo UJ
NOTARY PUBLIC
EILEEN WIWAMS.PREM
My commission expires: Neatly MARICOPACOUNTY Pubic - 8eoTAiibile
My Correniesion Expires (seal)
November 9, 2018
Warrant/Check Number 22289871
(if known) (6)
Original Date of Issue 7/1/2015
(# known) (7) i-mppRovEr
Reason for original issue of Warrant/Check (8):
IR Payroll
El For Services or Goods furnished
El Treasurer's refund/payment
LII Other:
C:\Users\williamse\AppData/Local\Microsoft\Windows\Temporary Internet Files/Content.Outlook\HTTOL74G \Warrants Checks notice
of claim.doc
Revised April 2015 A.R.S. 11-632 & 11-644

Memo
To: Fran McCarroll, Clerk of the Board
From: Wanda Childers
Date: July 7, 2015
Re: Replacement of Lost Payroll Warrants
Please find attached I Affidavit/Notice of Claim(s) for lost
payroll warrants for inclusion on the next available Board agenda.
The attached item(s) have been researched to ensure that the
warrant(s) in question have not been cashed or previously re-
issued. The original warrant(s) have had a stop payment done.
Please call Wanda at ext. 60409 for any questions. Please route
approved Affidavits back to County Payroll, Suite 220.
Stale Dated Warrant Duplicate Warrant
Thank you.
RECEIVED
JUL 0 8 2015
Replacement Lost Warrant Form MARICOPA COUNTY 02/25/2015
CLERK BOARD OF SUPERVISORS
'04,1,e1;vvi_dp4JZ


INTEROFFICE MEMORANDUM
gliaricopa County Education Service Agency (aka
514aricopa County Superintendent of Schoo(s. Office)
TO: CLEWKOE WE (BOARD
FROM: 914iirie Thompson
SUBJECT: )ffidavits Wcpracement of Lost Warrants
DATE: 7/7/2015
Pase find attached 4 Affidavit/fArotice of Craim(s)for Cost warrants for incrusion on
the nekt available (Board agenda
The attached item(s) have 6een researched to ensure that the warrant(s) in
question have not heen cashed or previousry re-issued
The original. warrant(s) have had a stop payment crone,
If you have any questions, please contact Millie (Thompson at 506.3898 or via e-mait - at
rnirrie.thompson@mcesa.maricoov. Approved _Affidavits may 6e routed 6ackto the
Superintendent of School - Finance Division at 4041 W. Central- Avenue #1200, ( 12tfi
Tibor) Thankyou.
#1 WY/OEN -IX ELE914 12,SVIW KMENT $73.92
#1 VrOENTX: ELE51/1 ,SVIMELTSTATTINg $4200.00
#781 yer.VVISINIENT LOVI,SA :ALLA WD $1838.20
#60 JfIgLET CIOVL rECIOW,MfAIWZ .3.14EZCVA $638.98
RECEIVED
JUL 0 8 2015
MARICOPA COUNTY
CLERK BOARD OF SUPERVISORS
41-irce, oLe“-e

RECEIVED
AFFIDAVIT APR 30 2015
ACCTS. PAYABLE
STATE OF ARIZONA
APPROVE`a
DATE, JUL P 9 2015
COUNTY OF MARICOPA
AZ Spray Equipment being first duly sworn, upon oath deposes and says:
That on the 30th, January 2015_presented to PHOENDC ELEMENTARY
SCHOOL DISTRICT #1 of Maricopa County, for payment, a claim for services
rendered or supplies furnished during the month of January 2015, said claim
being in the sum of $73.92 in payment of which Superintendent of Schools
caused his/her Warrant No. 45-0059499 to be issued on, drawn on the 001
Fund of PHOENIX ELEMENTARY SCHOOL DISTRICT #1 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 No. 45-
0059499 in the sum of $73.92.
0-79.(Q___AdF/Pahit iY1 40\mncV.-yattv2.
t\t-
Subscribed and sworn before me this dam of ..... 2O. i.
CARI M RITTER
Notary Pubilo.Stata of Arizona
Mericops County
My Commission Expires
Notary Public February 19 1 2018
My Cdmmission Expires ...... efol
Following approval please return this affidavit to COUNTY SCHOOLS OFFICE

AFFIDAVIT
Ein'AJ-1D7.1:-' JT , F!.°1VIS F17.
MARICO PA COUNTY
STATE OF ARIZONA
COUNTY OF MARICOPA
Sunbelt Staffing being first duly sworn, upon oath deposes and says:
That on the 21st, December 2014 presented to PHOENIX ELEMENTARY
SCHOOL DISTRICT #1 of Maricopa County, for payment, a claim for services
rendered or supplies furnished during the month of November 2014, said claim
being in the sum of $4,200.00 in payment of which Superintendent of Schools
caused his/her Warrant No. 45-0053277 to be issued on, drawn on the 001
Fund of PHOE1VIX ELEMENTARY SCHOOL DISTRICT #1 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 No. 45-
0053277 in the sum of $4,200.00.
Sherrui at,
mclivtier
Signature
I-••
Subscribed and sworn before me this day o FiloAL
A,4014.7 MARILYN HARMON
Notary Public, State of Florida
Notary Public Commission # FF 52085
My comm. expires Sept. 8, 2017
My Commission Expires.Liwm.L .
Following approval please return this affidavit to COUNTY SCHOOLS OFFICE

STATE OF ARIZONA
' COUII1TY OF MARICOPA
Louisa Allard being duly sworn, upon oath deposes and says;
That on the 25 day of June , 2015 he/she presented to the
Treasurers of Maricopa County, for payment, a claim for services rendered or
supplies furnished during the month of May , said claim being in the sum of
one thousand eight hundred thirty eight & 20/100 dollars ($ 1 '838.20 ) in payment of which the
Superintendent of Schools caused his/her Warrant Number 150079529 to be issued on
May 14 2015 , drawn on the 781 Fund of Treasurers of
Maricopa County, Arizona,
Claimant further says that although he/she was informed and believed that the above-
mentioned warrant was regularly issued, the same has never been received or has been lost,
Under penalty of perjury, claimant hereby affirms that this claim is correct and the amount
shown is due and owing.
Wherefore, claimant requests that the Board of Supervisors order and the Superintendent
150079529
of Schools issue hirn/her a duplicate of said Warrant Number in the sum of
1,838.20
Claimant Signature
Subscribed and sworn before me this (2 ct day of LANN
DIANE KAMM Notary Public
Notary Public - Stale of Arizona
My MAR Commission ICOPA COUNTY Expires My commission expires
June 25, 2017
Following approval please return this affidavit to Maricopa County Education Service Agency.

APPR L;)
DAT EA .10 0 9 205
AFFIDAVIT
PK. BOARD OF SUPETIVISORS
MATIICOPA COUNTY
STATE OF ARIZONA
COUNTY OF MARICOPA
Raul Hector Ramirez Amezcua , being first duly sworn, upon oath deposes and says:
(Name and Title of Person)
That on _June II , 2015 , he/she presented to Higley Unified School District of
(School District Name)
Maricopa County, Arizona, for payment, a claim for services rendered or supplies furnished during the
month of June , 2015 , said claim being in the sum of ($_638.98
six hundred thirty eight and 98 Dollars in payment of
which the Superintendent of Schools caused his/her Warrant Number _150087722 to be issued
on June 11 , 2015 , drawn on the 001 Fund of Higley Unified School District of
(School District Name)
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 150087722 in the sum of $ 638.98
Signed: /(1 /
(Name and Title of Authorized Personnel)
Subscrilied and sworn to before me this day of ( )0/1.-e ,20 /S-
fLui
NOTARY PUBLIC:
My commission expires: V/7//co
Following approval please return this affidavit to the Maricopa County Education Service Agency Office,
-• •
OFFICIAL SEAL
! \4.0 LYNETTE STEVVART j
• ..7t riWansos. Notary Public - Stite of Arizona
7t6,1 MARICOPA COUNTY
My Comm. Expires Sept, 17, 20161

INTEROFFICE MEMORANDUM
Waricopa County Education Service Agency (aka
Maricopa County Superintendent of Scfioots Office)
TO: CLERK,OF191 -E (BOARD
FROM: .914iirie 'Thompson
SUBJECT: Affidavits — Wopfacement of Lost 'Warrants
DATE: 7/7/2015
Tfease find attached 6 Affidavit/Notice of Claim(s)for Cost warrants for inclusion on
the ne.xt avaita6fe (Board agenda
The attached item(s) have been researched to ensure that the warrant(s) in
question have not heen cashed or previously re-issued
The originaf warrant(s) have liad a stop payment done.
If you have any questions, please contact 91/fillie Thompson at 506.3898 or via e-mail at
miftie.thompson@mcesa.nzaricopa.gov . Approved Affidavits may he routed back to the
Superintendent of School - finance (Division at 4041 X. Central _Avenue #1200, (12th
Tibor) 7hankyou,
#5 ISAAC YILLEVIW 911V,SIC $245.00
#60 .7-11- g LET ,SAWIA.N19(Arg 11A Sq.n(50.1%1 (3) $921.89, $921.89 et 921.89
#95 QUEEN' CREEK (DEFDXE, WrirEWS $452.30
#60 .7-11-g LET _ANCIE.Lyi J OUBEWRI.1\rg $15000.00
RECEIVED
JUL 0 8 2015
MARCO-p, COUNTY
CLERK 00AkD Cf: SUPERVISORS
a(Aurfit Vn4114:e

APPROVED
Affidavit JU) 0 9 201
ALA
STATE OF ARIZONA SUP
COUNTY OF MARICOPA )
ALLEGRO MUSIC,., being first duly sworn, upon oath deposes and says:
That on the 33" day OF MARCH ,2015 they presented to the ISAAC
SCHOOL DISTRICT NO. 5 of Maricopa County, for payment, a claim
for services rendered or supplies furnished during the month of
MARCH, said claim being in the sum of TWO HUNDRED FORTY FIVE
DOLLARS/00 CENTS ($245.00) in payment of which the Superintendent
of Schools caused his Warrant No. 450081566 to be issued on APRIL
21, 2015, drawn on the 040 fund of ISAAC SCHOOL DISTRICT NO. 5 of
Maricopa County, Arizona.
Affiant further says that although they were informed and believe
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 them a duplicate of said
warrant number 450081566 in the sum of $245.00.
Subscribed and sworn before me this 17day ofc5UAQ, 20(157
COLLEEN R. WINKLER
1 e ee_a_ 2 (Notary Public) Notary Public—Arizona
Maricopa County
Expires 09/05/2015
My commission expires 6 Vo
Following approval please return this affidavit to Maricopa County Schools.

AFFIDAVIT
STATE OF ARIZONA
COUNTY OF MARICOPA
aialaratia t\l', CAL. IV ieCbY,Ibeing first duly sworn, upon oath deposes and says:
(Name and Title of Person)
That on Ilk Vie..) , 20 i e-5 , he/she presented to H-1 .) IA.S1 +4-ire) of
Saw District Name)
Maricopa County, Arizona, for payment, a claim for services ren ered or supplies furnished during the
month ofkli.tVIC. , 20 IG , said claim being in the sum of ($ 69104- &-7 )
vi ; 1 Lt1CL trcet-fiAleAllitt ariel Dollars in payment of which
the Superintendent of Schools used his/her Warrant Number / 50/) c"i c. 13 to be issued
on \hi rtit-, , 20 /5 , drawn on the DP I Fund of 'As V 44 Loo of
.3,6chool istrict Name)
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 1500Re191 3 in the sum of $ .
Signed:
(Name and Title of Authorized Personnel)
Subscribed and sworn to before me this c12.3— day of --617 , 20 Pr
0/d/friD
NOTARY PUBLIC:
My commission expires:
Following approval please return this affidavit to the Maricopa County Education Service Agency Office.
•I ••••••11I•• -• II•••I••I••I •I• II •
OFFICIAL SEAL
TAMMY NAVARRO j
Notary PLOW State dArizoha
MARICOPA COUNTY I
My Comm EVres March 6, 20191

APPROVED
AFFIDAVIT DATE fini 0 9 2015
STATE OF ARIZONA
COUNTY OF MARICOPA
,.3.1.1(46111111/A 14;051e, fYiet5401(-9-3(1, being first duly sworn, upon oath deposes and says:
(Name and Title of Person)
That ordtine., , 20 , he/she presented to H9 10/1 tiso of
„(School District Name)
Maricopa County, Arizona, for payment, a claim for services rendered or supplies furnished during the
month of uttiot, , 20 said claim being in the sum of ($ gel )
nisyr, hit) /diced -I-well-11j nei re( 89 Dollars in payment of which
the Superintendent of Schools caused his/her Warrant Number 16 ,POfte' 4f3 to be issued
on J-4-1-Ae_, , 20 )5, drawn on the 6O1 Fund of '-titr) &O of
(School District Name)
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 15,002gg4 in the sum of $
Signed: ‘.-
(Name and Tia of Authorized Personnel)
Subscribed and sworn to before me this c:2- day of J VAL , 20
NOTARY PUBLIC: Ated 4L1
My commission expires: /6/
Not puo_ 7wAofif Ro
yAvui cotnnrcr1 6,,v, rt.
Nry
Following approval please return this affidavit to the lvlaricopa County Education Service Agency Office"'"••••.......Z ...%—"PM Atm.'. ea •
20181

AFFIDAVIT
STATE OF ARIZONA LIOAHD OF SU l'El iVibUSIG
MARICOPA COUNTY
COUNTY OF MARICOPA
arYlardlia fl\li(-4611161SICLAeing first duly sworn, upon oath deposes and says:
(Name and Title of Person)
That on I,..ILA41-e-' , 20 if=") , he/she presented to .1-tjeti (1st) (e of
School District Name)
Maricopa County, Arizona, for payment, a claim for services rendered or supplies furnished during the
month of \halt, , 201 C7, said claim being in the sum of ($ )
II: )(I hk tr&f-ft'iieinfj o6 avi Dollars in payment of which
the Superintendent of Schools caused his/her Warrant Number 16CCZ'S 477 to be issued
on di,U(Iti , 20 15, drawn on theO01 Fund of (S 13 of
(S chooListrlct Name)
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 1500g i-rn in the sum of $ CO-
Signed:
\lame and Title of Authorized Personnel)
Subscribed and sworn to before me this _c_21) day of 3-butt , 20 /
4:1"711frii
NOTARY PUBLIC:
My commission expires: 3/07=20, 9
Following approval please return this affidavit to the Maricopa County Education Service Agency Office.
40104 OFFICIAL SEAL
TAMMY NAVARRO
Notary Public - State ofArkoria
MARICOPA COUNTY I
My Comm. Evires March 8, 2019j

AFFIDAVIT
STATE OF ARIZONA
COUNTY OF MARICOPA
kladit-t. being first duly sworn, upon oath deposes and says:
That on the az-s.) day of , 20./. .'he presented to
Queen Creek Unified School District 1195 . of MaricOpa County, r payme t, a claim for
services rendered or supplies plies furnished during t e month of .... .. ..3‘). ..., said claim
being in the sum of ...2 .644A- d,,dt. 4--,„--,„------ dollars
($ 11/6-;-• 30 ) in payment of which u n tieek Unified School District #95
caused Warrant No. 115109 V./ Y b to be issued on 714(.44-t 20./
drawn on the 040 fund of Queen Creek ified School District 1/95 of
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
Queen Creek Unified School District #95 issue to him a duplicate of said Warrant No.
I./009 AdY0 in the sum of $ '1167D, .3 0
IL,, eidt
Signature Notary LORI Mk ANN - St* KATI'S of Arizona
MARICOPA COUNTY
My Commission Expires
—2 1/40-7 May 2, 2019
Sublcrib d sworg befus me, this I I day of , 201.2
My Commission Expires
Following approval please return this affidavit to the Maricopa County Schools Office.

A P P e 117 D
AFFIDAVIT
DA1 1_A JUL)) 9 2015
STATE OF ARIZONA
COUNTY OF MARICOPA
/1-n -eicl_ 3- 6 de Cdir)8 , being first duly sworn, upon oath deposes and says:
That on the a5 day of J-00- 20 /5-, he presented to Doi (1‘ cl 5Chcci
District of Maricopa County, Arizona, for payment, a claim for services rendered
or supplies furnished during the
month of T(..)&-)C- 20 15-, said claim being in the sum of
-cc f e en +in ouLcinG1 Dollars, ($ 15, boo cm in payment of which the
Superintendent of Schools caused his/her Warrant Number (--1 (Do c) 6 3 0 to be
issued on SuNe, , 20 I5 drawn on the Ai7o Fund of Pi Oni-F1Pci 5Chwl
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
LI -6-6 0 962 3 17 Ki in the sum of $ 1-51 006'
Signed:
Subscribed and sworn to before me this c2 day of ,T1A.rUb ,20 A
NOTARY PUBLIC
My commission expires:
Following approval please return this affidavit to the Maricopa Cotinty ---sTIFeiiriciperrarer..--.
i ./-----4.- TAMMYNAVARRO i 1
Notary Public - State of Arizona 1
? MARICOPA COUNTY I
'Com. Expires Math 8 201al

Maricopa County
Human Resources
Memo
To: Fran McCarroll, Clerk of the Board
From: Lisa Platek
Date: July 13,2015
Re: Replacement of Lost Payroll Warrants
Please find attached 1 Affidavit/Notice of Claim(s) for lost
payroll warrants for inclusion on the next available Board agenda.
The attached item(s) have been researched to ensure that the
warrant(s) in question have not been cashed or previously re-
issued. The original warrant(s) have had a stop payment done.
Please call Lisa at x 6-3619 for any questions. Please
route approved Affidavits back to County Payroll, Suite 220.
Stale Dated Warrant (Over 1 Year) Duplicate Warrant
Thank you.
RECEIVED
JUL 13 20th
CLERK MARICOPA BOARD OF COUNTY SUPERVISORS
RA40,40-1),

RE CEIVED
Application for a Duplictual5 teo riStale-D: o p 2 satsed Warrant/Check
JUL
Affidavit/Claim Form ni,r6;Atircrolp.21.cgtlf,
This application is for: gt buPlicad or- t2AI , Stale-Dated (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.
Robert C Espinoza (1), being first sworn, upon oath deposes and says:
Name/Claimant
On or about 07/01/2015 (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 $ 1,108.70 .(3)
Signed: 7- (4)
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 0022290065
(if known) (6)
Original Date of Issue 07/01/2015
(if known) (7)
Reason for original issue of Warrant/Check (8):
WI Payroll
El For Services or Goods furnished
E Treasurer's refund/payment
LI Other:
Revised April 2015 A kR.S. 11-632 & 11-644

INTEROFFICE MEMORANDUM
Ilaricopa County Education service Agency (ako
Waricopa County Superintendent of Schooh Office)
TO: CLERK OF lWE 00.3R9)
FROM; Willie Thompson
SUBJECT: avits Miacement of Lost Warrants
DATE: 7/14/2015
Tfease find attached 3 Afficiavit/Wotice of Claim(s)for Cost warrants for inclusion on
the next available Ooard agenda
The attached item(s) have been researched to ensure that the warrant(s) in
question have not been cashed or previously re-issued
The original- warrant(s) have had a stop payment done.
if you have any questions, please contact Mete Thompson at 506_3898 or via e-mail at
mil-Cie.thompson@mcesa.maricopa.gov. Approved Affidavits may be routed back to the
Superintendent of School- 'Finance Division at 4041 W. Central Avenue #1200, (12°'
Floor) Thankyou.
#59 LAVEEN JASON WOODS $58.52
#21 MOUNT - ARTZOXA DIA14051r0 OACXS 1 $8800.00
#781 GAR7V157 -11/LENT TifOgtIAS EVOELT $838.38
RECEIVED
JUL 1 , 5 2015
MAFilCOPA COUNTY
CLERK BOARD OF SUPERVISORS
444a) epe

Affidavit APPROVED
State of Arizona I :A IPA JUL 112015
(County of Ma ricopa) K, BOARD OF SUPERVISO46
MAR ICOPA COUNTY
Jason Woods being first duly sworn, upon oath deposes and says: That on the 30th day of June,
2015 he/she presented to the Laveen Elementary School District #59 of Maricopa County, for
payment, a claim for services rendered or services to be furnished during the month of June, said
claim being in the sum of $ Fifty-eight and 52/100 dollars
($ 58.52) in payment of which Superintendent of Schools caused his/her
Warrant No. 460000352 to be issued on June 30, 2015, drawn on the 40130 fund of Laveen
Elementary School District #59 of Maricopa County, Arizona.
Affidavit 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, affidavit prays that the Board of Supervisors order and the Superintendent of
Schools issue him/her a duplicate of said Warrant No. 460000352 in the sum of $ 58.52.
\ I
Printed name: Title with the comp
Subscribed and sworn before me this Co tk day of t \ A,„( Vz)t 6
(notary public signature and stamp)
JESSICA MINJAREZ my commission expires \,.oAo...0.1 tL 2.1311.,
NOTARY RAMO -ARiZCIP4A
MARMOPA COUNTY
My OurarnIsslan E:apires
January 24, 201a
Following approval please return this affidavit to Maricopa County Schools.

Affidavit
CLERK, BOARD OF SUPERVISORS
MARICOPA COUNTY
STATE OF ARIZONA
COUNTY OF MARICOPA )
eing first duly sworn, upon oath deposes and says:
, 20 4/he presented to the
fia-Y7-7L of Maricopa C?_1 1 . nty, for payment, a claim for services
rendered or supWies furnished during the month of 77L-44-- , said claim being
c_76/
in the sum of /00Dollars ($ (59) (5'00.0Q
e Superintendent of Schools caused his/her Warrant No. O/c á521
, 20 drawn on the /42 Fund of
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, afflant prays that the Board of Supervisors order and the Superintendent of
Schools issue to him a duplicate of said warrant number - C-)c) .51)5;,2- in the sum of
espeo.od PrAgmtEw •%1/464 7 to
$
M - tu* a g- evotr4-1 oil AL r revri v e"
Subscribed and sworn before me this day of ,
CANDACE A. KEREGE
Notary Public - State at Arizona • otary
MAR ICOPA COUNTY
(lltitasyuSeal) Expires
Mardi 24, 2017 a JC7
My Commission Expires
Following approval please return this affidavit to the Maricopa County School Superintendent's Office.
HAWorklAffidavit.doc 07/14/05

STATE OF ARIZONA
COUNTY OF MARICOPA
BOARD OF SUPERVISORS
MARICOPA COUNTY
THOMAS ERDELY being duly sworn, upon oath deposes and says;
That on the 9TH day of JULY 2015 netsne , „ presented to the
Treasurers of Maricopa County, for payment, a claim for services rendered or
supplies furnished during the month of JULY , said claim being in the sum of
EIGHT HUNDRED THIRTY EIGHT DOLLARS AND 38/100 dollars ($ 838. 38 ) in . payment of which the
16000032
Superintendent of Schools caused his/her Warrant Number to be issued on
2ND OF JULY 2015 , drawn on the 781 Fund of Treasurers of
Maricopa County, Arizona.
Claimant further says that although he/she was informed and believed that the above-
mentioned warrant was regularly issued, the same has never been received or has been lost.
Under penalty of perjury, claimant hereby affirms that this claim is correct and the amount
shown is due and owing.
Wherefore, claimant requests that the Board of Supervisors order and the Superintendent
16000032
of Schools issue him/her a duplicate of said Warrant Number in the sum of
838.38
Claimant Signature
Subscribed and sworn before me this q day of 02015" .
fi'v 11w:a /. iKf)
Notary Public
DANUSIA T. COLE My commission expires go, 02, ono"
Notary Public - Arizona
Maricopa County
My Comm. Expires Nov 2, 2015
••••-I—Iw^w—w—wP-Iw'11PTIIo
Following approval please return this affidavit to Maricopa County Education Service Agency.