Extracted text (via tesseract_tsv)
19431 characters
INTEROFFICE MEMORANDUM
Maricopa County Education Service Agency (aka
Maricopa County Superintendent of Schools Office)
TO: CLERK OF THE BOARD
From =—- Millie Thompson
SUBJECT: Uffidavits — Replacement of Lost Warrants
DATE: 6/4/2015
Please find attached 6 Affidavit/Notice of Claim(s) for lost 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.
V The original warrant(s) have had a stop payment done.
If you have any questions, please contact Millie Thompson at 506.3898 or via e-mail at
millie. thompson@mcesa.maricopa.gov. Approved Affidavits may be routed back to the
Superintendent of School Finance Division at 4041 N. Central Avenue #1200, ( 12
floor) Thank you.
#214 TOLLESON UNION VICTORY FUNDRAISING $6039.60
#216 AGUA FRIA UNITED SPIRIT ASSOCIATION $470.00
#31 BALSZ TECH FUNDS , INC $851.00
#5 ISAAC MARK, P THOMAS $5544.67
#5 ISAAC ESTHER A CAMARILLO DE GONZALEZ $6682.79
#214 TOLLESON UNION LUCYHELEN MATTA $50.00
RECEIVED
JUN 08 2015
MARICOPA COUNTY
CLERK BOARD OF SUPERVISORS
Inder office mail
ce)
APPROVED
JUN 0°R 2015
AFFIDAVIT “BOARD OF SUPERVISORS cc
MARICOPA COUNTY
STATE OF ARIZONA
COUNTY OF MARICOPA
Vi Fuvulrasivy / being first duly sworn, oath deposes and says:
ery , son
_/ of 1: 20\0, he presented to “ee Wormers Aran
That on the day as
Qoay\ Cy Cer ee
District of Maricopa County, Arizona, for payment, a claim for services rendered
or supplies furnished during the
of AGL LY 20‘, said claim being in the sum _ of
month
OK Aersconch Dollars, ($lo DEH -Wpdin payment of which the
ae
Wyner © Od Le
a of Schools caused his/her Warrant Number ISDDWOS\\ to be
Superintentient
AOA\ Why \, drawn on the RAD Fund of SOURED DaldN
issued on GOnod l Garces
TEGH
District of Maricopa County, Arizona.
Affiant further that although he/she was informed and believes that the above
says
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
of Schools issue to him/her a duplicate of said Warrant Number
Superintendent
At we) in the sum of 80, D2, OO
y J eto J. FoSsern
Signed; _ 7
Ae cw wet *L IM ape WOR RL
VY
Subscribed and sworn to before me this 2b day of A 20 IS
NOTARY PUBLI¢
¢
Va mnory 20. 26 |
My commission expires:
Following approval please return this affidavit to he Maricopa County School Superintendents Office.
”
MARY F. ANDERSON-DOWNEY }
“NOTARY PUBLIC - ARIZONA {
Maricopa County
My Commission Expires =f
sewaly 20, 2018 i/
AFFIDAVIT
BOARD OF SUF
MARICOPF
STATE OF ARIZONA —
COUNTY OF MARICOPA
* __ UNITED SPIRIT ASSOCIATION , being first duly sworn, upon oath deposes and says:
(name and title of person )*
That onthe 2ND_day April of 2015 ___, he/she presented to AFUHSD #216
District of Maricopa County, Arizona , for payment , a claim for services rendered or supplies furnished
during the month of __10/21___2014___, said claim being in the sum of ($470.00 )
Four Hundred Seventy and 00/100 _Dollars in payment of
Which the Superintendent of Schools caused his/her Warrant Number ___—« 450027059 ~—_—sitobe
Issued on the October 21_,2014__, drawn on the _040_Fund of _ AFUHSD#216 /Fund 526
___
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 _450027059___in the sum of $_470.00___
(! Leet CL
Signed:** CC
(Name & title of authorized personnel)**
Subscribed and sworn to before me this day of
NOTARY PUBLIC :
es
UN &
AW O
My commission expires: qe
ai St S
Following approval please return this affidavit to the Maricopa County Education Service Agency Office.
re
CERTIFICATE OF ACKNOWLEDGMENT/JURAT
CALIFORNIA NOTARY
ADDENDUM (FOR USE IN CA ONLY)
For use for CA Notary Acknowledgment only:
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 California
County of
insert name and title of officer),
(here
On before me who proved to me on the basis of
personally appeared isfare subscribed to the attached
satisfactory evidence to be the person(s) whose name(s) to me that
of cument) instrument and acknowledged
{name and that by his/her/their
executed the same in his/pefitheir authorized capacity(ies), acted
he/she/they behalf of which the person (s)
the instrument the perSon(s) or the entity upon
signature(s) on
executed the instrument.
the laws of the State of California that the foregoing
| certify under PENALTY PERJURY under
paragraph is true and ¢ ect.
WITNESS my hard and official seal
Signature)
+ hEGdavi+-
tached
For use for CA Notary Jurat only:
Com United Spiyik Associaton
A notary public or other officer completing
this certificate verifies only the identity of (hy)
the individual who signed the document to
which this certificate is attached, and not
the truthfulness, accuracy, or validity of
that document.
State of California
County of Yanae 22. of 2019, by
and swofn to (or affirmed) before me on this day Mow ;
Subscribed the basis of satisfactory evidence to be the personts).
Cea Camav\\o proved to me on
,
who appeared before me.
Seal
cal) AIDEE R.
|
bfbis g. h) a] NOTARY PUBLIC + CALIFORNIA 5
Signature { §
ORANGE COUNTY
My Commission Expires ™
March 7, 2018
05-53-8123NSBW 12-2014
APPROVED
AFFIDAVIT
STATE OF ARIZONA
COUNTY OF MARICOPA
Tec Lu MOS, /MC.., being first duly sworn, upon oath deposes and says:
(Name and Title of Person) —
That on Magccu %3 ,20_/5_, he/she presented to Baesz Seroon Dust: #31 of
(School District Name)
Maricopa County, Arizona, for payment, a claim for services rendered or supplies furnished during the
month of Nawcu 20_/5_, said claim being in the sum of ($_ §S/,00_)
,
E GHT Hu ISQRED a -ONE anc oF 00 Dollars in payment of which
Phe
the Superintendent of Schools caused his/her Warrant Number__ 4/3 00 7*/0 AW to be issued
on_ Marci4 26,20 /5_, drawnonthe 37Y Fund of Bawsz Scroopn Di St-#3! 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 4/500 740 Aly inthe sumof$__&’ 3). 00
Rohr Lara? Beaded
{
Signed:
er
(Name and Title of Authorized =
Subscribed and sworn to before me this__<@ day of Ay ,2015 .
NOTARY PUBLIC/ — | os 7 ETH
IS ADAM
HAYES
March: Al PUBLIC - AR
My commission expires: ST, f JO] 7 SORA COUNTY
ission Expires
31,2
Following approval please return this affidavit to the Maricopa County Education Service Agency Office.
— [
Affidavit APPROVED |
as
STATE OF ARIZONA) ‘
; OF
COUNTE, HARTOORA)
Mar Tina:
i): being first duly sworn, upon oath deposes and says:
shat
on the AS day of May 20.15. he
, presented
to the /s 0) #S.. of County, for payment, a claim for services
Maricopa
rendered or supplies furnished during the month of fies ., Said. claim
being the sum orhvethausand five dericten ¢ hits Ve SL Ups race
in
SHH-
(gD UEEnemseaesevscecoresses 07) in payment of which the Superintendent of Schools caused his
. Warrant no. QLSG/3 to be issued on LVI ZA. 20 12, drawn
sey on the
30 Fund of [SD AS... Maricopa ded wena,
.0f County,
-- Affiant further says that although he was informed and believes that
4
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 RenonLe issue to him a duplicate of said warrant number
CONSUELO S. HERNANDEZ
NOTARY PUBLIC - ARIZONA
MARICOPA COUNTY
My Comm. Exp.: February 24, 2016
Subscribed and sworn before me this 20.l2.
Cornoule dj
Sree (notary public)
commission Lidesoasese IY, 7016
my expires
Following approval please return this affidavit to Maricopa County Schools.
Affidavi t
‘STATE OF ARIZONA )
COUNTY OF MARICOPA)
Cotter Al: (Camarillo Zs Gonzale2.veing deposes
first duly sworn, upon oath ‘and says:
That on the PA day of duns 20.4.9... he presented
,
to the LSDES.. of County, for payment, a claim for services
‘Maricopa
rendered or supplies furnished during the month of LIE 1 said claim
é We
the of. OLX thausaad Six huadeck eighta fo Dollars
being in sum
(slele&é.:. 72%) in payment of which Superintendent of Schools caused his
ae the
Warrant No ISQODI0207F to be issued on MICE Z( 20..19.,, drawn on the
’
3
Fund of ISDS. of Maricopa County, Arizona.
fh erry
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 issue to him a duplicate of said warrant number
cehoaLs
Prererrereertir rrr eers try
Bs. CONSUELO S. HERNANDEZ
NOTARY PUBLIC - ARIZONA
J MARICOPA COUNTY
se My Comm. Exp.: February 24, 2016
ae J wae 20.1.5.
Subscribed and sworn before me Or day of |
Qonorio eof
p Bee avail, (notary public)
f:
2Y
my commission expires ohne 20
Following approval please return this affidavit to Maricopa County Schools.
APPROVE
AFFIDAVIT
STATE OF ARIZONA
COUNTY OF MARICOPA
| Nc tie len Wana, being jirst duly sworn, pon oath deposes and says:
. ost
That on the 2] day of Nau} _20 2015 , he presented to “ic
CAS
District of Maricopa County, Arizona, for payment, a claim for services
or supplies furnished during the
month of 20\5. said claim being in the sum_ of
Bot
fry Hoo Dollars, (is WOO) in payment of which the
Superintendent of Schools caused his/her Warrant Number USOCRWAA, to be
issued on hor) ( \4 20], drawn on the 32S Fund of ( inven
, gules
District of Maricopa County, Arizona. \Gn
Affiant further says that although °.¢/she was informed and believes that the above
mentioned warrant was requiarly 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 Warrani Number
in the su
ney
(x |
c par Teh 7
ror 7
vA
Subscribed and sworn te before me this ay of .20
SS NOTARY
PYBLIC
. “ee \) ee
lly commission expires: ml
Foliowing approval please return tnis affidavit 10 Ine Maricopa County Senco! Superntenagents Office
OFFICIAL SEAL
JENNADY ORENDAIN
Notary Public - State of Arizona
MARICOPA COUNTY
My Goiarn. Expires April 4, 2017
arcana NRT EOE 1 LS RI RS LI
MARICOPA COUNTY
Department of Finance
301 West Jefferson, Ste 960
Phoenix, Arizona 85003
INTEROFFICE MEMORANDUM
Date: June 9, 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.
e The attached item has been researched to ensure the warrant in question
has not been cashed or previously re-issued.
e 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: HARRIS CORPORATION GCSD
RECENVED
JUN 09° 345
MAR?! 2.0. JUNTY
CLERK BOA: * ©. SUPERVISORS
hand deliveres ad
s
pe cod On
Application for a Duplicate or Stale-Dated Warrant/ Check PARIZONAS PARIZONAS
Wl
Ne i
coy Ws
Affidavit/ Claim Form
This application is for: Duplicate or CI 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
paae 2 of this form.
HARRIS CORPORATION GCSD (1), being first sworn, upon oath deposes and says:
Name/Claimant
On or about 21-Apr-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 owing, and the applicant requests that a replacement
warrant/check be the sum of ¢ 37,233.00 (3)
Signed: (4)
USA DAVIS .
Note. Please attach a copy of the warrant/check if a, available and/or any other
evidence that a warrant/check was originally issued.
(5) Subscribed and sworn to before me this __~ $ day of Lyene— 20/5.
NOTARY PUBLIC
Debra L Cool
NOTARY PUBLIC
My commission expires: Sy STATE OF FLORIDA
ow, LE DL LOL va : © Commit FF021697 (seal)
Expires 5/27/2041
Warrant/Check Number
350026616
(if known) (6)
Original Date of Issue
21 -Ap r-2015
(if known) (7)
Reason for original issue of Warrant/Check (8):
1 Payroll
furnished_during the month of April, 2015
For Services or Goods
11 Treasurer’s refund/payment
>PROVED |
CO Other: |
| no 05,
MA AAF CO }UNT
_
HARRIS CORPORATION
HARRIS
Government
Communications Systems
P.O. Box 9800
Melbourne, FL USA 32902-9800
harris.com
06/05/2015
Maricopa County Department of Finance
Attn: Beth Brown
301 W. Jefferson, Ste 960
Phoenix, AZ 85003
Attention: Beth Brown
Subject: Application for Duplicate or Stale-Dated Warrant/Check Claim Form
Dear Ms. Brown:
Please find the enclosed signed Application for a Duplicate or Stale-Warrant/Check Claim Form. Ms. Lisa
Davis, the signer of this form, works in the Finance Department within Harris GCS and is authorized to
sign this document. She is the individual responsible for invoicing against Maricopa County Sheriff's
Office Purchase Order No. PG 15500041575. The invoice number that this check was intended to pay
against is INV6779-04575.
Sincerely,
WPG
Harris Corporation,
321-309-7178
assuredcommunications”
Ba
Eas
* 7 x
cease eo
l
~
ba 1G ify rer Ped AER ett
Maricopa County
Human Resources
Viemo
To: Fran McCarroll, Clerk of the Board
From: Linda Greinke
Date: June 10,2015
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 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
JUN 1.0 2015
CLERK __ MARICOPA COUNT
BOARD OF SUPERVISORS
hand-delivere (\
ofa,
Application for a Duplicate or Stale-Dated Warrant/Check
Affidavit/Claim Form
This application is for: [ml Duplicate or LI 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.
Abigail Wilimovsky (1), being first sworn, upon oath deposes and says:
Name/Claimant
On or about June 03, 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 ¢ 935.50 (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 S we day of Wene 20/5.
Gi acho
NOTARY PUBLIC OFFICIAL SEAL
=
Ma KAREN M. DICKEY
I NOTARY PUBLIC - State of Arizona
My comission expires: y MARICOPA COUNTY
Gebe fy,» 20/5 My Gorm. Expires July 1, 2019 tal)
v
Warrant/Check Number
0022282467
(if known) (6)
Original Mane Date of I
tknown) 7) _ [06/03/2015
Reason for original issue of Warrant/Check (8):
im Payroll
1 For Services or Goods furnished
SGSOTSNT 7 YAW
O Treasurer's refund/payment ALNNOD WdOdIyY
O Other: Hh ¢} g- NOP
cine
ee ——
A 2 PE a &O v EI iB | QSAISO
Revised April 2015 Fs. 11-632 & 11-644
JUNYL 1 2015
pate,
a
MARICOPA COUNTY
Maricopa County
Human Resources |
Vemo
To: Fran McCarroll, Clerk of the Board
From: Linda Widner
Date: June 17,2015
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 W. at ext. 68051 for any questions. Please
route approved Affidavits back to County Payroll, Suite 220.
Stale Dated Warrant C1 Duplicate Warran
Thank you.
RECEIVED
JUN LT 2015
MARICGPA COUNTY
CLERK BOARD OF SUPERVISORS
hand deli vered
ala
Application for a Duplicate or Stale-Dated Warrant/ Check
Affidavit/Claim Form
This application is for: bY Duplicate or _] Stale-Dated (definitions are on page 2)
STATE OF ARIZONA Note: Numbers on this form correspoiid to numbers on the
COUNTY OF MARICOPA Instruction sheet which is page 2 of this form.
=1eperen (1), being first sworn, upon oath deposes and says:
ame/Claiman
On or about (2(o/ 23/ DOIS _ (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.
windy
WNNH na
Therefore, under penalty of perjury, claimant hereby affirms that this claim 4 coxggct
and the amount shown is due and owing, and the applicant requests that a repkacenaént
x —_
mJ
warrant/check be issued to the sum of $_/, SS) TP 2 i
4
‘C. oe
Signed: igned- oO 6 =
a ae Bs
Note. Please attach a copy V4, the warrant/check if available and/or Hy der
evidence that a warrant/check was originally issued.
y
(5) Subscribed and sworn this __t “I day of SV MC 20_} >.
waa
NOTARY PUBLIC
MARIA QUEZADA
NOTARY PUBLIC - ARIZONA
Hai ene i; BS “3 Maricopa County
My Cons n expires: EA My Commission Expires
| FO Sain January 5, 2018 (seal)
Warrant/Check Number
(if known) (6) 003-322-524 20
Original Date of Issue
(if known) (7) (M0163 / DAOIS~
Reason for original issue of Warrant/Check (8):
sina ADDIE aie cD 7
(| Payroll
, , ove, JUN 17 108
L] For Services or Goods furnished oa
CL] Treasurer’s refund/payment —f— Telink [tr
——
O Other:
C:\Users\williamse\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\HTTDL74G\Warrants Checks notice
of claim.doc
Revised April 2015 A.R.S. 11-632 & 11-644