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INTEROFFICE MEMORANDUM gllaricopa County Education Service Agency (aka Maricopa County Superintendent of Schoo(s Office) TO: CLERX OF (1,--PE BOAU FROM: Willie 'Thompson SUBJECT: Affidavits — Wepfacement of Lost Warrants DATE: 5/21/2015 Trease find attached 6 Affidavitrnotice of Craim(s)for Cost warrants for incfusion on the net avaira6k Board agenda The attached item(s) have Been researched to ensure that the warrant(s) in question have not Been cashed or previous(); re-issued The originaCwarrant(s) have had a stop payment done. If you have any questions, lAxse contact Male Thompson at 506.3898 or via e-mail at milTie.thompson@mcesa.maricopa.gov. Approved Affidavits ma y Be routed 6ackto the Superintendent of School - Finance Division at 4041 .9I1: Central - Avenue #1200, ( 12th Tibor) Thankyou. #25 LIBERTY JESSE )1 SPARKS $ 725 . 81 #25 LIBERTY C0.914TASS gwovP vsA 1NC $44,114.05 #66 ROOSEVELT ROCIO SIERM L1.29VA $207.67 #66 ROOSEVELT ADRIANWA VI.911IREZ $363.16 #216 AGO TRIA WIORE q.7(AX WORDS SEECI-1 $1920.00 #216 AGO ERIA SIERRA NOLAX $402,56 RE BVED MAY 9, 2 ?0 5 MARICOPA COUNTY CLERK BOARD OF SUPERVISORS 1M-tr eif4k_ ma; (t. AFFIDAVIT .K :30ARD OF SUPERVISORS MA:Iic:nr'ACCIUN'Tv STATE OF ARIZONA COUNTY OF MARICOPA n-esse Sparks. , being first duly sworn, upon oath deposes and says: (Name and Titl of Person) That on 1Yl o H , 20 (5" , he/she presented to k--; berA-i .1.errkervl-cti-y Seiud I Dist-- of School District Name) ' Maricopa County, Arizona, for payment, a claim for services rendered or supplies furnished during the month of ri1 , 20 IS , said claim being in the sum of ($ 7s, I ) Seven iitkno1/2c141)Jervt-vi CNC 4 g Vi 00 Dollars in payment of which the Superintendent of Schools caused his/her Warrant Number ,2.5- 5-9A-.2.-9 I / 4o t -4d be issued "Vg /i7 on April 30 , 2015_, drawn on the Oo I Fund of 1,....Z6tr 304 kt&rt 0-3,-- Scitbo --- II of (Skhool District Name b.-On-cf.-44-as 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 Q55-92,29 I in the sum of $ 75: 2 . DEW LAKIN Notary Public - State of Arizona MAR1COPA COUNTY Signed: My Comm. Expires Nov. 301 2017 (Name and Title of uthorized Personnel) Subscn and sworn to before me this day of N\CLA , 20 NOTARY PUBLIC: 3 tjiv-- My commission expires: Following approval please return this affidavit to the Ma ricopa County Education Service Agency Office. Affidavit K, BOARD OF SUPERVISORS MARICOPA COUNTY STATE OF ARIZONA COUNTY OF MARICOPA ) mip 6e_evlo C4S/6( zw-e-, e----7 ' 44.0\,) -----C49 c k(14-k( being first duly sworn, upon oath deposes and says: That on the / / day of 1414\ y , 20/5- he presented to the 9icki tee25-- of Maricopa County, for payment, a claim for services rendered or supplies furnished during the month of Fbie /90/5- , said claim being in the sum of I .11ir-1iniiiaLgtAdat ALKI/MI iQ1rir ad 65;to - Dollars ($ Lif INec in payment of which the Superintendent of Schools caused his/her Warrant No. licA607/07,40(4.725-517e7i) to be issued on Wird\ 17 , 20 Lc ,, drawn on the 10 Fund of trfly bisio-m-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 Superintendent of Schools issue to him a duplicate of said warrant number 1./.6- Oolaa in the sum of $ qq1 lig. oC Subscribed and sworn before me this day of , 20 See Attachment (Notary Seal) For Notary Seal' Following approval please return this affidavit to the Maricopa County School Superintendent's Office. HAWarklAffidavit,doc 07/14/05 CALIFORNIA JURAT WITH AFFIANT STATEMENT GOVERNMENT CODE § 8202 „y-See Attached Document (Notary to cross out lines 1-6 below) Li See Statement Below (Lines 1-6 to be completed only by document signer[s], not Notary) Signature of Document Signer No. 1 Signature of Document Signer No. 2 Of any) 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 Subscribed and sworn to (or affirmed) before me County of YWg/4 on this I/4 day of , 20 by Date AA 'nth Year (1) Kt% 2a/27 , 7‘".97 (and (2) JOHNATHAN CHAO 4111.. Commission # 1947077 _ Name(s) of Signer(s) V:4441 Notary Public - California Shasta County proved to me onlitip basis of satisfactory evidence My Comm. Expires Aug 6, 2015 to be the pershnifst who appeared before me. Sig ignature of Notary Public Seal Place Notary Seal Above OPTIONA Though this section is optional, completing this informatLon an deter alteration of the document or fraudulent reattachment of this form to - unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Sig ner(s) Other__Tharriciamed Above: 7.::C<;•WWWW.:X;•C(.14::(12AX: 02014 National Notary_As naation • www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5910 APPlitUVE MAN 2 2015 AFFIDAVIT MAR1COPA COUNTY STATE OF ARIZONA COUNTY OF MARICOPA *Rocio Sierra De Luna, Kitchen Assistant, being first duly sworn, upon oath deposes and says: (name and title of person )* That on the 15 th day of April 2015 , he/she presented to Roosevelt School District #66 District of Maricopa County, Arizona, for payment, a claim for services rendered or supplies furnished during the month of April 2015, said claim being in the sum of ($207.67) Two Hundred-Seven 67/100 Dollars in payment of Which the Superintendent of Schools caused his/her Warrant Number 150069408 to be Issued on the April 2, 2015, drawn on the Treasurers Fund of The Roosevelt School 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 150069408 in the sum of $207.67. Signed:**4- (Name & title of authorized personnel)** Subscribed and sworn to before me this 4 day of , 20 )5 NOTARY PUBLIC : EETS Notary Public State of Arizona L Marloopa County My commission expires: My Raquel Commission Robles Expires 0710312017 Following approval please return this affidavit to the Maricopa County Education Service Agency Office. AFFIDAVIT STATE OF ARIZONA COUNTY OF MARICOPA *Adrianna Ramirez, Kitchen Assistant, being first duly sworn, upon oath deposes and says: (name and title of person )* That on the 15th day of May 2015 , he/she presented to Treasurers District of Maricopa County, Arizona , for payment, a claim for services rendered or supplies furnished during the month of May 2015, said claim being in the sum of ($363.16) Three Hundred sixty three 16/100 Dollars in payment of lq)b75q(Ci Which the Superintendent of Schools caused his/her Warrant Number 400026445 to be Issued on the May 1, 2015, drawn on the Treasurers Fund of Roosevelt School 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 400026445 in the sum of $363.16. S 'Drfit06) (06zr5fAj_ Signed:** (Name & title of authorized personnel)'— Subscribed and sworn to before me this day of MAIL/ ,20 15 r" NOTARY PUBLIC : My commission expires: Following approval please return this affidavit to the Ma ricopa County Education Service Agency Office. Notary Pubic State of Arizona Maricopa County Raquel Robres My Commismion Expires 07/0312017 AFFIDAVIT APPROVED-7 STATE OF ARIZONA v1.11'1 CC;7', CC N COUNTY OF MARICOPA More Than Words Speech Thera, being first duly sworn, upon oath deposes and says: That on the . 28 day of Apr 2015 , he presented to Aqua Fria Union High School District of Maricopa County, Arizona, for payment, a claim for services rendered or supplies furnished during the month of April 2015 , said claim being in the sum of One Thousand Nine hundrd Dollars, ($1,920.00 ) in payment of which the Superintendent of Schools caused his/her Warrant Number 450084694 to be issued on 28 _April , 2015 , drawn on the 001 Fund of Aqua Fria Union High School 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 450084694 in the sum of $1,920.00 Signed: A(\rt S Sg-e,edi ) -e.vvos P.C. 111Q,(6/1 Subscribed and sworn to before me this 7 day of 20/5 OTARY PUBLIC My commission expires: /4/27// Fsikiviine approvillffilbtisbleturn thi affidavit to the Maricopa County School Superintendents Office. NANCY DERRY ! Notary Pubfic State of Araone MARICOPA COUNTY i My Comm Expires Oct 31, 2017 : APPROY 14) AFFIDAVIT STATE OF ARIZONA COUNTY OF MARICOPA 5kricrk hi olarL, , being first duly sworn, upon oath deposes and says: (Name and Title of Person) That on b-L5 , 20 )5 , he/she presented to Agua Fria Union High School District 216 of (School District Name) Maricopa County, Arizona, for payment, a claim for services rendered or supplies furnished during the month of Apr et i , 20 [5 , said claim being in the sum of ($ 1--(A 0 4-- 6L'(LCJO Dollars in payment of which the Superintendent of Schools caused his/her Warrant Number 15co707a5 to be issued on Ap-i j , 20 15 , drawn on the 5I0 Fund of Agua Fria Union High School District 216 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 560-7 07(...0 in the sum of $ 02. G(0 Signed: (Name and Title of Aut orlzed Person Subscribed and sworn to before me this day of OFFICIAL SEAL NOTARY PUBLIC: ANDREA L. CRAVVLEY Notary Public - State of Arizona MARICOPA COUNTY My commission expires: My Comm. Expires July 17, 2917 Following approval please return this affidavit to the Ma ricopa County Education Service Agency Office.