050615 DUPLICATE WARRANTS - 4.PDF

INTEROFFICE MEMORANDUM
Ilaricopa County Education Serrike Agency (aka
31aricopa County Superintendent of Schoo(s Office)
TO: CLERK OE TOE (B0)RD
FROM: Willie Thompson
SUBJECT: Affidavits - Wopfaceinent of Lost Warrants
DATE: 4/20015
Pase find attached 6 Affidavit/Xotice of Cfaim(s)for Cost warrants for inclusion on
the ne.xt avaiCab Woard agenda
AI The attached item(s) have been researched to ensure that the warrant(s) in
question have not been cashed or previously re-issued.
Al The original-warrant(s) have had a stop payment done.
If you have any questions, please contact Millie Thompson at 506.3898 or via - at
mil-Cie.thompsongmcesa.maricopa.gov. Approved Affidavits may he routed backto the
Superintendent of School Finance (Division at 4041 ,1 I1: CentralAvenue #1200, (12t 6
Efoor) Thankyou.
#1 PHOENIX ELE14 RESOVWES EOREDVCA(110R5 $272.45
#59 LAVEEW AVTO SATD1TY -faUSE $224.44
#79 LITC.7-CE1ELD 3I-11W YaNRT $30.00
#216 AGVA TRIA JORDAN' .71 filiCKSOW $32.20
#216 ARIZONA scyfooL ALLIANCE FoRWORK,ERS COMP (2)
$11,144.64 et $9,532.60
RECEIVED
APR 2 2 2015
MAR1COPA COUNTY
CLERK BOARD OF SUPERVISORS

AFFIDAVIT PAIL
STATE OF ARIZONA
COUNTY OF MARICOPA
Resources for Educators being first duly sworn, upon oath deposes and says:
That on the 23rd, 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 December 2014, said claim
being in the sum of $272.45 in payment of which Superintendent of Schools
caused his/her Warrant No. 45-0053261 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 saiq,Woorraut No. 45-
.,...z. ..A., ,_.9.:0',..- citvilit i,irs_74 .;..,:':
0053261 in the surn of- $272.45.
....................... z.. :-- - - - • • .;. ' . • • REGISTRATION *o • ... . . . ........ NO .• -.71-
= ; 1601241 : =
MY COMM. EXPIRES: E
Signature z LA ---- -:-.:...,::, 'ii/ •., .0,.6. /3v:/:0. 1. 8
1- '.. 0,c. , ty‘l. , . • ' :::=
iiiiiil'i ; II ; Iwo\
Subscribed and sworn before me this 315+ day of .1114.A Rai , 20.15.
Notary Public
My Commission Expires GI 3 t1A 0i 1
Following approval please return this affidavit to COUNTY SCHOOLS OFFICE

Affidavit
State of Arizona
(County of Maricopa)
K Br:YARD-Dr SOPEFIVT6OFCS
MARICOPA C06NTY
Auto Safety House being first duly sworn, upon oath deposes and says: That on the 28th day of
February, 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 February,
said claim being in the sum of $ Two hundred twenty-four and 44/100 dollars
($ 224.44) in payment of which Superintendent of Schools caused his/her
Warrant No. 450066870 to be issued on March 3, 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. 450066870 in the sum of $ 224.44.
Vendor Signature
Printed Title with the company:
Subscribed and sworn before me this / day of _t__42L, Zo I 5-
\AA02,1:-.... L.41.citary public signature and stamp)
MARIA I. CASTILLO my commission expires p.n., _ 7O/
NOTARY PUBLIC. Stale of Arizona
MARICOPA COUNTY
My Comm. Expires June 8,2018
Following approval please return this affidavit to Maricopa County Schools.

DATEA AP 2 4 2015
AFFIDAVIT
RK, N1AAICOPA BOARD OF COUNTY SUPERVIS0146
STATE OF ARIZONA }
ss.
COUNTY OF MARICOPA
Henry, Shima, being first duly sworn, upon oath deposes and says:
That on the 19th of February, 2015 she presented to the Litchfield
Elementary School District # 79 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 THIRTY and 00/100 Dollars
($30.00) in payment of which the Superintendent of Schools caused
Warrant No. 4-5-0068030 to be issued on March 5, 2015, drawn on the
Refund for Unused Lunch Money Fund of Litchfield Elementary School
District # 79 of Maricopa County, Arizona.
Affidavit further states that although you were informed and believes that
the above mentioned warrant was regularly issued, the same has never
been received or has been lost, stolen or destroyed and has never been
deposited.
WHEREFORE, affiant prays that the Board of Supervisors order and the
Superintendent of Schools issue to Henry, Shima a duplicate of said
Warrant No. 4/0068030 in the sum of $30.00.
/4-
Pay)26 Signature
Subscribed and sworn to before me this day of
iPur ry Public
My commission expires: -
Following approval, please return this affidavit to Maricopa County
Superintendent's office.

A
PPROVED
AFFIDAVIT
STATE OF ARIZONA
COUNTY OF MARICOPA
Jordan H. Jackson, being first duly sworn, upon oath deposes and says:
(Name and Title of Person)
That on March 27, 2015, he/she presented to Agua Fria Union High School District 216 of Maricopa
(School District Name)
County, Arizona, for payment, a claim for services rendered or supplies furnished during the month of
March, 20 15 • said claim being in the sum of ($32.20) Thirty Two Dollars and Twenty/000 Dollars
in payment of which the Superintendent of Schools caused his/her Warrant Number 150063439 to be
issued on March 12, 2015, drawn on the 510 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 150063439 in the sum of $32.20.
Signed: 3.----c,ctrs 0,
(Name and Title of Authorized Personnel)
Subscribed and sworn to before me this 7.1;(- day of , 20
DIANE COLBARY
NOTARY PUBL1C:0--- --0 NOTARY PUBLIC ARIZONA
Marlcopa County
My commission expires: My Commission Expires
July 4, 2018
Following approval please return this affidavit to the Maricopa County Education Service Agency Office.

APPROVER:4
AFFIDAVIT
K, F3t)Af:10 Or SUPERVISORS
STATE OF ARIZONA
COUNTY OF MARICOPA
* Arizona School Alliance For Workers Comp, being first duly sworn, upon oath
deposes and says:
Marissa Johnson, Accounting Clerk
That on the 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 12/31 2014 , said claim being in the sum of ( $11,144.64 )
Eleven Thousand One Hundred Forty Four and 64/100 _Dollars in payment of
Which the Superintendent of Schools caused his/her Warrant Number 450047728 to be
Issued on the December 31_,2014_ , drawn on the _040_Fund of _WORKMANS COMP AFUHSD#216
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 _450047728_ in the sum of $_11,144.64_.
Signed:** r Es-kJ-1.4614 Are-CMAAA'frIte eivnc
(Name & title of authorized personnel)**
Subscribed and sworn to before me this v(- day of ,20 15
NOTARY PUBLIC :
My commission expires: 28/ 213/8
Following approval please return this affidavit to the Maricopa County Education Service Agency Office.

AFFIDAVIT ERK, IF.V)AFt OF I -
MAFIICOPA GOONTY
STATE OF ARIZONA
COUNTY OF MARICOPA
* Arizona School Alliance For Workers Comp, being first duly sworn, upon oath
deposes and says:
Marissa Johnson Accounting Clerk
That on the 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 _1O/23___2014 , said claim being in the sum of ( $9,532.60 )
Nine thousand five hundred thirty two and 60/100 _Dollars in payment of
Which the Superintendent of Schools caused his/her Warrant Number 450025820 to be
Issued on the OCTOBER 23_,2014__ , drawn on the _040_Fund of _WORKMANS COMP AFUHSD#216
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 _450025820 in the sum of $_9,532.60
MARIJON ANDERSON
Notary Public -Arizona
Citric Maricope County
Signed:** My Commission Expires
October 28.2018
(Name & title of authorized personnel)**
Subscribed and sworn to before me this day of ,20 15
NOTARY PUBLIC :
My commission expires:
Following approval please return this affidavit to the Maricopa County Education Service Agency Office.