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AFFIDAVIT STATE OF ARIZONA COUNTY OF MARICOPA CDW-G LLC, being first sworn, upon oath deposes and says: That on the 14th day of August, 2013, they presented to Maricopa County, for payment, a claim for services rendered or supplies furnished during the month of July 2013, said claim being in the sum of One Thousand Five Hundred Thirty Six and 78/100 dollars, ($1,536.78) in payment of which the Maricopa County Board Supervisors caused the Warrant Number 340003835 to be issued on 08/14/13, drawn on the County's Expense Fund. 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 requests that the Board of Supervisors issue to him/her a duplicate of said Warraiff Number 3400038 .35 in--the sum of $1,536.78. -5.14 Signed: N---0-y-6-1-t pc, `la) L--- - Subsj r ribed nd sworn to before me this ic day of A ej 2_0/ , Y OTARY PUBLIC V mwmpqrmignemerib My commission expires: 5 / biNS FFICIAL SEAL JOHN M MAXWELL Notary Public - State of Illinois Limir My Commission Expires May 25. 2015 lIcs1data\Finance$1AP PAY\FORMS107 Affidavit Form Blank,doc Revised March 2007 ms 2/12/2014 3:23:56 PM !APPROVED DAT If RECEIVED RK, MARICOPA BOARD OF COUNTY SUPERVISORS AFFIDAVIT APR 2 1 2014 RISK MANAGEMENT STATE OF ARIZONA, COUNTY OF MARICOPA Rolando Vega , being first sworn, upon oath deposes and says: That on the 26th day of March, 2014 , Maricopa County agreed to an Indemnity payment, in the sum of One Thousand Two Hundred Sixty Seven Dollars and Eighty-Four Cents, ($ 1,267.84) in payment of which the Board of Supervisors caused the Warrant No.AD 00340023338 to be issued on March 26, 2014, drawn on the Expense Fund. Affiant further say 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, affiants pray that the Board of Supervisors issue to them a duplicate of said Warrant No.AD 00340023338 in the sum of $1,267.84 , Signed: kfk Subscribed and sworn to before the th'i's' •\.cf' day of NOTARY PUBLIC NrolIrywP-abito State of AfiZ011a My commission commission expires: Jane Maricopa E Davies County My Commission Expires 0713112015 Return original signed, notarized form to: Maricopa County-Risk Management Dept. 222 N. Central Avenue, St., #1110 Phoenix, AZ 85004 AFFIDAVIT A. k DATE BOAFID OF 8UPEMIZORS MAI i ROPA COUNTY STATE OF ARIZONA COUNTY OF MARICOPA INSIGHT PUBLIC SECTOR, INC., being first sworn, upon oath deposes and says: That on the 14TH day of February, 2014, they presented to Maricopa County, for payment, a claim for services rendered or supplies furnished during the month of January 2014, said claim being in the sum of Fifty one thousand seven hundred forty six and 33/100 dollars, ($51,746.33) in payment of which the Maricopa County Board Supervisors caused the Warrant Number 340019546 to be issued on 02/14/14, drawn on the County's Expense Fund. 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 requests that the Board of Supervisors issue to him/her a duplicate of said Warrant Number 340019546 in the sum of $51,746.33. Signed: / Su4cribed and sworn to before me this /Fill day of NOTARY PUBLIC My commission expires: 67,2.5-tav 7 sHERRI ‘, :PEST , • &Arizona • 00UNTY Expire& June 25, 2017 llcsidataVinance$ \AP PAY \FORMS \07 Affidavit Fe.rra Blank.cloc Revised March 2007 ms 4/9/2014 10:06:59 AM APPAOYED IDATEA 9116 9sa yo, ill_ AFFIDAVIT _PXBOARD MAFIICOPA OF SUPERVISCHS COUNTY STATE OF ARIZONA, COUNTY OF MAR1COPA Ruben Garcia, being first sworn, upon oath deposes and says: That on the 26th day of March, 2014, Maricopa County agreed to an Indemnity payment, in the sum of One Thousand Two Hundred Ninety Five Dollars and Eighty-Four Cents, ($ 1,295.84) in payment of which the Board of Supervisors caused the Warrant No.AD 00340023339 to be issued on March 26, 2014, drawn on the Expense Fund. Affiant further say 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, affiants pray that the Board of Supervisors issue to them a duplicate of said Warrant No.AD 00340023339 in the sum of $1,295.84 Signed: Subscribed and sworn to before me this day of (767, , TiSiRY PUBLIC My commission expires: 8fift/5/ (,)W 1 ) Return original signed, notarized_fokii ;to: EVANGEL**, L. URIAS iMaricopa County-Risk Management Dept. NOTARY NIARICOPA PUBLIC COUNTY - ARIZONA 222 N. Central Avenue, St., #1110 My Comm. Exp.:,Augus1 15, 2016 Phoenix, AZ 85004 AFFIDAVIT/NOTICE OF CLAIM K, BbARD DE SUPERVISORS MAR ICOPA COUNTY STATE OF ARIZONA 14 APR 22 PPI 21 le COUNTY OF MARICOPA OPtifillAN RESOURCE& Adam R Rankin BEING FIRST DULY SWORN OATH, DEPOSES AND SAYS: That on the 7th day of April , 2014_, he/she presented to Maricopa County, for payment a claim for services rendered or supplies furnished during the month of February , said claim being in the sum of Two hundred and ninety two dollars Dollars ($292.00) ) in payment of which the Board of Supervisors caused the Warrant No. 240000582 to be issued on February 26 ,2014 , drawn on the Payroll Clearing Account fund. 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. Under penalty of pedury, affiant hereby affirms that this claim is correct and the amount shown is due and owing. WHEREFORE, affiant requests that the Board of Supervisors issue to him/her a duplicate of said Warrant No. 240.000582 In the sum of $292.00 Dated: , 20 / Signed: Affiant ***A $12.00 fee for the stop payment and reissuance of the warrant will be deducted from the replacement check.*** Subscribed and sworn to before me this day of lL , 20 NotateTublic ANTHONY CELEBRE My commission expires: - Notary Public STATE OF TEXAS My Comm. Exp. 06-23-16 UPON APPROVAL, PLEASE MAIL REPLACEMENT CHECK TO: En3=1,==.1=AMCC O