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AFFIDAVIT APPROVED DATE , t+. Polf STATE OF ARIZONA —; COUNTY OF MARICOPA • MARK:CPA BOA9E.‘ OF SUPERVSOFIS LATY • -- - tN- V.04.tre._U . on behalf of Phoenix Orthopedic Group, being first sworn, upon oath deposes and says: That on the 20th day of December, 2013, they presented to Maricopa County, for payment, a claim for services rendered or supplies furnished during the month of May, said claim being in the sum of Four Thousand Three Hundred Twenty Eight dollars and Thirty-two cents ($ 4,328.32) in payment of which the Board of Supervisors caused the Warrant No. 00340019715 to be issued on 02/18/2014, drawn on the Expense Fund. 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, affi ant prays that the Board of Supervisors issue to him/her a duplicate of said Warrant No.00340019715 in the sum of $ 4,328.32. SignedQ Subscribed and sworn to before me this day of 14.4.4 A7›20/V NOTARY PUBLIC My commi Return original signed, notarized form to: Maricopa County-Risk Management Dept. 222 N. Central Avenue, St., #1110 Phoenix, AZ 85004 APPROVED AFFIDAVIT CLERK, BOARD OF SUP R MARICOPA COUNTY STATE OF ARIZONA COUNTY OF MARICOPA Q/arri , being first duly sworn, upon oath deposes and says: (Ne and Title of Person) (4, - 1,D3tri(-4-4 1 That on , 20 he/she presented to hee-lit 4-4-(1 (School District Nam Maricopa County, Arizona, for payment, a claim for services rendered or supplies furnished during the month of Dkekintoe...r" , 2013, said claim being in the sum of ($ ) "AAA( kilLA-ncireci -(‘'t k)t_ tiat Dollars in payment of which the Superintendent of Schools caused his/her Warrant Number 1.-16650-05 to be issued on ate.tr14 l'•er.,), 2013 , drawn on the 0- k4 Fund of Plc.:scoot enit trktai a.,1,10b I IL/kit-CC/ (School District Nathe) 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 I "446 65g-0n in the sum of $ 556. . Signed: ( (Nairie arir1'itt6 of Authorized Personnel) Subscribed Subscribed and sworn to before me this day of ,j-cun ,20// NOTARY PUBLIC: a beti-Q-alAtAtoce/D My commission expires: cb liojalp t g Following approval please return this affidavit to the Maricopa County Education Service Agency Office. ----- AN-LLERENAS LISA DEAN -LLE RE NAS arv Public- Nizona Notary Pubk—Arizona ooa county Maricopa County pireS on 08/16/2014 Expires on 08/16/2014 AFFIDAVIT STATE OF OF ARIZONA COUNTY OF MARICOPA 14.) t=1--n-/b 6 t. kck- L„ , being first duly sworn, upon oath deposes and says That on the i C1 day of ) 11001_20/q, he presented to -1z(e District of Maricopa County, Arizona, for payment, a claim for services rendered or supplies furnished during the month of () r 20g, said claim being in the sum of Ajik; PL,AliACE1 )i&it Y At Dollars, ($99‘) •,9-.) in payment of which the Superintendent of Schools caused his/her Warrant Number Liq (-)6 33&702 to be issued on 1 0 -- I? - 13 , 20)3, drawn on the 001 Fund of HUD 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 °C) -3 '2,7 in the sum of $ 996 ' ec-..- VL JA- L- A L Subscribed and sworn to before me this .2/ day of 71/Z/:-C/L-,20 /y • . divo% .... NOTARY PUBLIC My commission expires: / Z - 4/ Following approval please return this affidavit to the Maricopa County School Superintendents Office APPROVED Affidavit STATE OF ARIZONA COUNTY OF MARICOPA ) l'ObwreeR., 0.4apturt,k, being first duly sworn, upon oath deposes and says That on the 11 day of F4T)rLxyl . 20 he presented to the 1411/11.14)1(d t, Wel , • t, -5 of Maricopa County, for payment, a claim for services rendered or supplies furnished during the month of 1--a3(00--(1,x, , said claim being in the sum of Tkon(toti ituot /161/ /D)-1301.1Vrs ) in payment of which the Superintendent of Schools caused his/her Warrant No. 4007555 to be issued on Pe,bartal. 20!-J , drawn on the Fund of t,V a-owl-n.114 a; a 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 in the sum of 9Z2N\ oD Subscribed and sworn before me thi /21 TAMMY CAMPBELL +Notery,P4iblie • Arizona r ` Atirieopa County 79ir My Comm Expires Feb 7, 2018 My Corfimission Expires Following approval please return this affidavit to the Maricopa County School Superintendent's Office. H:\WorklAffidavit.doc 07/14/05 APPROVIIID STATE OF ARIZONA 4- DAT COUNTY OF MARICOPA RK, BOARD OF SUPERVISORS MARICOPA COUNTY Terry Juarez being duly sworn, upon oath deposes and says; That on the 26th day of March 2014 he/she presented to the Treasurers of Maricopa County, for payment, a claim for services rendered or supplies furnished during the month of Marc h , said claim being in the sum of Seven Hundred Twenty Four 23/100 724.23 dollars ($ ) in payment of which the Superintendent of Schools caused his/her Warrant Number 140074663 to be issued on March 20 2014 drawn on the 779 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 140074663 in the sum of 724.23 Claimant Signature Subscribed and sworn before me this .2,c 9-4 day of MA Notary rubiic My commission expiresow,eldo CIL Notary Public State of Arizona Maricopa County Ma A Moran My Commission Expires 07/03/2017 Following approval please return this affidavit to Maricopa County Education Service Agency. Affidavit STATE OF ARIZONA ) BOARD OF SUPERVISORS COUNTY OF MARICOPA) MARQCPA COUNTY , .thx) Cho Ve 2_ _beling first duly sworn, upon oath deposes and says: That on the___ ........................... of /M641 20-af he presented to thel5 of Maricopa County, for payment, a claim for services rendered or supplies furnished during the month of,AW,Ch , said claim beiig in the sum 0f...00 -6 boxbed Dollars ($816.At...) in payment Of which the Superintendent of Schools caused his Warrant Nol lial730Yeeto be issued on. JW&Ch , 20-L4., drawn on the 22. Fund of #5— 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 11100132Nin the sum of $. Subscribed and sworn before me this.1m..... -14k day of 1140412-al , 20L. public) N." OFFCMLSEAL RYAN FRENCH my commission expires ;LI ............ NOTARY PUBLIC - STATE Of ARIZONA couNmo mum My commission expires March 13.2016. Following approval,please return this affidavit to Maricopa, County Schools. AFFIDAVIT STATE OF ARIZONA COUNTY OF MARICOPA 5:That AUTO ZONE , being first duly sworn, upon oath deposes (Name and Title of Person) and says: That on AUGUST/SEPTEMBER , 20_13._ , he/she presented to _MURPHY ELEMENTARY (School District Name) SCHOOL DISTRICT #21 of Maricopa County, Arizona, for payment, a claim for services rendered or supplies furnished during the month of SEPTEMBER 17, , 20_13__, said claim being in the sum of ($__761.88 ) SEVEN-HUNDRED —SIXTY-ONE AND 88/100 Dollars in payment of which the Superintendent of Schools caused his/her Warrant Number 44-0023894 to be Issued on SEPTEMBER 17, , 20_13__, drawn on the _001 Fund of (School District Name) SUPERINTENDENTS OFFICE 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 _44-0023894 In the sum of 761.88 Signed: Name and Title of Authorized Personnel) A-6.4 /../), 0-r IreAfc Subscribed and sworn to before me this .02 / day of ,20 NOTARY PUBLIC: My commission expires: z- z Following approval please return this affidavit to the Maricopa County Education Service Agency Office. V.11 Coll .gr • je, ob f D`A1t.. - n..ez AFFIDAVIT , BOARD OF SUPERVISORS ARICOPA COUNTY STATE OF ARIZONA COUNTY OF MARICOPA cs-rh&c. ft grviletelb. 4-ecounr AUTO ZONE , being first duly sworn, upon oath deposes (Name and Title of Person) and says: That on SEPTEMBER , 2013_ , he/she presented to MURPHY ELEMENTARY SCHOOL (School District Name) DISTRICT #21 of Maricopa County, Arizona, for payment, a claim for services rendered or supplies furnished during the month of 9/8 20_13 said claim being In the sum of 559.20 ) FIVE HUNDRED FIFTY-NINE AND 20/100 Dollars in payment of which the Superintendent of Schools caused his/her Warrant Number 44-0030710 to be Issued on _OCOTBER 8, , 20_13 , drawn on the Fund of (School District Name) SUPERINTENDENTS OFFICE 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 44-0030710 in the sum of 559.20 Signed: Name and Title - of - Authorized Personnel) 171-6,6 t—t it. Subscribed and sworn to before me this 2/ day of n'742 Le-4-T 20 / NOTARY PUBLIC: L4; My commission expires: / 2- Following approval please return this affidavit to the Nlaricopa County Education Service Agency Office. AFFIDAVIT STATE OF ARIZONA COUNTY OF MARICOPA I. if ti ov , ti-et:,4Ltelf LU- AUTO ZONE being first duly sworn, upon oath deposes (Name and Title of Person) and says: That on AUGUST/SEPTEMBER 20_13, he/she presented to MURPHY ELEMENTARY (School District Name) SCHOOL DISTRICT #21 of Maricopa County, Arizona, for payment, a claim for services rendered or supplies furnished during the month of .SEPTEMBER 10 , 20_13 ,said claim being in the sum of ($ 509.66 ) FIVE HUNDRED — NINE AND 66/100 Dollars in payment of which the Superintendent of Schools caused his/her Warrant Number 44-0021437 to be issued on 09/10 20_13 , (School District Name) drawn on the 001 Fund of _SUPERINTENDENTS OFFICE of Maricopa County, Arizona. Afflant 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 44-0021437 in the sum of $ 509.66 Signed: Uj (kkk\i' Div•a 6.4!4 n rz-ic (Name and Title of Aut corked Personnel) Subscribed and sworn to before me this / day of 721 CI-t4, 20 /X NOTARY PUBLIC: Le-49 My commission expires: .1--/e7er Following approval please return this affidavit to the Maricopa County Education Service Agency Office. A rzv CtVEZ AFFIDAVIT DATE 1-4 dof STATE OF ARIZONA BCrA.;5 CYF tUPErIVISORS MARICOPA COUNTY COUNTY OF MARICOPA cv)/40771/-14- %Vlr.7I14iC — being first duly sworn, upon oath deposes and says: ANC411- That on the 0/0 day of/14W- 20141, he presented to gtizsz L5,b-gt-3/ District of Maricopa County, Arizona, for payment, a claim for services rendered or supplies furnished during the month of NAjea- 20 j4L said claim being in the sum of &fa- vApir--47J4 t Dollars, ($ 1147:51 ) in payment of which the / Superintendent of Schools caused his/her Warrant Number to be issued on ,49A/2 , 20#, drawn on the CO Fund of ,8410Z &-W) /1fr3/ 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 /1-1074- / in the sum of $ 1j417-1-' • Signed: Subscribed and sworn to before me this k2. 1 day of '(YO. ILt DESIRE JASMINE DALEY NOTARY MAR1COPA PUBLIC COUNTY - ARVONA My November Commission 14, Expires 2016 My commission expires: \ dtrE OTARY PUBLIC Following approval please return this affidavit to the Maricopa County School Superintendents Office. Affidavit State of Arizona (County of Maricopa) , EcTAFth 5FtuPEriVisro-Rs MARICOPA COUNTY Accurate Vinyl Applications/Stephanie Ricks being first duly sworn, upon oath deposes and says: That on the 27th day of February, 2014 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 $ Five hundred ninety-three and 84/100 dollars ($ 593.84) in payment of which Superintendent of Schools caused his/her Warrant No. 440074241 to be issued on March 4, 2014, 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. 440074241 in the sum of $ 593.84. Vendor Signature Printed name: (S-\-e ckS Title with the company: CIA.S-k-tryvve_ r COLC-ed Subscribed and sworn before me this day of public signature and stamp) :_„.......".,,,..„,_r____.-_...,_...:......,_.__rr...„ 7 hlaricopa County L114 y Commission Expires my commission expires August 21,2014 Following approval please return this affidavit to Maricopa County Schools. AFFIDAVIT STATE OF ARIZONA COUNTY OF MARICOPA oe;Ati sd o &+f-kj 7ScLcL., , being first duly sworn, upon oath deposes arx S i That on the lek day of Scli 2013 , he presented to Rb District of Maricopa County, Arizona, for payment, a claim for services rertide or supplies furnished during the month of %isitten,TpaR 201 , said claim being in the sum 0 „24,0 %IN 6151110kb 1 1 0 .Vi•friefet oTlyzusp scis_Auw"-Dol !ars, ($ 15, 1Q%1 in payment of whicl h Superintendent of Schools caused his/her Warrant Number 41+tx326 I 45 1 to b issued on Ser. kct "441 , go , drawn on the cc)] Fund of RoMesi 1st- District of Maricopa County, Arizona. Affiant further says that although he/she was informed and believes that the ab mentioned warrant was regularly issued, the same has never been received, p been lost. WHEREFORE, affiant prays that the Board of Supervisors order ard Superintendent of Schools issue to him/her a duplicate of said Warrant N urn 4 ,itcy2,5 )45 in the sum of V% 4 Signed: tf riLl ry SAk 0 , et, sill to_ az.1 is b' Subscribed and sworn to before me this C/P/ day of LfileactO , / Armido R MOM= Notary Public 'C'L S tittutoopa County, Arizona My Conn. aping 08-30-14 1 NOTA PUBLIC issibii expires: 66 5C) /4 Following approval please return this affidavit to the Maricopa County School Superintendents Offic