STAMPED & REDACTED- ARIZONA FURNISHINGS.PDF

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MAR) COPA
COUNTY

INTEROFFICE MEMORANDUM

TO: MARICOPA COUNTY CLERK OF THE BOARD

FROM: MCSS FINANCE DESK (CHRISTY ADAMS)

SUBJECT: AFFIDAVITS ~ REPLACEMENT OF LOST WARRANTS

DATE: 07/28/2025

Please find attached 1 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.

The original warrant(s) have had a stop payment done.
If you have any questions, please contact the MCSS Finance Desk at 602-372-4833 (Option 1) or

via e-mail at FinanceDesk@maricopa.gov. Approved Affidavits may be routed back to the
Superintendent of Schools - Finance Desk at 4041 N. Central Ave #1100,

Thank you

District Payee Warrant # Amount

Littleton ESD #65 Arizona Furnishings 3700877469 $5,119.86

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Schools Affidavit/Claim Form MARICOPA

Application for a Duplicate Warrant/Check COUNTY
(definitions are on page 2)
STATE OF ARIZONA | Note: Numbers on this form correspond'to numbers oni the
- COUNTY OF MARICOPA Instruction sheet which is page 2 of this form.
424 whi (1), being first sworn, upon oath deposes and says:

Name/Claimant .
"On or about 06/04/2025 (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 (re to him/her in the sum of $514 19.86 . (3)
, Signed:. vghte We — (4)
" Print name: (required) Conari Shute

he ibed and sworn to before me this ay day of Sune 20ac.

AdbL Boe a Ly
: d

KOTARY PUBLIC LEEANNA RAE TINSLEY
Notary Pubtio - Arizona
y COMMISSION expires: Commission # 657164
. orn 3 My Commission Expires.
August 20, 2027 (seal)

Note: Please attach a copy of the warrant/check if available and/or any other evidence
that a warrant/check was originally issued.

bile il 3700877469

onan anew) 06/04/2025 _

Reason for original issue of Warrant/Check (8): = 7/29/25
O Payroll
i For Services or Goods furnished Furniture
Other:

S:\FinanceDesk\Schools-Warrants Checks notice of claim.docx
Revised May 2025 ARS, 11-632 & 15-999

June 30, 2025

Please reissue warrant to pay invoices #121645 & 121706; the check appears to have been lost in
the mall.

Also, Candice Shafer is an authorized representative of Arizona Furnishings and can request reissue
of warrants when necessary.

Thank youl

Meru >

Manya Snyder
General Manager

6913 West Buckeye Road STE 200
Phoenix, AZ 85043
ROC# 275932

EE EA OM OCIA NN ty OSE SA LE AEDT Ooo T aR —

LOO ER OF 7008774

PHOENIX, ARIZONA : ee DATE ~SOMTHOL NO. |

THIS WARRANT DRAWS INTEREST FROM DATE MARKED: sce FUNDS*

INTEREST STOPS ON DATE FUNDS AVAILABLE. (SEC 11-636, ARS956)
4 06/04/2025 65921001
LITTLETON ELEMENTARY SCHOOL DISTRICT #65
: ~_ WARRANT AMOUNT
PAY : wh
“Five Thousand One Hundred Nineteen and 86/100 Dollars { 95,1 9:86?

VOID AFTER 365 DAYS

TO ARIZONA FURNISHINGS - > 4

ORDER () .
(OF wa Superintendent of 9A98)BizeD SIGNATURES

MARICOPA COUNTY SCHOOLS PHOENIX, ARIZONA AP 20250605 3700877469

ARIZONA FURNISHINGS | 06/04/2025
; Payee { Check Date
Account Number PO Number Involce Amount

261600 © 12246

VOUCHER: 1144 TOTAL: $5,119,868

HARLAND CLARKE 122692 40036950

Attachments

Attachments

| Warrant | Status Print

Maintain Hew Status Setup |
3700877469
4 Warrant header

General

Warrant number 3700877469

Holder:

Issued date:

Status: Stopped

Exception flag: 7
Exception reason: None

Queued for positive pays | 1

Locked for reconcile, | |
Registered

Date registered:

No of days interest: o
Annual interest rate: 0.00000

Posting

laveice:

Invoice date:

Paid date:

Positive pay sent date:

Agency details

Agency voucher number: 1111
Agency claim number:
Agency low orig:

Agency PO number:

Agency sub fund:

Agency dept aunt:

® Warrant Lines

if lm BL |? | By | identification of the warrant

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