STAMPED & REDACTED-MARICOPA ASSOCIATION OF GOVERNMENTS.PDF

MAR COPA
COUNTY

Office of Budget & Finance
301 W. Jefferson St, 9" Floor
Phoenix, Arizona 85003

P: 602-506-3561
F: 602-506-4451

Maricepa.gov

To: Clerk of the Board

From: — Office of Budget & Finance, Accounts Payable

Date: 08.05.25

Subject: Affidavit - MARICOPA ASSOCIATION OF GOVERNMENTS

Please find attached one Affidavit for a Duplicate Dated warrant to be included on the
next available Board Agenda.

e The attached item has been researched to ensure the warrant in question has not
been cashed or previously re-issued.

* The original warrant is presumed lost.

Please call Marcia Anderson at 506-7291 if you have any questions. Please return the
approved Affidavit to my attention in the Office of Budget and Finance, 9 Floor.

Thank you.

Re: D220-HUMAN SERVICES-I.N. 25*40226 — HID-24-060 MAG-LEARNING MGMT TRAINING

MAR €CG@PA Application for a Duplicate or Stale Dated

COUNTY Warrant/Check Affidavit/Claim Form
___ This application is for Duplicate or im Stale-Dated (definitions are on page 2)
STATE OF ARIZONA Note: Numbers on this form correspond to the numbers
COUNTY GF MARICOPA on the Instruction sheet which is page 2 of this form

MARICOPA ASSOCIATION OF GOVERNMENTS (1), being first sworn, upon oath deposes and says:

Name/Ciaimant

On or about 22-JAN-2025 __(date) (2) a warrant/check was issued to the above named
person/entity in the amount stated below. Such warrant/check was either never received or
was subsequently inadvertently last 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 issues to him/her in the surn of $18,000.00 _. (3)

Signed: UCM Wet. _ (4)

Print Namtrequired) Vy esen iq_ WM gy iO.

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

5) Subscribed and sworn to hefore me this _Y day of Aygo st _ 20. 2S
iN
NOTARY#UBI® —
My commission expires:
Mb -28 -27 (seal)
Warrant eon 304 0203782
Original Date of issue a
wma (29-JAN-2025
8
Reason for ofiginal issue of Warrant/Check (8): . 15/98
1 Payroll

[1 For Services or Goods furnished ___

C] Treasurer's refund/payment
TA Other: 0220-HUMAN SERVICES - |.N. 25°40226 - HID-24-060 MAG - LEARNING MGMT TRAINING

Fond 296

S\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Current Clain Form\100518 Warrants Checks notice of claim.doc Revised
100518

ARS, 11-632 & 14-644

MARICOPA 302 North ist A Suite 360 4 Phoenix, Ari g5003
or st Avenue, Suite 4 Phoenix, Arizona 85)
ASSOCIATION of Phone (602) 264-6300 4 FAX (602) 254-6490

GOVERNMENTS E-mail: mag@azmeg.gov A www.azmag. gov

July 30, 2025

TO: Maricopa County Office of Budget and Finance
FROM: Ed Zuercher, Executive Director

SUBJECT: AUTHORIZATION TO EXECUTE CHECK AFFIDAVIT

|, Ed Zuercher, authorize Yesenia Mejia, Finance Director, to execute an affidavit
on behaif of Maricopa Association of Governments.

If you have any questions or require further clarification, please do not hesitate
to contact me.

Sincerely,

as

Ed Zuercher
Executive Director

cc. Fiscal Services

More Than 50 Years of Serving the Region

City of Apache Junction + Arizona Department of Transportation 4 City of Avondale 4 City of Buckeye * Town of Carefree * Town of Cave Creek * City of Chandler 4 City of Et Mirage A Town of Florence

Fort McDowell Yavapai Nation © Town of Fountain Hills 8 Town of Gila Bend » Gila River Indian Community 4 Town of Gilbert 4 City of Glendale 4. City of Geadyear & Town of Guadalupe
City of itchfield Park & City of Maricopa #. Maricopa County 4 City of Mesa 4 Town of Paradise Valley % City af Peoria & City of Phoenix 4 Pinal County & Tova of Gusen Creek
Salt River Pina-Maricopa indian Conimunity 4 City of Scottsdele City of Surprise 4 City of Tempe @ City of Tolleson & Town of Wickenburg 4 Tewn of Youngtown

TREASURER OF MARICOPA COUNTY WARRANT NUMBER

COUNTY EXPENSE WARRANT

) SRLCOS PHOENIX, ARIZONA 3010203782
a DATE
(| bers | () penbelives 91-2/1224
QO AN
Oun’t
Eighteen Thousand And 00/100 Dotiars
$18,000.00
PAY TO THE ORDER OF AMOUNT
MARICOPA ASSOCIATION OF GOVERNMENTS
Vold After
365 Days
NOT NEGOTIABLE

For Questions - 602-506-1379 or email AP@MAIL.MARICOPA.GOV
MARICOPA COUNTY DEPARTMENT OF FINANCE

RETAIN THIS FOR | PAYEE

WARRANT NO. | WARRANT DATE

WARRANT AMOUNT

YOUR RECORDS

MARICOPA ASSOCIATION OF GOVERNMENTS 3010203782 01/29/2025 $18,000.00
INVOICE NUMBER | DESCRIPTION PURCHASE ORDER NO. | VOUCHER NO. AMOUNT
ARPA-MAG-JAN25 | HID-24-060 MAG - LEARNING MGMT TRAINING D€ 5229) 240000007452 250000025371 18,000.00

[D Agency Status Warrant number issued date Paid date
wv Issued (3010203782 wv, * ; +
Issued 3010203782 1é28 72025 T2000 am
|
|
Warrant number 32962
Amount Payee Account

MARICOPRs

CCHATION OF GOVERNIME, . PY