STAMPED & REDACTED - RUSH TRUCK LEASING INC.PDF

v
MAR) COPA
COUNTY

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

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

Maricopa.gov

To: Clerk of the Board

From: Office of Budget & Finance, Accounts Payable
Date: 1-28-2025

Subject: Affidavit — Replacement of Lost Warrant

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

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

e The original warrant is presumed lost.

Please call Walter Chang at 506-8747 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: Fund: 100 / Environmental Services - D880 / vendor name : Rush Truck
Leasing Inc

SN

ENTERPRISES

a ee

AUTHORIZATION TO PAY THIRD PARTY

Effective, February 6, 2001, WHEREAS, Rush Truck Leasing, Inc. dba Rush Truck
Leasing, Phoenix and Interstate Billing Service, Inc. have entered into an agreement to
centralize and manage the collections for our company. This letter authorizes your
company to pay Interstate Billing Service, Inc. for the invoices purchased and to mail all
payments to them.

Interstate Billing Service, Inc. will remit a monthly statement and you should mail
payments directly to them. If necessary, you may make your checks payable to us but still
remit them to Interstate Billing Service at the below address:

Remit to:

Rush Truck Leasing, Phoenix
or Interstate Billing Service

Thank you for your cooperation.

Sincerely,
Rush Truck Leasing, Inc. Interstate Billing Service, Inc.

dba Rush Truck Leasing, Phoenix

Application for a Duplicate or Stale-Dated Warrant/ Check
Affidavit/Claim Form

This application is for: Duplicate or CO stale-Dated (definitions are on page 2)

STATE OF ARIZONA Note: Numbers on this form correspond to
COUNTY OF MARICOPA numbers on the Instruction sheet which is
. paae 2 of this form.
Fe te Leasing, Inc (1), being first sworn, upon oath deposes and says:
On or about 06-Sep-2024 (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 issued to him/her in the sum of $1,060.96 -(3)

Signed: __ Ron, \onnnr- ANP (4)

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

a Subscribed and sworn to before me this _ |S‘ _day of anuacy/ 20 AS |

NOTARY =i Wg LER

My commission expires:
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W. Check be! ;
eran check Humber | 3h4 0192072 —
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eS mG) |O6-Sep-2024 2/6/25 _

Reason for original issue of Warrant/Check (8):

0 Payroll
For Services or Goods furnished / Truck and Van Rental or Lease

O Treasurer’s refund/payment
Other: / check presumed lost / fund : 100, initiated by the vendor