STAMPED & REDACTED - AIKINS DISTRIBUTION INC.PDF

RES
.-

MARYCOPA

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: 02-11-25

Subject: Affidavit — Aikins Distribution Inc.

Please find attached one Affidavit for a lost 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.

e The original warrant is presumed fost.

Please call Marcia Bulanda 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: FUND 255-D500 SHERIFF-I.N. 25*24087, 25*24088, 25*24094, 25*24097-MILK, ALL
TYPES

Application for a Duplicate or Stale-Dated Warrant/ Check

Affidavit/ Claim Form

This application is for: Duplicate or C1] state-Dated (definitions are on page 2}

STATE OF ARIZONA Note: Numbers on this form cores spond to

COUNTY OF MARICOPA numbers on the Insfruction sheet which is
nade 2 of this forrn.

AIKINS DISTRIBUTION INC (1), being first sworn, upon oath depnses and says:

RNamarCaivant

On or about 21-Nov-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 $13,419.63 -{3)

Signed: Vn Orullf (4)

Note. Please attach 8 copy of the warrant/check if available and/or any other
evidence that a warrant/check was originally issued.

(5) Subscribed and sworn to before me this {ots day of Fé brudyy 2025.

‘iD done dorcane HO, WEI

NOTARY PUBLIC _ roars

“Notary Public State of Arizona
Maricapa County
Deborah Loulse Milllron
My Commission Expires 10/30/2028 ( at)
Commission Number 675401 $8

My cammissian expires:
i | 3%} 26

An sLtir dnd

‘Warrant/Check Number 3010198432

{ifknowen) (6)

Original Date of Issue Nav.
(if kisoven} (7) 21-Nov-2024

Reason for original issue of Warrant/Check (8): 2/11/25

LI Payroll
lM) For Services or Goods furnished _ _

CO Treasurer's refund/payment :
A. Other: FUND 255-0500 SHERIFP-.N. 25*24087, 25°24088, 2524084, 25°24097 - MILK, ALL TYPES

DISTRIBUTION

Maricopa County Office of Budget and Finance
Atin: Accounts Payable

301 W Jefferson Street, 9th floor

Phoenix AZ 85003

2/5/2025
RE: Application for a duplicate check #3010198432 $13,419.63

1, Jeremy Aikins, authorize Kimberly Crail, bookkeeper, to execute an affidavit on behalf of
Aikins Distribution, inc.

Sincerely, log

Jeremy Aikins
Owner
Aikins Distribution, Inc.

COUNTY E“@ENSE WARRANT TREASURER OF MARICOPA COUNTY WARRANT NUMBER le
, PHOENIX, ARIZONA 3010198432

DATE

Po —_

Thirteen Thousand Four Hundred Nineteen And 63/100 Dollars

$13,418.63
PAY To THE ORDER OF AMOUNT
Aikins Distribution Inc.
Void After
365 Days
Por Questions - 602-506-1379 or email AP@MATL,.MARICOPA.GOY NOT NEGOTIABLE
MARICOPA COUNTY DEPARTMENT OF FINANCE
RETAIN THIS FOR [PAYEE : _ WARRANT NO. H WARRANT DATE | WARRANT AMOUNT |
YOUR RECORDS a none } a
_ Aikins Distribution Inc. 3010198432 | 11/21/2024 $13,419.63
INVOICE NUMBER | DESCRIPTION PURCHASE ORDER. NO. | VOUCHER NO. AMOUNT
|58304 58304 JOOINV3 D500 “/250000014982 3,157.56
250000000140
58397 58397 DOINV3 D500 250000014982 3,157.56
250000000140
58395 58395, DOINV3 D500 250000014982 3,157.56
250000000140
58398 58398 DOINV3 D500 250000014982 3,946.95

250000000140

“f Issued warrants {Uns

cra

eto jiter

'L) Agency Status ‘Narrant number — Issued date Paid date Amount

y Issued jsovorgea32 | + . ~
3010198432" 14/21/2024 12:00:00 am "72419.83 |

#2000 ssued

Warrant number 30

i! Amount» Payee Account

13,418.62 Aikins Distribution Ine, |

| aD TREIE432

a Warrant header

General

Warrant number: / 3010198432

Holder:

Issued date: 14/21/2024 12:00:00 am
Status: ‘Stopped

Exception flag:

Nene
> Queued far positive pay:
: Lacked for reconcile:
Registered
: Date registered:
: Mo of days Interest: a
1 Annual interest rate; 00000

Po wane se

Invoice date: 7
|

Paid date:

Positive pay sent date: 11/22/2024

Agency details
Agency voucher sumber:

Agency chim number:
Agency PO nurnher
Agency sub fund:

Agency dept num:

O0027 am