STAMPED & REDACTED-BEST FUNERAL SERVICES INC.PDF

MARICOPA
COUNTY

Office of Budget & Finance To: Clerk of the Board
301 W. Jefferson St., 9" Floor

From: Office of Budget & Finance, Accounts Payable
Phoenix, Arizona 85003

Date: 08.14.25

Subject: BEST FUNERAL SERVICES INC
P: 602-506-3561

F: 602-506-4451

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

Maricopa.gov

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 lost.

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, 3" Floor.

Thank you.

Re: FUND 296 - D220 Human Services ~ GAX1D 25*15631 — FUNERAL ASSISTANCE ~
K DENNY

MAR COPA Application for a Duplicate or Stale Dated
COUNTY werrant/Check Affidavit/Claim Form

This application is for Duplicate or [| Stale-Dated (definitions are on page 2)

STATE OF ARIZONA Note: Numbers on this form correspond to the numbers
COUNTY OF MARICOPA on the Instruction sheet which is page 2 of this form

BEST FUNERAL SERVICES INC (1), being first sworn, upon oath deposes and says:
Name/Claimant

On or about 2 Apr 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 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 warrani/check
be issues to.him rime sum of $1,441.32 . (3)
signed, yy (4)

Print Name: (required) _ SE “4 iZ megtick

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

5) Subscribed and swom to before me this. \Ae day of PWNS! 20. 15 .
Afurrel As fini Kaede
NOTARY RUBLIC

PAMELA JEANNE KONTE
(ze 3 Notary Public « Anzona

MARICOPA COUNTY
| My commission ex; cd WES 5

ad Cee ore 2028
Ayn\ hy RIVAU Expires April 28, 2026 (seal)
t/Check
Warran /Gheck Number 3010208841
Original Date of Issue ~
L (if known) (7) 2 Apr 2025 8/14/25 _|
Reason for original issue of Warrant/Check (8):
O Payroll

(1 For Services or Goods furnished

(1 Treasurer's refund/payment
Other: Funeral assistance - K Denny / GAX1D D220 25°15631 / Fund 296

SAPROCESSES\Warrants - Duplicate or Stale\02 Forms\Current Claim Form\100518 Warrants Checks notice of claim.doc Revised
100518

ARS. 11-632 & 11-644

COUNTY EXPENSE WARRANT TREASURER OF MARICOPA COUNTY

WARRAN

TT NUMBER

’ PHOENIX, ARIZONA 3010208841
RICO
‘sree
RULONT DATE
() (| 04-02-2025 91-2/1224
ay
fo UNS
One Thousand Four Hundred Forty One And 32/100 Dollars
$1,441.32
PAY TO THE ORDER OF AMOUNT
BEST FUNERAL SERVICES INC
Void After
365 Days
For Questions - 602-506-1379 or email AP@MATL. MARICOPA,GOV NOT NEGOTIABLE
MARICOPA COUNTY DEPARTMENT OF FINANCE
RETAIN THIS FOR | PAYEE WARRANT NO. | WARRANT DATE | WARRANT AMOUNT
YOUR RECORDS
BEST FUNERAL SERVICES ENC 3010208841 04/02/2025 $1,441.32

INVOICE NUMBER } DESCRIPTION PURCHASE ORDER NO. | VOUCHER NO. AMOUNT
INV-0000640366 CAS-171267-G5D7X2, K.Denny - Funeral Assista! }GAX1D D220 250000015631 1,441.32

250000015631

www, bestfuneralservices.com,

BEST FUNERAL SEHUICES

WIEST VALLEY CHAPEL NORTH CENTRAL CHAPEL
9380 West Peoria Ave. 501 East Dunlap Ave.
Peoria, AZ 85345 Phoenix, AZ 85020
(623) 486-1955 (602) 906-9600
08/14/2025

I, Spencer Perlman, authorize Jeffrey Payne, Manager, to execute an
affidavit on behalf of Best Funeral Services.

Yours Truly,

Lpora, Fe hen

Spencer Perlman
President

Status

issued

Warrant number Issued date

3010208841

issued

ON208E4T 4/2/2025

‘Narrant nurnken

SOG

Amount Payee Account

2 BEST FUNERAL SERVICES INC