REDACTED-FOR AGENDA ATTACHMENT-JACKSON WHITE PC TRUST ACCOUNT OF - CK#3010160792.PDF

MARICOPA
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: 03-25-25

Subject: Affidavit — Jackson White PC Trust Account Of

Please find attached one Affidavit for a Stale-Dated 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 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 234 — D640 Transportation ~- GAX1D 24*4448 — CV2023-012225 D24577, APN:

304-72-02 CV2023-012225

Application for a Duplicate or Stale-Dated Warrant/ 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 ta
COUNTY OF MARICOPA numbers on the Instruction sheet which Is

pade 2 of this form.
JACKSON WHITE PC TRUST ACCOUNT OF (1) being first sworn, upon oath deposes and says:
Name/Claimant

On or about 14-Sep-2023 (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, ar 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/elféck be issued to! ira/her in the sum of of $80. 918.00 (3)

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

Signed:

(5) Subscribed and sworn to before me this 1G day of VOB 20 29

WAU, UNDO

NOTARY PUBLIC

TES BILLIE MEAGHER
Q

Rubli rizona.

Maricopa County
My Commission Expires
02/18/2028

MPA expires: Commission # 561161

A ral 9028, (seal)

W: t/Check Numb:
Warrant/Check umber 13010160792

Original Date of Issue 14-Sep-2023

{if known) (7)

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

Payroll

1 For Services or Goods furnished

QO Treasurer's refund/payment
Other, / Original check presumed lost in the mail

FUND 234 - D640 TRANSPORTATION - GAXID 24°4448 ~ CV2023-012225 TT0630 D24577, APN: 304-72-02

CV2023-012225

ADAM M, ASHBY
JouN K, DOSDALL
TIMOTHY W. DURKIN
JARED E. EVERTON
ZOE N. FIGGINS
JEREMY S. GEIGLE
NATHANIEL J, HILL
RYAN K. HODGES
TRAVIS W, JENSON
COLTON B. JOHNSTON

JACKSONWHITE Brick Micooxatn

nena rr ~ : Jon M. McAvoy
ATTORNEYS AT LAN ANTHONY H, MISSELDINE

A Professional Corporation KELSEY M, MISSELDINE
Monica A, NOLAN

MICHAEL R, PRUITT

EVAN C. TOMPKINS

Davip L, WEED

ASHELEE J, WEEKS

SPENCER M, WILKINSON

March 19, 2025

Jennifer Rodriguez
Maricopa County Real Estate Department
2801 West Durango St.

Phoenix, AZ 85009

Hi Jennifer!

Attached please find the Affidavit/Claim Form signed by Attorney
Anthony Misseldine and notarized regarding Warrant Number 3010160792 dated

PROJECT : TT0630 — Item# D24577 CV2023-012225
PARCEL NO : 304-72-027
CLIENTS : JACOB AND JEANNE BROGDON

September 14", 2023 in the amount of $60,918.00 made payable to Jackson White
PC, Trust Account of.

Also attached is notice by Brad Black as Firm Administrator of

Jackson White PC authorizing Attorney Anthony Misseldine to sign the affidavit
on behalf of the business.

Enclosures :

480.464.1111
Toll Free 800.243.1160
Fax 480.464.5692

Thanks!
LIENDY NYSSELDINE

Wendy Misseldine

Signed/Notarized A ffidavit/ClaimForm
Notice By Jackson White Firm Administrator Brad Black

E-Mail: firm@jacksonwhicelaw.com
40 North Center Street, Suite 200 * Mesa, Arizona 85201 www.jacksonwhitelaw.com
Serving clients throughoitt Arizona www.arizonaseniorlaw.com

COUNTY EXPENSE WARRANT TREASURER OF MARICOPA COUNTY

poet PHOENIX, ARIZONA

AVIZONS

Couns

DATE

Sixty Thousand Nine Hundred Eighteen And 00/100 Dollars

PAY TO THE ORDER OF

Jackson White PG

Trust Account of Vold After
365 Days

WARRANT NUMBER
3010160792

$60,918.00

AMOUNT

Por 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

Jackson White PC 3010160792 09/14/2023 $60,918.90
INVOICE NUMBER | DESCRIPTION PURCHASE ORDER NO. | VOUCHER NO. AMOUNT
CV2023-012225 CV2023-012225 TT0630 D24577, APN; 304-72-0: | GAX1D D640 240000004448 60,918.00} PU

240000004448
CV2023-012225

ADAM M. ASHBY
JOHN K. DosDALL
TIMOTHY W. DuRKIN
JARED E, EVERTON
ZOE N, FIGGINS
JEREMY S. GEIGLE
NATHANIEL J, HILL.
RYAN K, Hopaes
TRAVIS W, JENSON
COLTON B. JOHNSTON

DATE: March 19, 2025

JACKSONWHITE

ATTORNEYS AT LAW

A Professional Corporation

March 19, 2025

ERIC K, MACDONALD
Jon M. McAvoy
ANTHONY H, MISSELDINE
KELSEY M. MISSELDINE
Monica A, NOLAN
MICHAEL R, PRUITT
EVAN C. TOMPKINS
Davip L. WEED
ASHELEE J, WEEKS
SPENCER M, WILKINSON

1, Brad Black, authorize Anthony Misseldine, Attorney, to execute an affidavit on behalf of

Jackson White PC.

Yours truly,
G Bok

Brad Black

Firm Administrator of Jackson White PC

480.464.1111
Toll Free 800.243.1160
Fax 480.464,5692

40 North Center Street, Suite 200 . Mesa, Arizona 85201
Serving clients throughout Arizona

E-Mail: firm@jacksonwhitelaw.com

www.jacksonwhitelaw.com
www.arizonaseniorlaw.com

oO Agency Status Warrant number : Issued date Paid date Amount
“< Fr pete r r
p Stlle 4 30101 60792 “aya/2g24 “72:00:00 am 9/30/20... 60,913.00;
Zé
‘Warrant number 2010
Amount Payee Account

Jackson White PC FY