STAMPED & REDACTED - WEST COAST AROBORIST INC.PDF

MARICOPA COUNTY

Office of Budget and Finance
301 West Jefferson, 9" Floor
Phoenix, Arizona 85003

INTEROFFICE MEMORANDUM
Date: November 21, 2022
To: Clerk of the Board
From: Marcia J. Bulanda

Office of Budget and Finance

Subject: Affidavit - WEST COAST ARBORISTS, INC.

Please find attached 1 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 lost.

Please call me 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: D690 FLOOD CONTROL — EN. 23*3543
Tree Trimming, Pruning, Removal, and Replacement Services

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

This application is for: Duplicate or CI 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
pade 2 of this form.

WEST COAST ARBORISTS INC (1), being first swom, upon oath deposes and says:

Name/Chaimant

On or about 17-Aug-2022 (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, er it was not
presented for payment within one year after the date of issuance.

Therefore, under penalty of perjury, claimant hereby affirms that this cdaim 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 $1,618.00 -(3)
Signed: é VbeAem— . (4)

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

(5) Athos Tat and ri. to before me this_[ "#0 day of NOUeWer — 2093_.

a) Lal boom

NOTARY PUBLIC

ALEXUS GILLESPIE

“ Notary Public - Arizona
Maricopa Co. / #607089
Expires 06/15/2025

My com real expires:
OWNS 1a0aG

ret see it

(seal)

W. Check Numb
arrant/Check il er 730104 24950

Original Date of Issue
9 Gf known) {7) 17-Aug-2022

Reason for original issue of Warrant/Check (8):
C1 Payroll
C1 For Services or Goods furnished

Cl] Treasurer's refund/payment
Other; / original check presumed lost in the mail

FUND 994 - D890 FLOOD CONTROL - LN, 2343643
TREE TRIMMING, PRUNING, REMOVAL, AND REPLACEMENT SERVICES

11/22/2022

Tree Care Professionals Serving Communities Who Care About Trees
October 28, 2022

Maricopa County Department of Finance

Attn: Accounts Payable

Phoenix, AZ 85003

Subject: Affidavit/Claim for re-issuance of a lost or stale dated check (warrant)
To whom it may concern;

|, Patrick Mahoney as owner/President for West Coast Arborists, Inc. give authorization to Justin Menzel,
Area Manager, to execute an affidavit on behalf of West Coast Arborists, Inc.

Should you have any questions please contact me by phone at

Sincerely, } ie
j A
Ae,

i f
Patrick Mahoney L
President

West Coast Arborists, Inc.
CEE Anchen, CA 92806 - a - Sa - ox

COUNTY EXPENSE WARRANT TREASURER OF MARICOPA COUNTY

PHOENIX, ARIZONA

DATE
08-17-2022

One Thousand Five Hundred Eighteen And 00/100 Dollars

PAY TO THE ORDER OF
West Coast Arborists Inc

For Questions « -  oremen
MARICOPA COUNTY DEPARTMENT OF FINANCE

Void Afier
365 Days

WARRANT NUMBER
3010124950

91-2/1224

$1,518.00
AMOUNT

crn ANCIAL OPPO

NOT NEGOTIABLE

RETAIN THIS FOR | PAYEE
YOUR RECORDS

WARRANT NO, | WARRANT DATE | WARRANT AMOUNT

West Coast Arborists Inc

3010124950 08/17/2022 $1,518.00

INVOICE NUMBER | DESCRIPTION

PURCHASE ORDER NO.

VOUCHER NO. AMOUNT

41-8161 Invoice #1-8164

DO D690 230000000536

230000002519 1,518,00