STAMPED & REDACTED- BMD PRINTING AND BUSINESS SERVICES.PDF

INTEROFFICE MEMORANDUM 
TO: 
MARICOPA COUNTY CLERK OF THE BOARD 
FROM: 
MCSS FINANCE DESK (ANDIE DE LA ROSA) 
SUBJECT: 
AFFIDAVITS – REPLACEMENT OF LOST WARRANTS 
DATE: 
10/25/2022 
Please find attached 1 Affidavit/Notice of Claim(s) for lost warrants for inclusion on the next 
available Board agenda. 
The attached item(s) have been researched to ensure that the warrant(s) in question have not been 
cashed or previously re-issued. 
The original warrant(s) have had a stop payment done. 
If you have any questions, please contact the MCSS Finance Desk at (Option 1) or via e-mail at . 
Approved Affidavits may be routed back to the Superintendent of Schools - Finance Desk at . 
Thank you 
District 
Payee 
Warrant # 
Amount 
Saddle Mountain Dist #90 
BMD Printing and Business 
Services 
3700566252 
$3,261.39

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Office of the Maricopa Co nty 
School Super ntendent 
Warrant Void/Stop Request 
District Name/ Number: SADDLE MOUNTAIN USO #90 
Contact Name: JORGE GARCIA 
Attachments: 
D Original Warrant 
Finance Dc~k 
mm 20201016 
Contact e-mail: 
Iv! Lost Warrant Affidavit (required for ALL reissues) 
!vi Vendor Letter (if requesting Vendor reissue) 
W arrant Number 
Warrant Date 
Amount 
Payee 
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3700566252 8/12/2022 
$ 3,261.39 
BMD BUSINESS SERVICES 
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Notes: 
District Approver: 
Date: 10/25/2022 
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Clerk of Board Date: 
Void Report Date:

Schools Affidavit/Claim Form 
Application for a Duplicate Warrant/Check (definitions are on page 2) 
STATE OF ARIZONA 
Note: Numbers on this form correspond to numbers on the 
COUNTY OF MARICOPA 
Instruction sheet which is page 2 of this form. 
_B"TlM=D=P,.,,.Rl""'N=Tl=N=G_&_e_u_s1_N_Es_s_s_v_c_s __ (1), being first sworn, upon oath deposes and says: 
Name/Claimant 
On or about 48 .. l "2. --1 C. 
(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, m: 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/ch~~.;! to hi~m 
of $_3_,2_6_1_.3_9 ______ .(3) 
Signed: 
tJ--;J1 ~ 
--==--== 
(4) 
NOTARY PUBLIC 
My commiss,Z? expires: 
· / · --2-5 
I 
Note: Please attach a copy of the warrant/check if available and/or any other 
evidence that a warrant/check was originally issued. 
Warrant/Check Number 
3700566252 
(If known) (6) 
Original Date of Issue 
08/12/2022 
(if known) (7) 
Reason for original issue of Warrant/Check (8): 
D Payroll 
Iii For Services or Goods furnished printing services 
•_...;..._ __ ___.;;...._ ____________________ _ 
o Other: printing services 
S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Schools\Schools-Warrants Chi 
Revised June 2015

10/25/22, 7:21 PM
VMware Horizon
https://horizon.maricopa.gov/portal/webclient/#/desktop
1/1
12!1 Warrant (1 - mcto) - Warrant number: 3700566252, Stopped 
Warrant 
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Warrant 
Status 
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0 
Print 
Attachments 
Maintain 
New 
Status 
Setup 
Attachments 
3700566252 
4 Warrant header 
General 
Warrant number: 
Holder: 
Issued date: 
Status: 
Exception flag: 
8/ 12/ 2022 
Stopped 
Exception reason: 
None 
}ueued for positive pay: 
_ocked for reconcile: 
Registered 
Date registered: 
No of days interest: 
0 
Annual interest rate: 
0.000! 
4 Warrant Lines 
12:00:00 am 
Posting 
Invoice: 
Invoice date: 
Paid date: 
Positive pay sent date: 
8/ 15/ 2022 
Agency details 
Agency voucher number: 
Agency claim number: 
Agency low orig: 
Agency PO number: 
Agency sub fund: 
Aoencv dept num: 
D 
Amount Payee 
Account 
3,261.39 
BMD PRINTING AND BUSINESS S... 
210100-520-5090-5040-51036-410 ... 
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.... ...., I / I ~ I Identification of the warrant 
09:00:16 am 
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