STAMPED & REDACTED FERGUSON ENTERPRISES_2.PDF

INTEROFFICE MEMORANDUM

Maricopa County Schools Superintendent Office

TO: CLERK OF THE BOARD

FROM: Terri Ysaguirre

SUBJECT: Affidavits — Replacement of Lost Warrants
DATE: 1/6/2022

Please find attached 1 Affidavit/Notice of Claim(s) for lost warrants for inclusion on the next
available Board agenda

v The attached item(s) have been researched to ensure that the warrant(s) in question have
not been cashed or previously re-issued.

Vv The original warrant(s) have had a stop payment done.

If you have any questions, please contact Terri Ysaguirre at 602-372-1245 or via e-mail at
terri.ysaguirre@maricopa.gov. Approved Affidavits may be routed back to the Superintendent
of School Finance Division at 4041 N. Central Avenue #1200, (12th Floor)

Thank you.

#5 Isaac Elementary Ferguson Enterprises $3284.05

sehaols Affidavity/ Cain Forin

Application for a Duplicate Marrant/ Check (definitions are on page?)

STATE OF ARIZONA Note: Numbers on this form correspond to numbers on the
COUNTY OF MARICOP A, Instruction sheet which ts page 2 of this form.

on =

Eelgs usr. Cinlerprses ___(1), being first sworn, upon oath deposes and says:
On or about na is Oo" Hs (date)(2) a warrant/check was issued to the

above named person/entity in the amount as stated below. Such warrant/check was
elther never received of was subsequently inadvertently lost or destroyed and there is
no reasonable probabllity of its being found or presented for payment, or it was not
presented for payment within one year after the date of issuance.

Therefore, uncer 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

wee j 7 /her in the gum of $
Signed: :
AL
(5) Subscribed and sworn to before me this (Q2_day of Ne 20%\_.

— yunenes
we PUBLIC G0 wa09!
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2284.05" 3)

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My cornmission expires: ie &
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Note: Please attach a copy of the warrant/check if available and/or ajip roth
evidence that a warrant/check was originally issued. ananynn¥

Warrant/Check Number
__(if known) (6) i Pennine
Original Date of Issue ‘
if known) (7) : “Tob l Perea

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

if For Services or Goods furnished Goods Tuy nished
C1 Others 2

iat ee

;\PROCESSES\Wanrants - Duplicate or Stale\02. Forms\Schools\schools Warra 01 / 06 / 3022
Revised June 2015 “

4 FERGUSON

HVAC

December 7, 2021

To whom it may concern,

Please be advised that Roger Reed, Market Credit Market for
Ferguson HVAC, Phoenix, Arizona is authorized to sign documents
on behalf of Ferguson HVAC, relating to customer accounts and
financial transactions.

Sincerely,

v

Rion Child
Director of Branch Management
Ferguson HVAC