STAMPED & REDACTED RAPTOR TECHNOLOGIES.PDF

INTEROFFICE MEMORANDUM

Maricopa County Schools Superintendent Office

TO: CLERK OF THE BOARD

FROM: Terri Ysaguirre

SUBJECT: Affidavits - Replacement of Lost Warrants
DATE: 11/30/2021

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.

#509 Maricopa County Regional Raptor Technologies $7,017.00

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.

Rapotor Technologies, LLC (1), being first sworn, upon oath deposes and says:

Name/Claimant

On or about 7/26/2021 (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, 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

warrant/check be issued to hing, er in the sum of $7,017.00 .(3)
oo , / } +
Signed: <x t rel? (4)
(5) Subscri to before me this ite day of Oz[— 202 .
C-
NOT ¥ PUBLIC
LAURI YAGER WRAY
My commission expires: Notary #125086721
AC i 2e a c " ovenber 8 2081" (seal)
Note: Please attach a copy of the warrant/check jf ~~~" t= ~—-1"
evidence that a warrant/check was originally issued.
Warrant/Check Number 12/07/2021
Weronyereckiume (3700449644.

r
Original Date of Issue
ome eae’ |7/26/2021
Reason for original issue of Warrant/Check (8):
QO Payroll
% For Services or Goods furnished Technoloey -Nisiter Manat Sy Sten
O Other:

S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Schools\Schools-Warrants Checks notice of claim.doc
Revised June 2015 A.RS. 11-632 & 15-999

RAPTOR’

TECHNOLOGIES

THE GOLD STANDARD IN SCHOOL SAFETY

November 3, 2021

Maricopa County Regional School District 509

To whom it may concern:

Please cancel check number #3700449644 and reissue check for invoice INV18363, in the amount of
$7,017.00. Please refer to the affidavit included with this request.

This letter also confirms that Donald Schad, signer of the affidavit, is the CFO of Raptor Technologies,
LLC and is an authorized signer for the Company.

Sincerely,

Kelly Jones
Collections Specialist

O:

Houston, TX 77008 |