STAMPED & REDACTED - FOR AGENDA ATTACHMENT - ACCEL.PDF

Maricopa County — Formal (2024-11-06)

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Office of the Maricopa County
School Superintendent

Steve Watson

INTEROFFICE MEMORANDUM

TO: MARICOPA COUNTY CLERK OF THE BOARD
FROM: MCSS FINANCE DESK (ANDIE DE LA ROSA)
SUBJECT: AFFIDAVITS -REPLACEMENT OF LOST WARRANTS

DATE: 10/10/2024

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 602-372-4833 (Option 1) or

via e-mail at FinanceDesk@maricopa.gov. Approved Affidavits may be routed back to the
Superintendent of Schools - Finance Desk at 4041 N. Central Ave #1100.

Thank you

District Payee Warrant # Amount

Saddle Mtn Dist #90 ACCEL 3700770757 | $12,183.56

Date

Amount

Reissue WT #

Office of the Maricopa County

Finance Desk
School Superintendent sm 2e201016
Warrant Void/Stop Request

District Name / Number: SMUSD 90 Attachments:

Contact Name: Crystal Mondragon [] Original Werrant

Contact “— Cll tst~—s—sSY Lost Warrant Affidavit (required for ALL reissues}
lv] Vendor Letter (if requesting Vendor reissue}

Warrant Number Warrant Date | Amount Payee

{starting with “37") fom /dd/yyyy}

{as it oppeors in Check Manager)

3700770757) 5/29/2024 |$ 12,183.56

ACCEL

Notes: Lost check

District Approver: fd. Walle

For Internal Use Only

Date: 40/2/2024

Clerk of Board Date:

Void Report Date:

Schools Affidavit/Claim Form

Application for a Duplicate Warrant/Check (dotinitions are on page 2)

STATE OF ARIZONA Note: Numbers on this ferm correspond to numbers on the
COUNTY OF MARICOPA instruction shea! which is page 2 of this form,

ACCEL (1), being first sworn, upon oath deposes and says:
Rame/Clainiant
On or about 5/39 [aH (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 destrayed 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

watrant/check be issued to him/her in the sum of 394 2,183.56 (3)
Signed: ZX AIO tecpho ) (4)

===]

(5) Subscribed and sworn to before me this ! of day of Ochapor 20.24.

SONGS dessin

MELISSA DENISE

Notary Public, State SUARON
Maricopa County

Commission # 663100

My Commission Expires
January 16, 2028 (seal)

BL

"SS SS

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

W heck Numb
arrant/Check © {3700770757

Original Date of Issue
i Gf known) (7). 5/29/2024

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

@ For Services or Goods furnished SPED services
© Other; SPED services

S:APROCESSES\Warrants + Ouplicate or Stale\o2 Forms\Sch 10/15/24
Revised June 2015 ‘ 999

Accel

To whom it may concern:

As the Accounting Manager, Sharon Fischer Is an authorized representative of Accel. Please
proceed with processing our request for reissue of check # 3700770757 in the amount of
$12,183.56,

ronica Sas, EA
Chief Financtal Officer

10/40/24, 8:25 AM

Warrant |

Warrant (1 - mcto) - Warrant number 3700770757, Stopped

a  — ) sid) 88
tohi Warrant | Status | Print | Attachments
y
Maintain New Status | Setup | Attachments

VMware Horizon

3700770737

4 Warrant header
General

Warrant number;

3700770757)

Posting

lavoice:

Holder: Invoice date:
Issued date: Paid date:
Status: Stopped Positive pay sent date:
Exception flag: I Agency detatls
Exception reason: None Agency voucher number; 2497
Queued for positive pay: | | Agency claim number:
Agency low orig:

Locked for reconciles | | Agency PO number:
Registered Agency sub fund:
Date registered: Agency dept num:
No of days interest: 0
Annual interest rate: 0.00000

« Warrant Lines
co: Amount : Payee Account

12,183.56 ACCEL

|

hitos://horizon.maricopa.gov/portal/webollenti#/desktop

b bl | eo | 9} | identification of the warrant

in