STAMPED & REDACTED - FRO AGENDA ATTACHMENT - SHAMROCK FOODS CO.PDF

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: 08/19/2024

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

Riverside Dist #2 Shamrock Foods Co 3700770653 $428.28

Date

Amount

Reissue WT #

Office of the Maricopa County
School Superintendent

Finance Desk
mm 20201016

Warrant Void/Stop Request

District Name / Number: Riverside School District #2

Contact Name: Teresa Solares

Attachments:

Original Warrant

WA Lost Warrant Affidavit (required for ALL reissues)

v Vendor Letter (if requesting Vendor reissue)

Warrant Date |. Amount Payee

(mm/dd/yyyy)

Warrant Number
{starting with “37")

(as it appears in Check Manager)

Void
Stop

Re-issue

3700770653 /5/28/2024|$ 428.28

SHAMROCK FOODS CO

<

Notes:

District Approver: ~ :
¥ MMC LEO

Please stop payment as the warrant is lost and reissue.

Date:

For Internal Use Only

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,

Shamrock Foods Co
Name/Claimant

On or about May 28, 2024 _ (date)(2) a warrant/check was issuéd to the
above named. person/entity in the amount.as, stated below. Such warrant/check was
either never received or was subsequently Inadvertently fost of 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,

_{1), being first sworn, upon oath deposes and says:

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 him/her in the. sum of $428.28 (3)

Signed: st drce Ves, - (4)

(5) Subscribed and sworn to before me this Sale day of A tact 202 v4
NOTARY DOB LIC —_ -
i vo “siti chin cBbemcxtitenssilracilna seica alice at,

My S mmission. expires: Notary Pubtle State of Arizona
rfe3 3° hi 2 x Maricopa County
‘ght?

Annjeanette Colligan (seal)
My Commission Expires 41 312028
Gommieslon- Numb.

635.

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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 Numbe 077
farran feheck pum " 13700770653

‘Original Date of Issue
one noun) 7) 5-28-2024

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

f@ For Services or Goods furnished Food Goods
CO Other: Food Goods

S:APROCESSES\Warrants - Duiplicate or Stale\02 Forms\Schools\$ 8/19/24
Revised Junie 2015 /

SHAMROCK FOODSCO-pDAIRYDIV _—«~Reall Farm. Real Fresh.
2228 North Black Canyon
PHOENIX, AZ 85009

07/30/2024

To Whom It May Concern:

This letter is to request to void check number 3700770653 and reissue a new one. In addition,
Patricia King, the person signing the affidavit, is an authorized representative of Shamrock
Foods Company -— Dairy Division.

Kind Regards,

Ware Maliger
Mark Meltzer

Credit Manager Dairy/Systems/National Accounts

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- SCHOOL EXPENSE: WARRANT:
“TREASURER OF MARICOPA COUNTY:- — ovanaes feed oy
05/28/2024 2059941 |
Riverside Elementary District #2 5
PAY WARRANT AMOUNT &
Four Hundred Twenty Eight and 28/100 Dollars . $428.28 z
: , VOID AFTER 365 DAYS 2
TO SHAMROCK FOODS CO E
ORDER ~ z
¥ Iz Stew te) 5
OFT ee a iw, a supartandont SER co SIGNATURES 4
05/28/2024 Check: 2059941 EXPENSE
MARICOPA COUNTY SCHOOLS + PHOENIX, ARIZONA AP 20240529 3709770853
SHAMROCK FOODS CO | |_ os/2a/2024_ | |
Payee | | Check Date | i
AccountNumber = PONumber Invoice Amount
; Ss Bait NST Tae

| MAY 29 2024

(BU SINES 3S SERVICES)

VOUCHER: 1109 TOTAL: $428.28

HARLANO CLARKE 22692 40108562

8/19/24, 9:46 AM
Warrant (1 - mcto) - Warrant number; 3700770653, Stopped
Fie Warrant |

VMware Horizon

Ny fa N
flit Warrant | Status | Print | Attachments
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Maintain New Status | Setup | Attachments
3700770653
“4 Warrant header
General Posting
Warrant number: Invoice:
Holder: invoice date:
Issued cate: 5/28/2024 12:00:00 am Paid cate:
Status: Stopped Positive pay sent date: 9/29/2024 09:00:43 am
Exception flag: I | Agency details
Exception reason: None Agency voucher number; 1109
Queued for positive pay: | Agency claim number:
Agency low orig:

Locked forreconcile: | | Agency PO number:
Registered Agency sub fund:
Date registered: Agency dept num:
No of days interest: 0
Annual interest rate: 6.00000

, 4 Warrant Lines

O Amount : Payee
428,28 SHAMROCK FOODS CO

Account

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