STAMPED & REDACTED - FOR AGENDA ATTACHMENT - THERAPY TRAVELERS.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: 08/06/2024

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

Roosevelt Dist #66 Therapy Travelers 3700759390 | $2,600.00

Date

Amount

Reissue WT =

Olffce of the Maricopa County
School Superintendent

Warrant Void/Stop Request

District Name / Nuinber: Roosevell School District 66

Contact Nome: Gabriela German

“ones

Finanev Dest,
mmas 20201016

Attachments:

LE] Orlginal Worrant

[V1] Lost Warrant Affidavit (required for ALL raissues)
C] Vendor Letter (if requesting Vendor relssve}

Warrant Number Warrant Date | Amount Payee

(itorting with “37°) (mm/dt/yyyn) » | (ortt appear in Check Manager}

Void
Stop

Re-issue

3700759390} 4/23/2024 /$ 2,600.00

Therapy Travelers

ORO}

©oU

Notes:
Relssue of warrant.

District remo | WK IQen Date: 8/5/2024

Vor duteread Use on 1) C 5
Clerk of Board “O Vold Report Date:

Schoois 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.
Therapy Travelers (1), being first sworn, upon oath deposes and says:
jes Mt
On or about 94/23/2024 (dale)(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 him/her in the sum of $2,900.00 (3)

Signed:

(5) Subscribed and sworn to before me this_2°¢ day of ____ AUSUSt_ 29 24

NOTARY PUBLIC Bay Poke DIANA SABINA DUMITRESCU
‘ Notary Public - State of Florida
My commission expires: Blu Conymission f? HH 420158
wyxanaxx 07/26/2027 2 Explras on July 26,2027 (seal)
aia

Hotarized remotely online using communication teclnology via Proof

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

Mreriimeme [6692345 AAQDAG PAD HAW

Original Date of Issue ,
9 (if known) (7) 04/23/2024

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

For Services or Goods furnished
0 Other:

Si\PROCESSES\Worraits - Duplicate or Stale\02 Forms\Schools\Schoots-Warrants Chiecl 8 / 06 / 24
Revised June 2015

Docusign Envelope 1D: 40378253-8F 9C-4AFF-925B8-288E052BASEC

August 2, 2024

Roosevelt School District No, 66

RE: Missing TherapyTravelers Check 66923345

Dear Sit/Madam,

This letter is to request a reissmance of check number 66923345 issued around 4/23/2024 for $2,600, This check has not
yet been received and was cither Jost or destroyed and there is no reasonable probability of it's being found or presented for payment.

Please reach out if you have any questions,
Sincerely,
“-—-ocuSigned by: DocuSigned by:
Nathan Wogaicht Melanic luderson,
DEBA/SO7SETEAF2., —-0901F 562290451,

Nathan Woznicki, Controtler Mel Anderson, Billing and Collections Supervisor

Thorapytrovators Ivnew Epke Syraciat Educators Stating. 4

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Eple Spectal Education Staitiny,

@ Natian Woznicki {| Controtter

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8/6/24, 11:22 AM
Warrant (1 - meto) - Warrant number: 3700759390, Stopped

VMware Horizon

Warrant | me
hin Warrant | Status ] Print | Attachments
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____ Maintain New Status | Setup | Attachments _. -
3700759390

General Posting

Warrant number: 3700759390) Invoice;

Holder: Invoice date:

Issued cate: 4/23/2024 42:00:00 am Paid date:

Status: Stopped Positive pay sent date: = 4/24/2024 09:00:24 am

E tian flag:

Exception flag i Agency details

Exception reason; Mane

Queued for positive pay: |]

Locked fer reconcile; | |
Registered

Date registered:

No of days interest: 0

Annual interest rate; 0,00000

Agency voucher number: 2080
Agency claim number:

Agency low arig:

Agency PO number:

Agency sub fund:

Agency dept num:

« Warrant Lines

Oo Amount : Payee
2,600,00 Therapy Travelers, LLC

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B& bl | ae | 9) | Identification of the warrant

Account

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