REDACTED - FOR AGENDA ATTACHMENT - DESERT VIEW COUNSELING AND CONSULTING.PDF

<

kL
MAR' COPA
COUNTY

Office of Budget & Finance
301 W. Jefferson St., 9" Floor
Phoenix, Arizona 85003

P: 602-506-3561
F: 602-506-4451

Maricopa.gov

To: Clerk of the Board

From: Office of Budget & Finance, Accounts Payable

Date: 06.28.24

Subject: Affidavit — DESERT VIEW COUNSELING AND CONSULTING

Please find attached one Affidavit for a stale dated warrant to be included on the next
available Board Agenda.

e The attached item has been researched to ensure the warrant in question has not
been cashed or previously re-issued.

e The original warrant is presumed lost.

Please call Marcia Bulanda at 506-7291 if you have any questions. Please return the
approved Affidavit to my attention in the Office of Budget and Finance, 9" Floor.

Thank you.

Re: Fund 219 — GAXIF 23*06988 — D190 COUNTY ATTORNEY - 1909243-1-rqst2 -
VICTIM COMPENSATION CHECK

Application for a Duplicate or Stale-Dated Warrant/ Check
Affidavit/Claim Form

This application is for: O Duplicate or Stale-Dated (definitions are on page 2)

STATE OF ARIZONA Note: Numbers on this form correspond to
COUNTY OF MARICOPA numbers on the instruction sheet which is

paae 2 of this form.
being first sworn, upon oath deposes and says:

Desert View Counseling And Consulting (1)
Name/Claimant ,

On or about 28-Oct-2022 (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 him/her in the sum of ¢/62.77 (3)

nena a

Signed: __. a a (4)

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

(5) Subscribed and sworn to before me this 72s day of “Sort 20°

NOTARY PUBLIG.

DENNIS D THOMPSON
ON Notary Public - Arizona

aoe : i Cs
My commission expires: are 3010

ogee 3 OZER, TF my Comm. Expires Mar 1, 2028

TER

(seal)

Wi t/Check Numb
arrant/Check Number 13040432648

Original Date of Issue
one" Ge known) () 28-Oct-2022

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

1 Payroll

0 For Services or Goods furnished

(1 Treasurer’s refund/payment

Other: Victim Compensation Check: 1909243-1 Req 2

SEES,

ee

@mm@ Desert View Counseling
=, Balancing Life’s Challenges

a =<
Phone EE —i—
Date: 06/20/2024
To: Maricopa County Attorney's Office

From: Desert View Counseling & Consulting

Subject: Check for Victim Compensation Case #: 1909243-1

Subject 2: Shaniece Randolph - $762.77 - Not Cashed

To whom it may concern,

My name is Joseph Zamora and my official title at Desert View Counseling and Consulting Inc, is Director of Finances
and Operations. Furthermore, | also have a 50% owners stake in Desert View Counseling Consulting Inc. As part
owner and having a directors title at the company I am able to sign on on behalf of Desert View Counseling and
Consulting Inc. Lastly, I am including the original check in the enclosed paperwork.

Sincerely,

Joseph Zamora

Director - Finance/Operations

Desert View Counseling and Consulting Inc.
Phone:

Website -

[-— Nee

Signature: _“

Date: le loo/ 9024

(C] Agency Status _ Warrantnumber issued date Paid date Amount
+ 301037648 + . . .

_ —

Warrant qumber:

Amount Payee Account

J6R77 DESERT VIEW COUNSELING & CONSL |

226 Wi, Madison St
Phoenix, AZ 85003
www. maricopacountyattorney.arg

5.

filaricopa County Attorney's Office

October 26, 2022

Desert View Counseling And Consulting

Victim Compensation Case #: 1909243-1

Victim Name: Shaniece Randolph

Enclosed is a check for the following decision made by the Victim Compensation Board on 10/05/2022

Request Provider Account Type of Service Dates of Service —_ The Victim Compensation :
Number | Board Approved Payment of:
2:Desert View 10007627-1/ © MENTAL 10/28/2020 - $762.77
Counseling And 10008084-1 HEALTH 05/13/2022 (60
Consulting DOs)

Based on the Subrogation Agreement that the Victim or Claimant signed during the completion of the original
application, monies received from restitution, settlements and/or insurance MUST be reimbursed to the Victim
Compensation Program.

Please be advised that the enclosed amount does not reflect payment or reimbursement on ALL of the bills that Victim
Compensation Services has received, In some circumstances, it is necessary to obtain additional documentation.
Thank you for your patience, as this process can take some extra time. If there are any additional bills or out of pocket
expenses, please contact me at

Sincerely,

Luis Barzotti

Victim Advocate
Victim Compensation Services

R OF MARIC

PHOENIX: ARIZONA

DATE
10-28-2022

Seven Hundred Sixty Two And 77/100 Dollars

PAY TO THE ORDER OF

DESERT V CONSU
Void After
365 Days

For Questions - 602-506-1379 or email AP@MAIL.MARICOPA.GOV
MARICOPA COUNTY DEPARTMENT OF FINANCE

91-2/1221

“WARRANT NUMBER
3010132648

$762.77

AMOUNT

220 cl.

CHAIRMAN

NOT NEGOTIABLE

RETAIN THIS FOR | PAYEE WARRANT NO. | WARRANT DATE | WARRANT AMOUNT
YOUR RECORDS
DESERT VIEW COUNSELING & CONSU 3010132648 10/28/2022 $762.77
INVOICE NUMBER | DESCRIPTION PURCHASE ORDER NO. | VOUCHER-NO. AMOUNT
00000065273K 1909243-1-rqst2 GAXIF D190 230000006988 762.77

230000006988

CA