DEER VALLEY GARDENS APT.PDF

Maricopa County — Formal (2020-12-09)

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MARICOPA COUNTY
Department of Finance

301 West Jefferson, Ste 960
Phoenix, Arizona 85003

INTEROFFICE MEMORANDUM

Date: November 9, 2020
To: Clerk of the Board
From: Walter Chang

Department of Finance

Subject: Affidavits - Replacement of Lost Warrants

Please find attached 1 Affidavits for lost warrants to be included on the next available

Board Agenda.
e The attached items have been researched to ensure the warrant in question
have not been cashed or previously re-issued.

e The original warrants have a void/stale date/stop payment done.

Please call me at 506 - 8747 if you have any questions. Please return the approved

Affidavits to my attention in the Department of Finance, Suite 960.

Thank you.

Re: Fund: 200 / Dept: D220 - Human Services / Company : DEER VALLEY GARDENS APT

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Application for a Duplicate or Stale-Dated Warrant/ Check

Affidavit/Claim Form

This application is for: Duplicate or O stale-Datea (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
page 2 of this form.

DEER VALLEY GARDENS APT (1), being first sworn, upon oath deposes and says:
Name/Claimant

On or about 21-Sep-2020 (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

to him/her i um of $3,000.00 .3)
Signed: cL y

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

(5) Subscribed and sworn to before me this day of 20.
SEE ATTACHED CALIFORNIA NOTARY
NOTARY PUBLIC

My commission expires:
(seal)

Warrant/Check Number 3010067068

(if known) (6)

Original Date of Issue
° (if known) (7) 21-Sep-2020

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

O Payroll
1 For Services or Goods furnished

1 Treasurer's refund/payment
Other: Rental assistance payment

A notary public or other officer completing this certificate verifies only the identity of the
individual who signed the document to which this certificate is attached, and not the truthfulness,
accuracy, or validity of that document.

State of CALIFORNIA

County of ORANGE

Subscribed and sworn to (or affirmed) before me on this 2nd day of November 2020, by
Ana Marie del Rio, proved to me on the basis of satisfactory evidence to be the person(s)
who appeared before me.

Ax pbb.

Notary Public

F
OMM,
NOTARY Mite Cem i)

ORANGE County
Lee” MY Comm Exp, APR. 10, 2022 i

18100 Von Karman Avenue, Suite 500 ¢ Irvine, CA 92612 ¢ Phone: 949-852-0700 ¢ www.steadfastcompanies.com

CERTIFICATE OF INCUMBENCY

I am the Chief Executive Office of Steadfast Companies (“Company”) and the beneficial owner of
Steadfast LB Deer Valley, L.P., which owns Deer Valley Apartments in Sun City West, AZ
(“Property”). I have the power and authority to execute this Certificate on behalf of the Property
owner.

The individual below is authorized to execute and deliver certain documents on behalf of the
Company in connection with the Property and its management, and the signature after the authorized
officer's name below is the genuine signature of such individual.

NAME TITLE (by, 2

Ana Marie del Rio Chief Legal Officer (Ln turBea

Dated: November 2, 2020.

STEADFAST LB DEER VALLEY, L.P.

By:

Rodney F. Emery, CEO
Steadfast Companies

Proceed With Integrity Value People Embrace Opportunity Pursue Excellence Do Good As We Do Well

COUNTY EXPENSE WARRANT = TREASURER OF MARICOPA COUNTY

WARRANT NUMBER

PHOENIX, ARIZON 3010067068
€ Vos W ara’
an fe) 0 DATE
09-21-2020
JPMorgan Chase Bank N.A st-ariaat
Phoenix, AZ
Three Thousand And 00/100 Dollars
YTOTHEOR $3,000.00
PAY TO THE ORDER OF
DEER VALLEY GARDENS APT AMOUNT
15051 W DEER VALLEY DR Void After
ATTN RENTAL OFFICE 365 Days
SUN CITY WEST AZ 85375
For Questions - 602-506-1379 or email AP@MAIL.MARICOPA.GOV NOT NEGOTIABLE
MARICOPA COUNTY DEPARTMENT OF FINANCE
RETAIN THIS FOR | PAYEE WARRANT NO. | WARRANT DATE | WARRANT AMOUNT
YOUR RECORDS
DEER VALLEY GARDENS APT 3010067068 09/21/2020 $3,000.00
INVOICE NUMBER | DESCRIPTION PURCHASE ORDER NO. | VOUCHER NO. AMOUNT
21-112844-09 SHARON MEYER RENTAL ASSISTANCE GAX1D D220 210000004618 3,000.00

210000004618