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MARICOPA COUNTY Department of Finance 301 West Jefferson, Ste 960 Phoenix, Arizona 85003 INTEROFFICE MEMORANDUM Date: October 7, 2020 To: Clerk of the Board From: Beth Brown Department of Finance Subject: Affidavit — Replacement of Lost Warrant Please find attached affidavit for lost 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 has a void/stale date/stop payment done. Please call me at 506-1329 if you have any questions. Please return the approved Affidavit to my attention in the Department of Finance, Suite 960. Thank you. Re: TIDES ON LEMON INVESTORS LLC DEPT 220 FUND 200 Application for a Duplicate or Stale-Dated Warrant/ Check Affidavit/Claim Form This application is for: Duplicate or (JJ State-Dated (definitions are on page 2) STATE OF ARIZONA Note: Numbers on this form correspond to COUNTY OF MARICOPA numbers on the Instructlon sheet which is paae 2 of this form. TIDES ON LEMON INVESTORS LLC (1), being first sworn, upon oath deposes and says: Name/Claimant On or about 19-Aug-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 a) be 0) to exe" $4,500.00 (3) Signed: £2 : _ (4) Cc. Note: Please attach a copy of the warrant/check if available and/or any other evidence that a warrant/check was originally issued. (5) Subscribed and sworn to before me this Gre day of _ Cotober”__-20_ 20. Lf OF NOTARY FUBLIC O == Christopher Gentry +s Sos Notary Public My orm ion expires: Coconino County, Arizona 4/2 My Comm. Expires 02-04-2022 (seal) | eee Warrant/Check Number 3010064391 (if known) (6) Original Date of Issue 9 (iF known) (7) 19-Aug-2020 Reason for original issue of Warrant/Check (8): T 20 2020 EL Payrl Seber 0 For Services or Goods furnished O1 Treasurer's refund/payment Other; Rental assistance payment No Yes Yes COVID-19 EXPENDITURE VERIFICATION Pursuant to Guidance for Local Governments - April 22, 2020, Coronavirus Relief Fund Completed form must be submitted as part of expenditure supporting documentation. Please indicate the following to provide support for potential CARES Act Funding: Were expenditures accounted for in the budget as of March 27, 2020, prior to any potential COVID-19 adjustments? Were the expenditures incurred necessary due to the COVID-19 crisis? Were the expenditures incurred during the period March 1, 2020, to December 30, 2020? Indicate type of COVID-19 Expenditure (check all that apply): Medical expenses such as: © COVID-19-related expenses of public hospitals, clinics, and similar facilities. ¢ Expenses of establishing temporary public medical facilities and other measures to increase COVID-19 treatment capacity, including related construction costs. ° Costs of providing COVID-19 testing, including serological testing. Emergency medical response expenses, including emergency medical transportation, related to COVID-19. ° Expenses for establishing and operating public telemedicine capabilities for COVID-19related treatment. Public health expenses such as: Expenses for communication and enforcement of public health orders related to COVID-19. Expenses for acquisition and distribution of medical and protective supplies, including sanitizing products and personal protective equipment, for medical personnel, police officers, social workers, child protection services, and child welfare officers, direct service providers for older adults and individuals with disabilities in community settings, and other public health or safety workers in connection with the COVID-19 public health emergency. ° Expenses for disinfection of public areas and other facilities, e.g., nursing homes, in response to the COVID-19 public health emergency. * Expenses for technical assistance to local authorities or other entities on mitigation of COVID-19-related threats to public health and safety. * Expenses for public safety measures undertaken in response to COVID-19. ¢ Expenses for quarantining individuals. [| Payroll expenses for public safety, public health, health care, human services, and similar employees whose services are substantially dedicated to mitigating or responding to the COVID-19 public health emergency. Payroll or benefits expenses for employees whose work duties are not substantially dedicated to mitigating or responding to the COVID-19 public health emergency are not eligible expenditures. (Attach COVID-19 Employee Payroll Certificatino Form.) Expenses of actions to facilitate compliance with COVID-19-related public health measures, such as: Expenses for food delivery to residents, including, for example, senior citizens and other vulnerable populations, to enable compliance with COVID-19 public health precautions. Expenses to facilitate distance learning, including technological improvements, in connection with school closings to enable compliance with COVID-19 precautions. * Expenses to improve telework capabilities for public employees to enable compliance with COVID-19 public health precautions. Expenses of providing paid sick and paid family and medical leave to public employees to enable compliance with COVID-19 public health precautions. © COVID-19-related expenses of maintaining county jails, including as relates to sanitation and improvement of social distancing measures, to enable compliance with COVID-19 public health precautions. © Expenses for care for homeless populations provided to mitigate COVID-19 effects and enable compliance with COVID-19 public health precautions. Expenses associated with the provision of economic support in connection with the COVID-19 public health emergency, such as: Expenditures related to the provision of grants to small businesses to reimburse the costs of business interruption caused by required closures. Expenditures related to a State, territorial, local, or Tribal government payroll support program. ¢ Unemployment insurance costs related to the COVID-19 public health emergency if such costs will not be reimbursed by the federal government pursuant to the CARES Act or otherwise. [] Other COVID-19-related expenses reasonably necessary to the function of government that satisfy the eligibility criteria. Describe: Department: [Human Services Name &Title:[Kristen Ralston, Financial Business Anal Phone/Email:[¢ 932-506-2513 kristen. ralston@maricopa.gov] The Robinson Group Professional Real Estate Services Office: (602) 396 — 2000 Fax: (602) 396 — 2034 Web: RobinsonGroupRE.com 8970 E. Raintree Drive, Suite 200, Scottsdale, AZ 85260-7300 October 15, 2020 Maricopa County Department of Finance 301 W. Jefferson, Suite 960 Phoenix, AZ 85003 Dear Beth Brown, |, Jarrod Robinson, authorize Boualy Ratsavong, Administrative Assistant, to execute an affidavit on behalf of Tides on Lemon Owner LLC c/o The Robinson Group. Yours truly, hao Robinson Vice President The Robinson Group 8970 E. Raintree Dr. ste 200 Scottsdale, AZ 85260