AMERICA'S SUPPLIERS INC.PDF

Maricopa County — Formal (2020-10-21)

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INTEROFFICE MEMORANDUM

Maricopa County Schools Superintendent Office

TO: CLERK OF THE BOARD

FROM: Terri Ysaguirre

SUBJECT: Affidavits — Replacement of Lost Warrants
DATE: 9/28/2020

Please find attached 1 Affidavit/Notice of Claim(s) for lost warrants for inclusion on the next
available Board agenda

v The attached item(s) have been researched to ensure that the warrant(s) in question have
not been cashed or previously re-issued.

v The original warrant(s) have had a stop payment done.

If you have any questions, please contact Terri Ysaguirre at 602-372-1245 or via e-mail at
terri.ysaguirre@maricopa.gov. Approved Affidavits may be routed back to the Superintendent
of School Finance Division at 4041 N. Central Avenue #1200, (12th Floor)

Thank you.

#59 Laveen Elementary America’s Suppliers Inc $9,617.15

RECEIVED - tt mw

SEP 80 2020

MARICOPA COUNTY
CLERK BOARD OF SUPERVISORS

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

This application is for: Duplicate or 1 state-Dated (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.

America's Suppliers, Inc.
Name/Claimant

On or about _August 25, 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.

(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 Reh of $9,617.15 (3)
Signed: Aleyanabva. (4)

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

(5) Ligh and we me this ) day of Segresmloo 2020 ,
_ H

NOTARY PUBLAC Aurelio Goytia ur

Notary Public
My commission expires: Maricopa County, Arizona
oe) zy yore My Comm. Expires Geeteor al)

Wi t/Check Numb
ae : ‘ace Pd "13700348819

Original Date of I
rigina brane oe 08/25/2020

Reason for original issue of Warrant/Check (8):
O1 Payroll

For Services or Goods furnished

OO Treasurer's refund/payment
O Other:

S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Warrants Checks notice of claim - Copy.doc
Revised April 2015 A.R.S. 11-632 & 11-644

DiFLLARDAYS

Laveen School District

Attn: Cynthia Sanchez/Accounts Payable
5001 West Dobbins Road

Laveen, Arizona 85339

September 18, 2020
Dear Cynthia:

I, Alex Barrientos, a representative of DollarDays International, Inc., state that payment for
services provided to the Laveen school District was not received. The check was mailed to a
previous remit address, and has been declared lost in the mail. Payment is in the amount of
$9,617.15.

Thank you,

Alex Barrientos
Staff Accountant
(480) 922-8155 x176

3033 North 44th Street | Suite 330 | Phoenix, Arizona 85018 | Phone: +1 (480) 922-8155 | Fax: +1 (480) 922-2476

a RTS ERS, pn ST em aS SS i

WAY TO SHOP!

Laveen School District
Attn: Cynthia Sanchez
5001 W. Dobbins Rd
Laveen, AZ 85339

October 1, 2020

Alex Barrientos is an authorized signer for DollarDays International, Inc.

anks,

Chris Usdrowski

Controller

DollarDays International, Inc.

3033 N. 44" Street, Ste. 330 | Phoenix, AZ 85018
Phone (480) 922-8155 x163 | Fax (480) 922-2476
cusdrowski@DollarDays.com
www.DollarDays.com

3033 North 44th Street | Suite 330 | Phoenix, Arizona 85018 | Phone: +1 (480) 922-8155 | Fax: +1 (480) 922-2476