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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: 4/23/2020 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. Vv 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. #5 Isaac Elementary Miner Southwest $726.00 RECEIVED °o* onde’ dul 044 AUG 28 2020 _ MARICOPA COUNTY CLERK BOARD OF SUPERV!SORS as a ww coer © MCESA Schools 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. MAtner Leryn. (1), being first sworn, upon oath deposes and says: Name/Claimant On or about _ 4 / tal 14 (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 fs due and owing, and the applicant requests that a replacement rn to him/her in the sum of $_ 7oG@ , 2& 3) Signed: 4 g 72S (4) (5) Subscribed and sworn to before me this Gh day of March 2020 . NOTARY POBLEe — - TIFFANY CARLOCK ~ My commission expires: No S- 25-202 fi My se bad aad (seal) May 25, 2021 Note; Please attach a copy of the warrant/check if available and/or any other evidence that a warrant/check was originally issued. Warrant/Check Number E (if known) (6) 3700 227074 SEp+O-2-2020 Original Date of Issue DA,E_Y : (if known) (7) Q& -le-14 Ay Reason for original issue of Warrant/Check (8): O Payroll For Services or Goods furnished O Other: S:\PROCESSES\Warrents - Duplicate or Stale\02 Forms\Schools\Schools-Warrants Checks notice of daim.doc Revised June 2015 ARS, 11-632 & 15-999 3/2/2020 DashBoard Warrant Number - 3700227079 Status Issued Account # 210100-510-5005-5040-50342-4100-—-- Paid Date issuad Date 09/12/2019 Registered Date Payee MINER SOUTHWEST Amount $726.00 interest : $0.00 Glalm # Sub Fund Dept # PO# LowOrig Voucher 1646 hitps://traasurer.maricopa.goviAgencyWeb/Dashboard# 1A Customer PO: EAM#364120 SERVICE REPORT Customer: 18TH ST WATER PLANT #1 Address: 501 W. 18TH ST BUILDING 10 TUCSON, AZ 85701 Contact: Phone: E-Mail: Miner, Ltd 1101 W Grant Rd #201 Tucson, AZ 85705 (620) 202-3350 Phone servicemsw@minercorp.com Date: 8/18/2020 Job #: WO-00465800 Installed Product: South Exit gate Customer Asset #: 335-GAT-08B Equipment Type: Sliding Gate Make: Hysecurity Model: 222SS Work Performed: Note Type Notes Arrived on site found south exit off. Turned power on and downloaded history. Error codes were ALE12 outside loop on for more Work Performed than 5 minutes. Went to test loop, and power tumed off to detector. Found that by moving detector, power would turn off and on. Found that 24+ terminals on power supply board would lose voltage. Was able to move loop detector to 24+ on contro! board. Also found power supply board is suppling to much power. Board has 32 volts coming out. Power supply needs replaced. Time On Site: Technician Name Work Description Start Date and Time End Date and Time Tim Quattlander Troubleshoot gate 8/18/2020 2:00 PM 8/18/2020 3:00 PM Materials: Billing Quantity L Part l Work Description ] Expenses: Billing Quantity I Expense Type L Work Description | Travel: Billing Quantity Activity Type Work Description — 4 Standard Labor Travel Recommended Service: Note Type Notes Recommended Service Need power supply board for Hysecurity 222 ss st. Serial number so-#2.00-21073 Printed Name: 4PM % Hour Minimum On-Site + On-Site Labor Billed in % Hour Increments « Normal Business Hours are Mon-Fri 7:30 -5:00pm (excluding holidays)