STAMPED & REDACTED - FOR AGENDA ATTACHMENT - PALOMA SECURITY LLC.PDF

Office of the Maricopa County
School Superintendent

Steve Watson

INTEROFFICE MEMORANDUM

TO: MARICOPA COUNTY CLERK OF THE BOARD
FROM: MCSS FINANCE DESK (ANDIE DE LA ROSA)
SUBJECT: AFFIDAVITS -REPLACEMENT OF LOST WARRANTS

DATE: 06/03/2024

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

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

The original warrant(s) have had a stop payment done.
If you have any questions, please contact the MCSS Finance Desk at 602-372-4833 (Option 1) or

via e-mail at FinanceDesk@maricopa.gov. Approved Affidavits may be routed back to the
Superintendent of Schools - Finance Desk at 4041 N. Central Ave #1100.

Thank you

District Payee Warrant # Amount

Sentinel Dist #71 Paloma Security LLC 3700765185 | $3,002.00

Date

Amount

Reissue WT #

Office of the Maricopa County Finance Desk

School Superintendent ram 20201016

Warrant Void/Stop Request

District Name / Number: Sentinel Elementary School District 71 Attachments:

Contact Name: Agustina Sly [| Original Warrant

Contact a [] Lost Warrant Affidavit (required for ALL reissues)
C] Vender Letter (if requesting Vendor reissue)

Warrant Number | Warrant Date | Amount [

{starting with “37") (am/dd/yyyy}

Payee
{os It appears in Check Manager)

Vold
Stop

Re-Issue

3700765185 05/09/2024] 3002.00 Paloma Security LLC

Notes: Please stop and re-issue

S-2$-24

District Approver: Ob _ ho é) ; Ate, Date:

For Internal Use Only

Clerk of Board Date: Void Report Date:

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.

aloma Secure by LL (1), being first sworn, upon oath deposes and says:

Name/Clatmant

On or about 05 / 09/902U (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 ea him/her in the sum of $3, 00 2.. OO (3)
Signed: (4)
(5) Subscribed and sworn to before me this 3 day of Duane 20.24 .
Ohuscttt Mate —
NOTARY PUBLIC ANNETTE MAYNES
My ee expires: * Gomme # Seana
Or.\2, 202 Expos Orbit (seal)

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 |. . 4)
(if known) (6) 3100 TLS gS _
Original Date of Issue
(tknown) (7) | OD /OF /2v2a Ye
Reason for original issue of Warrant/Check (8):
O Payroll

@ For Services or Goods furnished.
C1 Other:

6/3/24
S:\PROCESSES\Warrants ~ Duplicate or Stafe\02 Forms\Sche /
Revised June 2015 on

06/03/2024

To Whom This May Concern:

I did not receive the check for $3,002.00 that was issued on 05/09/2024 made out to Paloma
Security LLC. This check was to cover invoice# 20250506-1. | have signed the Schools
Affidavit/Claim Form and need a check to be reissued for my services.

George Sanchez
Owner
Paloma Security LLC

6/3/24, 8:49 AM VMware Horizon
Warrant (1 - mcto) - Warrant number: 3700765185, Stopped

Warrant |
FR Uelele

velit Warrant | Status | Print Attachments
¥

___ Maintain New Status | Setup | Attachments oo . _
3700765185
“a Warrant header —_ 7
General Posting i
Warrant number: 3700765185) invoice:
Holder: Invoice dates
Issued cate: 5/9/2024 12:00:00 sm Paid date:
Status: Stopped Positive pay sent date: 5/10/2024 09:00:02 am

Exception flag: ii

k . Agency details
ception reason: None Agency voucher number; 1063
Queued for positive pay: || Agency claim number
. Agency low crig:

Locked for reconcile: |} Agency PO number:
Registered Agency sub fund:
Date registered: Agency dept nur
No of days interest: 0
Annual interest rate: 0.00900

a Warrant Lines :
Cl] Amount | Payee { Account

| Fea] | tdenti ‘ation of the warrant

b bl] 2

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