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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: 5/21/2020 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.vsaguirre@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. #7 Wilson Elementary Norcon Industries Inc $3,318.56 RECEIVED xl0 MAY 2 7: 2020 MARICOPA COUNTY CLERK BOARD OF SUPERVISORS (seal) r ARY PUBLIC My commission expires: /4, 1 2-/ JULIE WOOD NOTARY PUBLIC, ARIZONA MARICOPA COUNTY My Commission Expires February 16, 2021 07/ &/620,2•O Warrant/Check Number if known) (6 Original Date of Issue (if known) (7) 3 57V 0 Reason for original issue of Warrant/Check (8): El Payroll Err For Services or Goods furnished 0 Other: 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. AtNaoreml me/Claim?daskes 2k. (I), being first sworn, upon oath deposes and says: / On or about Aka/try 61c90-0 (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, gr 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 Vg warrant/check b • e sued to him/her in the sum of $ .(3) Signed: V (4) (5) Subscribed and sworn to before me this /2-_ day of Mel- 20..1 . cn-ri Note: Please attach a copy of the warrant/check if available and/or any other evidence that a warrant/check was originally issued. s:\PROcEssEs\warrants - Duplicate or StaleN,02 Forms\Schools\Schools-Warrants Checks notice of claindoc Revised June 2015 A.R,S, 11•632 & 15-999 NoRam INDUSTRIES, INC. AZ LIC. 088670 /088671 NM LIC. 51909 Following a tradition of business in Arizona since 1917 May 12, 2020 I, Edward B. Norris, hereby authorize Ron Brown, Controller to sign Affiriavit/Clai;m forms on behalf of Norcon Industries, Inc. Sincerely, Edward B. Norris President 5412 E. CALLE CERRITOS GUADALUPE, AZ 85283 (480) 839-2324 FAX (480) 839-2281 2480 W. RUTHRAUFF RD., #140P TUCSON, AZ 85705 (520) 325-5752 FAX (520) 325-5753 An affiliate member of the Arizona School Board Association www.norconindustries.net Invoice Data invoice # 1/30/2020 159110 Norcon,Industries, Inc Phone 480-839-2324 PO Box 61988 Fax 480-839-2281 Phoenix, AZ 85082 Bill To Wilson ESD Accounts Payable 3025 E. Filhnore Street Phoenix, AZ 85008 Terms Mohave Contract No. PO Number Job Name Job Number Net30 191-NOR1-1015 200516 Wilson ES 19-1021 Item Description Est Amt Prior Amt Prior % Qty Rate Curr % Total % Amount Bleacher... Phase 1: General Maintenance Service for Hussey Maxam Bleachers in the Main Gym (2) Banks 3,318.56 3,318.56T Subtotal $3,318,56 Sales Tax (0.0%) moo Total $3,318.56 Payments/Credits moo Balance Due $3,318.56