SCHEIDER&ASSOC. STRUCTURAL ENG.PDF

INTEROFFICE MEMORANDUM 
Maricopa County Schools Superintendent Office 
TO: 	
CLERK OF THE BOARD 
FROM: 	
Terri Ysaguirre 
SUBJECT: Affidavits — Replacement of Lost Warrants 
DATE: 	
1/27/2020 
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. 
$1,300.00 
#25 	
Liberty Elementary 
Scheider & Assoc Structural Eng 
RECEIVED 
JAN 2 9 Z020 
MARICOPA COUNTY 
CLERK BOARD OF SUPERVISORS

ed to him/her in the sum of $ 	
I/ 3oo  
warrant/check 
.(3) 
Signed: 
(4) 
pt; 
NOTARY PUBLIC 
aqicad  
V M., 
MARICOPA COUNTY 
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. 
c,If\-e (de dr,44,06 5-hfuctwed  (1), being first sworn upon oath deposes and says: 
Name/Claimant 
On or about  
 (date) (2) 
'1 (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 
(5) Subscribed and sworn to before me this  Ph*  day of  a9-Nt1.4-/ZY  20 20  . 
My comm7ion expires: 
V23 2o2.d.  
LORI FRANCES ROSADO 
Notary Public - Arizona 
Pima County 
Commission #515447 
My Comm. Expires Sep 23, 2020 
- (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 
(If known) (6) 
3 7 00 a 30? q3 
Original Date of Issue 
(if known) (7) 
0 Z 1-1/i0/ 6?- 
---- -- 
Reason for original issue of Warrant/Check (8): 
0 Payroll 
X For Services or Goods furnished 	
 
0 Other: 
SAPROCESSES\Warrants - Duplicate or Stale\02 Forrns\Schools\Schools-Warrants Checks notice of daim.doc 
Revised June 2415 	
A.R.S. 11-632 & 15-999 
c(. A _A/Y.0,, Assoc, 	
PO,266,5-4

SCHNEIDER ATIf 
STRUCTURAL ENGINEERS 
January 14, 2020 
Mr. Chris Molitor 
Liberty Elementary School District #25 
19871 West Freemont Road 
Buckeye, Arizona 85326 
RE: 	
Liberty Elementary Bldg B HVAC Unit Replacement 
Buckeye, Arizona 
SSE Project #319041 
LSD PO #200543 
To Whom it May Concern: 
Ronald H. Schneider, Principal of Schneider a Associates Structural Engineers, Inc., d/b/a Schneider 
Structural Engineers, is authorized to sign the attached affidavit. 
Please contact our office with any further questions or clarifications you require. 
Sincerely, 
SCHNEIDER STRUCTURAL ENGINEERS 
Lori Rosado 
Office Manager 
435 East 9th Street I Tucson, AZ 85705 I 520.512.8183 520.512.8169 fax I www.sastructural.com  
CREATING ELEGANT SOLUTIONS