STAMPED & REDACTED - FOR AGENDA ATTACHMENT - AURELIE FLORES COSTUMES.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: 04/23/2024

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
Queen Creek Dist. #95 Aurelie Flores Costumes 3700663410 $3,750.00

Date

Amount

Reissue WT #

Office of the Maricopa County

School Superintendent

District Name / Number: QCUSD 95

Contact Name: Andria Johnson

Finance Desk
mm 20201016

Warrant Void/Stop Request

— = Po

Attachments:

[| Original Warrant
Lost Warrant Affidavit (required for ALL reissues)

Vendor Letter (if requesting Vendor reissue)

(starting with “37") (mm/dd/yyyy)

Warrant Number Warrant Date

Amount Payee

(as it cppears in Check Manager)

Void
Stop
Re-issue

3700663410) 6/20/2023

$ 3,750.00 |AURELIE FLORES COSTUMES|O ©

©OU

©OU

©OU

Notes: VENDOR DID NOT RECEIVE CHECK DUE TO INTERUPTION IN MAIL SERVICE TO HER HOME. € a
\

+

District Approvér: s )
fale ia To hus ort ea

4
A

Date: 4/48/2024

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

COUNTY OF MARICOPA Instruction sheet which is page 2 of this form.

Note: Numbers on this form correspond to numbers on the

AURELIE FLORES COSTUMES _ (1), being first sworn, upon oath deposes and says:

Name/Claimant

On or about 96/20/2023 (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 be issued to him/her in the sum of $3750.00 (3)

Signed Alin re 7 | (4)
\ a

(5) at meena me this_|{ day of [1h E nl 20s

NOTARY PUBLIC

CASSANDRA KENNEDY
Notary Public - State of Arizona
PINAL COUNTY
Commission # 629036

Expires May 8, 2026 (seal)

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

a ico 3700663410
ae _\oewomo23

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

O Payroll

@ For Services or Goods furnished__

O Other:

S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\School:

Revised June 2015

AURELIE FLORES

COSTUMES

04/19/2024

Dear Sir or Madam,

1 am writing to inform you that | have permission to sign on
behalf of Aurelie Flores Costumes. | own the business and
am solely responsible for the financial matters of the

company.

Thank you for your help in resolving this issue with the lost

check.

Sincerely,
Aw da

Aurelie Flores

4119/24, 11:00 AM VMware Horizon

Warrant (1 - mcto) - Warrant number: 3700663410, Stopped
Warrant |

: |
| Warrant | Status | Print | Attachments |
Maintain _ New | Status | Setup | Attachments |

3700663410
« Warrant header
General Posting
Warrant number: Invoice:
Holder: Invoice date:
Issued date: 6/20/2023 12:00:00 am Paid date:
Status: Stopped Positive pay sent date: 6/21/2023 09:00:26 am
Exception flag: Agency details
Exception reason: None

Agency voucher number: 6278
Queued for positive pay: »“) Agency claim number:
Agency low orig:
Locked for reconcile:

Agency PO number:
Registered Agency sub fund:
Date registered: Agency dept num:
No of days interest: 0
Annual interest rate: 0.00000
« Warrant Lines
Oo Amount Payee Account

Hd bp p| Zs

2) | Identification of the warrant

https://horizon.maricopa.gov/portal/webclienti#/desktop