STAMPED & REDACTED - FOR AGENDA ATTACHMENT - AZ SCHOOLS RISK RETENTION TRUST.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
Isaac School Dist #5 AZ Schools Risk Retention Trust 3700694582 | $582,248.00

MCI Stop/Cancel/Void Form

School District | Tsaae Schas! Dishick BS ~~ Wiascopa County
Educatio ice Agency Attachments: [7 Original Warrant
District #: #5 [7 Affidavit
ms T7 Void Report
Voucher Number 50234 I other
Fund pepe nck xumber Amount Warrant Date System Generated Warrant# Payee
loo( = 12 ALowoay M5 SA,d48.00 | 7ge/aas | IAZ Schools isk Keterttion
| [ we
|
\. |
Reason for Stop, Cancel or Void: 7 Check here if to be reissued by MCESA
Check was lostin the mail.
Print Form Pespareee Wank M ariscal ate | I / j / 9023
Approved By: Date: j oe \- aoa

StopCancelReleaseForm.pdf alcd
11/14/11

Schools Affidavit/Claim Form

Application for a Duplicate Warrant/ Check (detinttions ae on page 2)

STATE OF ARIZONA Note: Nurabers on this form correspond to numbers on the
COUNTY OF MARICOPA Instructlon sheet which Is page 2 of this form,

Zz hpols Gisk &
A Seh HS rtemtiod_), being first sworn, upon oath deposes anc says:

On or about 9093 (date{2) a warrant/check was Issued to the
above named person/entity In the amount as stated below. Such warrant/check was
elther never received or was subsequently Inadvertently lost or destroyed and there Is
no reasonable probability of Its belng found or presented for payment, ox It was not
presented for payment within one year after the date of Issuance,

Therefore, under penalty of perjury, clalmant hereby affirms that this claim ts correct
and the amount shown is due and owing, and the applicant requests that a replacement

Warrant/chectfe i issued to him/her in the sum of $. ova 124 yr. ce. (3)
signed: oe (4)
‘or pal dees a3
(5) Subsctibed and sworn to before ine this _\2 —_day of : WC. 2WAD,
Z _ _
NGTARY PUBLIC ” eh, TENNTEER G RICHARDSON
corannission expires: Mebanaeh cana
eA aia cea)

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
i known) (6) o? 00 xd | USO.
Original Date of Issue

(known) (7) Flee / G0)3

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

For Services or Goods furnished
(1 Other:

4/23/24
S:\PROCESSES\Warrants ~ Oupiicate or Stale\02 Forms\Schools\Schor /
Revlsed June 2015 in

\\ THE TRUST

Isaac ESD No. 5

Attn: Steve Watson

4041 N. Central Ave. Ste. 1100
Phoenix, AZ 85012

Dear Steve Watson,

This letter serves as written authorization providing Garrett Mahoney, Client Accounting
Manager of Arizona Risk Retention Trust, Inc. to request a replacement warrant/check for
#28068 by signing the attached affidavit.

Sincerely, .

Ryan Cole

he 51'Executive Director of Arizona School Risk Retention Trust

~ BCHOOL EXPENSE WARRANT:
- TREASURER OF MARICOPA COUNTY. :
PHOENIX, ARIZONA

THIS WARRANT ORAWS INTEREST FROM DATE MARKED ‘INSUFFICIENT FUNDS"
INTEREST STOPS ON DATE FUNDS AVAILABLE, (SFG 11-638, ARS§956)

ISAAC SCHOOL DISTRICT NO. 5

PAY
“*Elve Hundred Eighty Two Thousand Two Hundred Forty Eight and 00/100*** Dollars

6) AZ SCHOOLS RISK RETENTION TRUS
THE
IRDER

OF

iene

3700694582 |

~ CONTROL NO.

09/20/2023

Deteits on Back, 23

ED

_ WARRANT AMOUNT |
$582,248.00
VOID AFTER 365 DAYS

Security Features Included,

Su petite dent Ba 2e0 SIGNATURES

MARICOPA COUNTY SCHOOLS + PHOENIX, ARIZONA

09/20/2023 Check:

AP 20230920
AZ SCHOOLS RISK RETENTION TRUS a | . oe
Payee
Account Number PO Number Invoice Amount
| 240260 223-2020 552,248.00
VOUCHER:

HARLAND CLARKE 122692 20129912

4118/24, 2:42 PM VMware Horizon
Warrant (1 - mcto) - Warrant number: 3700694582, Stopped
oFile = | | Warrant |

se ig) OS
ee] I=] |e?) |
badii Warrant | Status | Print | Attachments
Maintain New Status | Setup | Attachments
3700694582
“4 Warrant header ~ /
General Posting
Warrant number: 3700694582] Invoice:
Holder: Invoice date:
Issued date: 9/20/2023 42;00;00 am Paid date:
Status: Stopped Positive pay sent cate:
Exception flag:
xception flag i Agency details
Exception reason: None

Queued for pasitive pays || Agency claim number:

Agency low orig:
Locked forreconcile: | |

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

Agency voucher number; 5033

‘12:00:40 pra

582,248.00 AZ SCHOOLS RISK RETENTION TRUS PO

I4 @ is eB | ao | oa | Identification of the warrant

https.//horizon.maricopa.gov/portal/webclianti#t/desktop