STAMPED & REDACTED - FOR AGENDA ATTACHMENT- FERGUSON ENTERPRISES, INC.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: 03/27/2024

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
Litchfield Dist #79 Ferguson Enterprises, Inc 3700734346 | $2,183.74

Date

Amount

Reissue WT #

Office of the Maricopa County

School Superintendent

Warrant Void/Stop Request
District Name / Number: Lach etd Elem enhary / 74 Attachments:
Contact Nome: Hever ly Warstatl

Finance Desk
mara 20201016

| Original Warrant

Lost Warrant Affidavit (required for ALL reissues)

[O}) Werder Letter (if requesting Vendor reissue}

Warrant Number Warrant Date | Amount Payee D ao ©
{storting with “37") {mm/dd/yyyy) {est oppears In Check Manager) g é 3
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3700773434 | orfor/aor4| 2183-24 |FERGuION EnteRPRISES, INC. © OY

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For Internal Use Only

Clerk of Board Date:

Void Report Date:

20240327092155107.pdf file:///C:/Users/marstal |/Downloads/20240327092 155 107.pdf

Schools Affidavit/Cialm Form

Application for a Duplicate Warrant/ Check (definitions are on pago 2)

STATE OF ARIZONA Note: Numbers on this form carrespond to numbers on the
COUNTY OF MARICOPA "Instruction sheet whioh Is page 2 of thle form.

FERGUSON ENTERPRISES, INC(1), belng first swom, upon oath ee and says:

On or about 92/01/2024 —_(ete)(2) a watrant/check was Issued to the
above named person/entity In tha amount as stated below. Such warrant/check was i
elther never recelved or was subsequently Inadvertentty lost or destroyed and there Is a
no reasonable probability of {ts being found or presented for payment, ar it was not et
presented for payment within one year after the date of Issuance, '

Therefore, under penalty of perjury, clalmant hereby affirins that this. claim Is correct
wife amount shown Boneionea s _ me So SERRE OME LA RORRERORE

Wotes Please alah 2 copy ofthe weronteteck avalible ender an othe F
_ edence that a waranteek Was evlahaly ued fo ee Bee Fi

Bi For Services or Goods shad. haere oral ohare el 3
Gi Other: 5 3

'S;\PROCESS Es\Wacmts ~ Dupticata or Staic\02 Forms\Sthoo’|\Schools Warrants Chedss notice of daim.doc
Revised Juno 2015 = ARS. 15-632 & 15-999

3/29/24

2 of 2 +A}

20240327092155107.pdf

file:///C:/Users/marstall/Downloads/20240327092155107.pdf

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To Whom It May Concern:

A Ser uwd tree

Regional Credkt Sager SW Region
Ferguson Enterprises

1 of 2

3/27/2024, 8:24 AM

3/22/24, 11:11 AM VMware Horizon
Warrant (1 - mcto) - Warrant number; 3700734346, Stopped

Va ras if G
Yi ae ~ |
Warrant Status Print = Attachments
Maintain New Status Setup Attachments
3700734346
4 Warrantheader a cae
General Posting
Warrant number: 3700734346 Invoice:
Holder: Invoice date:
Issued date: 2/1/2024 12:00:00 am Paid date:
Status: Stopped Positive pay sent date: 2/2/2024 09:00:16 am
Exception flag:
E pion Mag Agency details
epee a none Agency voucher number: 6065
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
4 Warrant Lines
oO Amount Payee Account

2,183.74 FERGUSON ENTERPRISES, INC Po

lq <4: Pb Dl | 2 | 9) | Identification of the warrant

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

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