REDACTED - FOR AGENDA ATTACHMENT - LAKE MEAD NATIONAL RECREATION AREA.PDF

v
MAR) COPA
COUNTY

Office of Budget & Finance
301 W. Jefferson St., 9* Floor
Phoenix, Arizona 85003

P: 602-506-3561
F: 602-506-4451

Maricopa.gov

To: Clerk of the Board

From: Office of Budget & Finance, Accounts Payable
Date: 3-21-2024

Subject: Affidavit — Replacement of Lost Warrant

Please find attached one Affidavit for a lost warrant to be included on the next
available Board Agenda.

* The attached item has been researched to ensure the warrant in question has not
been cashed or previously re-issued.

e The original warrant is presumed lost.

Please call Walter Chang at 506-8747 if you have any questions. Please return the
approved Affidavit to my attention in the Office of Budget and Finance, 9" Floor.

Thank you.

Re: Fund : 230 / D300 - Parks and Recreation / Lake Mead National Recreation Area

Application for a Duplicate or Stale-Dated Warrant/ Check

Affidavit/Claim Form

This application is for: L] Duplicate or [¥] Stale-Dated (definitions are on page 2)

STATE OF ARIZONA Note: Numbers on this form correspond to

COUNTY OF MARICOPA numbers on the Instruction sheet which is
paae 2 of this form.

Lake Mead National Recreation Area (1) being first sworn, upon oath deposes and says:
Name/Claimant

On or about 31-Jan-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 ¢ 23,000.00 .(3)

Signed: Ate Ss ZILLA an (4)

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

(5) Subscribed and sworn to before me this aor day of Maro. 202 j

NOTARY PUBLICY =‘ ()  { > LESLEY HARVEY
: Notary Public, State of Nevada
My commission expires: M Pe Bi sy te +5, 2027
: ly Appt. Exp. Oct. 15,
JO—|5 -o ¥ (seal)

Warrant/Check Numb
m einen) ‘a “13010142050

Original Date of Issue
(if known) (7) 31-Jan-2023

Reason for original issue of Warrant/Check (8):
OO Payroll
For Services or Goods furnished / 2306-0801 SC Invasive Species Treatments - DFFM Grant

O Treasurer's refund/payment
Fl Other; / check presumed lost / fund : 230 , initiated by the vendor/TF

United States Department of the Interior

A, NATIONAL
3 PARK

NATIONAL PARK SERVICE

ee
Pd
|

IN REPLY REFER TO:

March 19, 2024

I, Scott Briggs, authorize Curt Deuser, Supervisory Ecologist, to execute an affidavit on behalf of Lake Mead
National Recreation Area.

Yours truly,
Scott Briggs
Supervisory Financial Administration and Program Analyst

n neous
= Fry
= ean
Se meron
= eer
— Se
=
==
st
=
Heretne wos
<ca preaearaicopeg 7 ore @

TR Date: 3/20/ reasurer

@ Dashboard
Fie Import Accountinquiry Warrant Inquiry CreditLine  PooledFunds —_Reports

Warrant Results

[com GBlexce Gcsv ror Berm Sean show ~ entres

Worrant Number

001 $23,001 00

‘Account Numba u
na Tot Amoust (AB Suarchad Records) $23,00000

reemancopage 7 or @@

>er014208

Warrant Number - 3010142050

Repistered Date

Poree

Amount
teomest x
Owe

Pos

a

4
MARICOPA ==

COUNTY mn enemas ina
wean,
be younewesscen sa ea a amen
amy,

Vv
MAR)COPA
COUNTY

Helo Cec Agena
Presse formar to COB for even

COUNTY ‘Exact ener Tater | | tan

lots
MARICOPA ===

e@oers