STAMPED & REDACTED - FOR AGENDA ATTACHMENT -GLEIBERMAN PROPERTIES INC.PDF
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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: 03.01.24 Subject: Affidavit — Gleiberman Properties Please find attached one Affidavit for a duplicate lost/stolen warrant to be included on the next available Board Agenda. e 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 Marcia Bulanda at 506-7291 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 222 — D220 Human Services — GAX1D 24*11088 & 24*11130 - Tapia, Deborah --Rental Assistance Application for a Duplicate or Stale-Dated Warrant/Check Affidavit/ Claim Form This application is for: [J Dupticate or (J Stale-Dated (definitions are on page 2) STATE OF ARIZONA Note: Numbers on this form correspond to | COUNTY OF MARICOPA tiumbers on the Instruction sheet which is i page 2 of this form. GLEIBERMAN PROPERTIES INC (1), being first sworn, upon oath deposes and says: “Namelcman On or about 22-Dec-2023 (date)(2) a warrant/check was issued to the above named person/entity in the amount as staled 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 $2,961.34 (3) NS | Note; Please attach a copy of the warrant/check if available and/or any other : | evidence that a watrant/check was originally issued. | (5) Subscribed and ey me, this ay of ___ Fe 2024. | Wh gea~ | NOTARY PUBLIC My commission expires: aye 2b OLGUIN one Wa Check Number sia rer miy 3010169580 Original Date of Issue mane (if incon) (2) 22-Dec-2023 Reason for original issue of Warrant/Check (8): O Payroll For Services or Goods furnished. Treasurer's refund/payment ® Other: Fund 222-0220 HUMAN SERVICES - GAX 1D 24°11086 & 24711130 - TAPIA, DEBORAH - RENTAL ASSISTANCE 3/7/24 February 29, 2024 |, Joseph C, Anfuso, authorize Danny Gonzales, agent, to execute an affidavit on behalf of Gleiberman Properties, inc. Sincerely, omer CY won Joseph C. Anfuso CFO of Gleiberman Propértles, Inc. dba MG Properties courvexrensewarrant — TREASURER OF MARICOPA COUNTY PHOEMIX, ARIZONA DATE 12-22-2023 Two Thousand Five Hundred Sixty One And 34/100 Dollars PAY TO THE ORDER OF GLEIBERMAN TIES INC ATTN OFFICE For Questions - 602-506-1979 or email AP@MAIL.MARICOPA.GOV MARICOPA COUNTY DEPARTMENT OF FINANCE Void Afier 365 Days WARRANT NUMBER 30107169580 $2,561.34 AMOUNT NOT NEGOTIABLE RETAIN THIS FOR | PAYEE a WARRANT NO. | WARRANT DATE WARRANT AMOUNT YOUR RECORDS ho a en nn _ GLETIBERMAN PROPERT! ES INC 3010169580 12/22/2023 $2,561.34 INVOICE NUMBER | DESCRIPTION PURCHASE ORDER NO. | YOUCRER NO. AMOUNT INV-0000624638 TAPIA, DEBORAH - UTILITY ASSISTANCE GAX1D 0220 240000011088 96.24 240000011088 GAX1D D220 240000011130 2,465.10 INV-0000624671 TAPIA, DEBORAH - RENTAL /.SSISTANCE 240000014130 + Issued lapap1esseo Marrant number Issued date ri Amount + Warrant number: 3015168 Amount Payee 2S61.34 GLEIBERIMAN PROPERTIES INC 72/22/2023 2 Account eis