STAMPED & REDACTED - FOR AGENDA ATTACHMENT - LAZ PARKING SOUTHWEST LLC 3010162672.PDF

v
MARICOPA
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: 02.16.24

Subject: Affidavit — LAZ Parking Southwest LLC LAZ Karp Associates LLC

Please find attached one Affidavit for a duplicate 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: D540-Legal Defender-Fund 100- - Security Building Parking Garage
TONS AY Gay

Application for a Duplicate or Stale-Dated Warrant/ Check
Affidavit/ Claim Form

This application is for: [1 Duplicate or [1 Stale-Dated (definitions are on page 2)

STATE OF ARIZONA | Note: Numbers on this form correspond fo
COUNTY OF MARICOPA numbers on the Instruction sheet which is
page 2 of this form.

U2 PARKING SOUTHWEST LLG LAZ KARP ASSOCIATES LL (4) being first sworn, upon oath deposes and says:
RamelClaimant

On or about 05-Oct-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

to him/her in the sum of $6,187.01 (3)

(4)

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

wait were orn to before me this has md of LS or wourn70 2b :

—_ PUBLIC

Wy A ea

warrant/check be

10 (Soe TA
St, JEANNE ANN BLOSSER

& Notary Public - Stale of Arizona

MARICOPA COUNTY
Commission 4 631907
Explees July 27, (s@al)

[ Warrant/Check Numbe

arrant/Check Number ]3919162672 |
Original Date of

a (if known) o OS- Oct-2023 _ ——-

2/16/2024

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

O Payroll
{1 For Services or Goods furnished__

C) Treasurer's refund/payment_
{J Other: ad Runs raadinted LEGAL DEFENDER. FUND 100 - eaten BUILDING PARKING GARAGE

COUNTY EXPENS-S WARRANT TRESSURER OF MARICOPA COUNTY WARRANT NUMBER

PalCon PHOENIX, ARIZONA 3010162672
ny bien Sy
a, aes “1p pare
( ey ( en 94 -2/4294
Couns

Six Thousand One Hundred Eighty Seven And 01/100 Dollars

INY02293315 TAX DO D540 230000008403 | 240000010368 145.01)

$6,187.04
PAY TO THE ORDER OF -
. AMOUNT
LAZ Parking Southwest LLC
LAZ Karp Associates LLC Void After
365 Days
For Questions - 602-506-1379 or email APG@ MATE. MARICOPA.GOV NOT NEGOTIABLE
MARICOPA COUNTY DEPARTMENT OF FINANCE
RETAIN THIS FOR | PAYER, ‘T WARRANT NO. | WARRANT DATE WARRANT AMOUNT
YOUR RECORDS: eee a _
__|LAZ Parking Southwest LLC __. 3010162672 1/05/2023 $6,187.01
INVOICE NUMBER | DESCRIPTION .. | PURCHASE ORDER NO. | VOUCHER NO. AMOUNT
/INVG2293315 october parking A00115663 DO D540 230000008403 | 240000010368 6,042.00]

C

SORA RYOCE RS

Partners in Packing’

One Financial Plaza

p: COMPANY RESOLUTION
F:
www.lazparking.com OF MEMBERS OF

LAZ PARKING SOUTHWEST, LLC

THE UNDERSIGNED, LAZ KARP ASSOCIATES,
LLC, being the sole member of LAZ PARKING
SOUTHWEST, LLC a limited liability company organized
and existing under the laws of the State of Arizona (the
"“Company") hereby represents that:

A Meeting of the Members of the Company was
held on February 16, 2024.

At said meeting after motion duly made and
seconded, the following Resolutions were unanimously
adopted:

RESOLVED, that the Company is hereby
authorized to sign any and aii documents, contracts
and agreements in regard to: Stale-dated
warrant/check documents

FURTHER RESOLVED, that Benny Rios is
authorized to sign such documents, contracts and
agreements and such documents, contracts and
agreements shall be binding upon the Company.

DATED at Hartford, Connecticut, this 16th day of
February, 2024

Glenn T. Terk

General Counsel, Contract Compliance

“y [ssuec warrants {Unsaved filter) ~

[1 Agency Status Issued date Paid date Amount

~ = Issued v v v

$/2023. 12:00.00am. 9. 6187.01!

Warrant number: 3010162672

Armnount Payee Account

6,187.01 LAZ Parking Southwest LLC P|