STAMPED & REDACTED - FOR AGENDA ATTACHMENT - KARPEL SOULTIONS.PDF

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:  10-9-2023

Subject: Affidavit — Replacement of Lost Warrant

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

e The attached iter 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 (FIN) 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 100 — D190/ MCAO / KARPEL SOLUTIONS

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

This application is for: Duplicate or (J Stale-pated (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.
Karpel Solutions (1), being first sworn, upon oath deposes and says:
al aman
On or about 16-Feb-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 $24.98 .(3)
Signed: _ ang ert AG eps 2 (4)
A

evidence that a warrant/check was originally issued.

(5) Subscribed and sworn to before me this Alo day of 4g Prowler 2023.

robes Bann. woe
NOTARY PUBLIC SO sess tne eM,

My commission expires:

(52.094
Warrant/Check Number 3010143364

(if known) (6)

Original Date of Issue 16-Feb-2023

Cif. known) (7)

ao
. ao

0101647

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

2 Payroll
For Services or Goods furnishedInvoice MSP-59985

 Treasurer’s refund/payment
C1 Other:

10/9/2023

ARPEL

LUTIONS

CORPORATE RESOLUTION

Karpel Cornputer Systems, Inc. dba Karpel Solutions

L, Elizabeth A Karpel, as Secretary of Karpel Computer Systems, inc. dba Karpel Solutions, a
corporation organized and existing under the laws of the State of Missouri, DO HEREBY certify
that the following is a true and correct copy of a resolution duly adopted at a meeting of the
Board of Directors of Karpel Computer Systems, Inc. duly held and convened on June 29, 2023
at which meeting a duly constituted quorum of the Board of Directors was present and acting
throughout, and that the resolution has not been modified, rescinded or revoked, and is at
present in full force and effect:

RESOLVED: That Jeffery L. Karpel, CEO; LeeAnn Karpel, President; anc Elizabeth A Karpel,
Secretary; are empowered to and authorized to execute and deliver contracts on behalf of
Karpel Computer Systems, Inc.

IN WITNESS WHEREOF, the undersigned has affixed her signature and the corporate seal
of Karpel Computer Systems, Inc. this 29" day of June 2023,

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