HomeMy WebLinkAbout2013-01-07 - ($1,149.35) - Check Register (2) 13/01/07-15:29 XITTITAS COUNTY FY 2013 Da.nua.ry 07 2013 Page 1
AP411 Void Check Approval Register
For the Hand / Sub Fund 641 010 FIRE DISTRICT #7
Signature: ....__—_ / /_...,_.. Signature:
Batckl 1334.53 CL Period 1 from 01/01/13 to 03./31/13 Bank GI, Code 641 2011110 Date 01./07/13
Sheet Invoice Type Dated Due Description PC Inv. P.mownt Paid Arcjxit
Seq GT, Code Description 'Transaction Description Local Amount
Check No. 411.257413 12311.2 Supplier D0659 .ZONES, MICHAEL 3.,149.35
3. 12/2012 1:R I 123112 1.>,3112 PAYROLL - PIRG DISTRICT .;7 1,,149.35 3,149.35
Batch Summary Local Amount
Total Invoices Reinstated 1,,149.35
Total Holdbacks Reinstated 0.00
Total Discounts 0.00
-----------------
Net 1,149.35
Check Count 1
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APPLICATION FOR DUPLICATE INSTRUMENT AFFIDAVIT
(RCW 43.08)
Regtzrements Before Is of Duplicate enls
Before a d-aplicate.iWftment is igsued th6 issuing officer shall require the person making application for
its issue to file in his, office a written affidavit specifically alleging on oath that he is the proper- owner,
payee, or legal representative of such owner or payee of the original instnmient,giving the daW of issae,
the number, amount, and for what services of claim or purpose the original ins uummt or series of
instnments of which it is a piw was issued,and that the same has been lost or destroyed,and has not been
paid,
AFFIDAVIT
STATE OF WASHINGTON,
COUNTY Of KITTITAS.
I, MICHAEL JONES being &st duly sworn upon oath, depose and say that I
am the proper owner, pay co, car legal representative of such owner or payee of Kittitas County
original warrant nurnber# 411257413 dated . 12/31/2012 in the amount of Oat 'housand One
Hunderd SPAY Nine & 35/100 -($1,149.35) in which said instnMont payable to —Michati
lorles wag issuc-d—wyment L^t
--EglyroLl and that the same has been lost or destroyed and has
not been cashed.
Sign Here
Subgcribad and swom to before nie this 34 day 0f, 6t��-----,2013
(I for
'Dora Jean VVoife Notuy Public i and fbr the State of Washington
)"'a q 'f"
=NotaryPubfic Residing at
Mate 'f VVa
State of Washogton
M "'PP 'I
y,APPOitAr"efIt ExOres W/0512013
30V d ENkN-960ST TZ:EZ EIGZAPO/To
KITTITAS COUNTY FIRE PROTECTION DIST RTICT NO 1
123 EAST I ST STREET
CLEELUM WA 98922-1101
PHONE: (509) 674-5371 FAX (509) 674-7263
RESOLUTION 132013
A RESOLUTION BY THE BOARD OF FIRE COMMISSIONERS
OF KITTITAS COUNTY FM PROTECTION DISTRICT NO 7�TO
CANCEL WARRANT NUMBER 411257413 DATED 12/31/2012 IN
TPE AMOUNT OF ONE THOUSAND ONE ffUNDRED FORTY NINE
DOLLARS AND .35 CENTS ($1149.35) THE PAYROLL WARRANT
WAS ISSUED PAYABLE, TO MICHAEL JONES, WARRANT IS
LOST AND HAS NOT BEEN CASHED. TO RE-ISSUE A NEW
WARRANT TO MICHAEL JONES
WEELEAS,the Board of Fire Commissioners of Kittitas County Fire District No
7, Kittitas County Washington, do hereby resolve to cancel warrant number 411257413
in the amount of$1,149.35 dated 12/31/2012 paid to Miohael Jones, the Warrant has
been lost. Resolve to reissue new warrant for Michael Jones.
W]HELEAS, the above listed warrant was issued to Michael Jones and has been
lost. A new warrant needs to be reissued to Michael Jones.
NOW THEREFORE, be it resolved by the Board of Fire Commissioners of
Kittitas County Fire District # 7, to cancel Warrant #411257413 in the amount of
$1,149.35 Payable to Michael Ion"
Dated this 3rd Day of January 2013
KITTITAS COUNT FiRE DISTRICT NO 7
KITTITAS COUNTY, WASHINGTON
BY;
ZItAe"-AN COMMISSIv
ONER
0
BY; -
COMMISSIONER
ATTEST;
Lj 0 ISSIONER.
DISTRICT SECR ARY
60/Z0 39VJ 69zz.N.9609T TZ:6T ETOZ/t?O/TO
......-
WARRANT DATE VENDOR-.NO.--F VENDOR NAME � WARRANT NO. DETACH AND RETAIN
- -
1213112012 00668 JONES, MICHAEL 411267413
FOR YOUR RECORDS
INVOICE [SATE INVOICE NO
DESCRIPTION T �
. INVOICE
._............
�
AMOUNT _
PAYROLL, _ FIRE DISTRICT #7 12/2612 PR $O 00t
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TO THE TREASURER OFDATE I WARRANT NO AMOUNT
.. ...... ...
KITTI 'AS C JN Y ° 213 12{ 1 4° 1257413 v $1,149.35
'w 205 WEST FIFTH
�t ELLENSBURG, WASHINGTON 98926
( QQ)962-75{}2 S TANK
arci as >, -n
�' 96-671
"�aorer3ti
1232
PAY ***One Thousand Cine Hun r rty Nine Dollars And 35 Cent**
To JONES, MICHAEL TO fHE,R
The 301 1/2 W 3RD STREET
Order CLE SLUM WA 98922
eery ,.ittlta..Gaurty kut�irnr
of.