HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Transportation Engineering; 2017-03-21RECORDS DESTRUCTION AUTHORIZATION FORM
DATE:
REQUESTING DEPARTMENT: fvf?t.tc WIJR/(..S REQUESTER:
/"'\ DESTRUCTION APPROVALS: th certify that the r[.ords listed below have been retained for th e scheduled retention period, required audits have been
complete .', and no gending or on oing litigation or investigation involving these records is known to exis .
RECORDS MANAGEMENT:
I
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS TAB BARCODE
PERIOD (if applicable)
;;... ~ T/2/JFF;c R~l,fiD 2.000 /()L/(}-o; 1 cL-1-s-IV .rJ,
*if more spaces are needed, click in the last box in right hand corner of table and hit "tab". This will create more fields in the table.
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY: --=twa---'-'~-------DATE: Yh1/J,Of7 .
CERTIFICATE OF DESTRUCTION? _0 YES O NO
SMEADSOFT BARCODES DELETED BY: ___________ _ DATE: ------
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
\[City of
Carlsbad Revised: 2/14/2017
CERTIFICATE OF DESTRUCTION & RECYCLING
This Certificate is presented to: CITY OF CARLSBAD
Per the express request of Client, Corodata has received the Material referred to below and has/will destroy and then
recycle said Material in accordance with its standard procedures. As the parties have agreed, Corodata will not
inventory, record or track any information contained within or related to the Material.
Account #(s)
Certificate #
Date Issued
Service Locations
Date Range of Service
Work Ticket(s)
Quantity/Item
SD012455
106452
Tuesday, March 21 , 2017
5815 EL CAMINO REAL
Mar-21-2017 thru Mar-21-2017
381606
• Nothing in this certificate shat/ be deemed to modify the terms of the parties' Service Agreement(s) or Work Ticket(s).
tJ corodata SSAE 16
Type II Audit Completed HIP£