HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Records Management; 2019-01-24/
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RECORDS DESTRUCTION AUTHORIZATION FORM
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DATE: 01-15-2019
REQUESTING DEPARTMENT: Records Management REQUESTER: Pat Downie
DESTRUCTION APPROVALS:
We certify that the records listed below have been retained for the scheduled retention period, required audits have been
completed, and no pending or ongoing litigat~~hese records is known to exist.
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DEPA~ OECORDS MANAGEMENT: CITY ATTORNEY:
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS TABBARCODE
PERIOD (if applicable)
General Information -Cablevision 1991-2005 0300-05 CU+2
*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: ---~-~_,d_~----DATE:
CERTIFICATE OF DESTRUCTION? 1iQ._ YES □ NO
SMEADSOFT BARCODES DELETED BY: _____ -______ _ DATE: __ -___ _
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
«~> rn, •· Revised: 4/26/2013 ~ CARLSBAD
CERTIFICATE OF DESTRUCTION & RECYCLING
This certificate is presented to: CITY OF CARLSBAD -RECORDS MANAGEMENT DIVISION
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
109525
Monday, January 28, 2019
5815 EL CAMINO REAL
Jan-24-2019 thru Jan-24-2019
553347
62 -62 Boxes for Destruction (standard)
• Nothing in this certificate shall be deemed to modify the terms of the parties' Service Agreement(s) or Work Ticket(s).
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Type II Audi! Compleled HIP£