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HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Risk Management; 2016-11-01RECORDS DESTRUCTION AUTHORIZATION FORM DATE: 8/16/16 ------~--~-------- R EQUESTING D EPARTMENT: RISK MANAGEMENT REQUESTER: T R ERIE OWLEY D ESTRUCTION A PPROVALS: 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 litiga tion or investigation involving these records is known to e ~ ~-(C.-f(d OceO ~~ ~2.~/ (,_---:::::.~~--- DEPARTMENT HEAD DATE RECORDS MANAGEMENT DATE DATE BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS TAB BARCODE PERIOD (if applicable) RKM33 Acclaim Resource Partners-Vehicle Closed 0745-20 CL+5 see a-ttacltuL collision 2009 I is I-of hlt:..S RKM33 Ackman, Jeffrey-Tree other than Closed 0745-20 CL+5 sewer/water related 2009 RKM33 Adeva, Alvin-Vehicle collision Closed 0745-20 CL+5 2009 RKM33 Aggson, Van-Vehicle collision Closed 0745-20 CL+5 2009 RKM33 Aladits, James-Law enforcement Closed 0745-20 CL+5 2009 / Closed RKM33 Albano, Mark-Vehicle collision 2009 0745-20 CL+5 RKM33 Ali, Saiyed-Sewer/water (tree Closed 0745-20 CL+5 related) 2009 RKM33 Asbury, Suzanne-Other-property Closed 0745-20 CL+5 damage 2009 RKM33 Barnes, Jean-Trip/fall Closed 0745-20 CL+5 2009 RKM33 Becker, David-Vehicle collision Closed 0745-20 CL+5 2009 RKM33 Brumley, Robert-Law enforcement Closed 0745-20 CL+5 2009 RKM33 Buys, Georgia-Sewer/water (other Closed 0745-20 CL+5 than tree related) 2009 This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program. ~ <.<~4).\ CITY OF ':!'CARLSBAD Revised: 8/16/2016 P a ge /1 RKM33 RKM33 RKM33 RKM33 RKM33 RKM33 RKM33 RKM33 RKM33 RKM33 RKM33 RKM33 RKM33 RKM33 RKM33 RKM34 RKM34 RKM34 RKM34 RKM34 RKM34 <&'~CitY OF ~CARLSBAD Childs, Theresa-Vehicle collision Closed 0745-20 CL+5 2009 Colony at Calavera Hills-Closed 0745-20 CL+5 Sewer/water (tree related) 2009 Da Prato, Teresa-Trip/fall Closed 0745-20 CL+5 2009 Davis, Thomas-Law enforcement Closed 0745-20 CL+5 2009 Diaz, Andres-Law enforcement Closed 0745-20 CL+5 2009 Dixon, James-Sewer/water (other Closed 0745-20 CL+5 than tree related) 2009 Duray, Thomas-Vehicle Comprehensive (other than Closed 0745-20 CL+5 collision, tree or law enforcement 2009 related) Epperson, Robby-Vehicle Comprehensive (other than Closed 0745-20 CL+5 collision, tree or law enforcement 2009 related) Ercan, Erhan-Vehicle collision Closed 0745-20 CL+5 2009 Erismann, Fernando-Law Closed 0745-20 CL+5 enforcement 2009 -. Closed Ertel, Pamilla-Other-fence damages 2009 0745-20 CL+5 Floyd, Stella-Trip/fall Closed 0745-20 CL+5 2009 Goodrich, David & Aimee-Closed Sewer/water (other than tree 2009 0745-20 CL+5 related) Grand Design Builders, Inc.-Vehicle Closed 0745-20 CL+5 collision 2009 Graziano, Rocky-Other-Fire Dept. Closed 0745-20 CL+5 exercise-debris in pool 2009 Hafezi, Mathew-Vehicle collision Closed 0745-20 CL+5 2009 Humphrey, Keir-Sewer/water (other Closed 0745-20 CL+5 than tree related) 2009 Lewis, Claude-Sewer/water (tree Closed 0745-20 CL+5 related) 2009 Loberg, Erick & Kathy-Other-Police Closed 0745-20 CL+5 lost property 2009 Lopez, Carlos-Vehicle collision Closed 0745-20 CL+5 2009 Mahoney, Patrick-Vehicle collision Closed 0745-20 CL+5 2009 This form documents the destruction of City records in occordonce with the City of Corlsbod Records Management Program. RevBed:B/16/2016 Page /2 RKM34 RKM34 RKM34 RKM34 RKM34 RKM34 RKM34 RKM34 RKM34 RKM34 RKM34 RKM34 RKM34 RKM34 RKM34 RKM34 RKM34 RKM34 RKM34 RKM34 RKM34 RKM34 RKM34 ~ <_{ •!i;.'> co " 0 ' ~·CARLSBAD Martin, Vern-Sewer/water (tree Closed 0745-20 CL+5 related) 2009 May, Helen-Vehicle collision Closed 0745-20 CL+5 2009 May, Helen-Vehicle collision (2nd Closed 0745-20 CL+5 claim) 2009 McCa rthy, Justin-Tree (other than Closed 0745-20 CL+5 sewer/water related) 2009 Miller, Barbara-Sewer/water (tree Closed 0745-20 CL+5 related) 2009 Moody, Claudette-Trip/fall Closed 0745-20 CL+5 2009 Morev, Pavei-Sewer/water (other Closed 0745-20 CL+5 than tree related) 2009 Mutscheller, Wayne-Law Closed 0745-20 CL+5 enforcement 2009 Nicholson, Christopher-Sewer/water Closed 0745-20 CL+5 (tree related) 2009 North County Transit District-Vehicle Closed 0745-20 CL+5 collision 2009 O'Reilly, Daniel-Vehicle collision Closed 0745-20 CL+5 2009 Pacific Bell Telephone Co .-Trip/fall Closed 0745-20 CL+5 2009 Plush, Bruce and Francine-Closed Sewer/water (other than tree 2009 0745-20 CL+5 related) Progressive (Caskey)-Vehicle Closed 0745-20 CL+5 collision 2009 Raikoglo, Vernon-Tree (other than Closed 0745-20 CL+5 sewer/water related) 2009 Richards, Diana-Sewer/water (other Closed 0745-20 CL+5 than tree related) 2009 Sea Point Tennis Club-Tree (other Closed 0745-20 CL+5 than sewer/water related) 2009 Sears, Tom-Tree (other than Closed 0745-20 CL+5 sewer/water related) 2009 Sizemore, Morgan-Trip/fall Closed 0745-20 CL+5 2009 Smeltzer, Paul-Law enforcement Closed 0745-20 CL+5 2009 Smeltzer, Paul-Law enforcement (2nd Closed 0745-20 CL+5 claim) 2009 Smith, Susan-Tree (other than Closed 0745-20 CL+5 sewer/water related) 2009 Stephens, Alicia-Vehicle collision Closed 0745-20 CL+5 2009 This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program. Revised: 8/16/2016 Page /3 RKM35 RKM35 RKM35 RKM35 RKM35 RKM35 RKM35 RKM35 RKM35 RKM35 RKM35 RKM35 RKM35 RKM60 RKM60 RKM60 RKM60 RKM60 RKM60 RKM60 RKM60 RKM60 RKM60 RKM60 ~ <.,{{~ CtTY Of ~CARLSBAD Tavui, Malotumau-Vehicle collision Closed 0745-20 CL+5 2009 Telacu Construction Management, Closed 0745-20 CL+5 Inc.-Other {breach of contract) 2009 Tokman, llya-Vehicle collision Closed 0745-20 CL+5 2009 Trinidad, Ana-Trip/fall Closed 0745-20 CL+5 2009 Turner, Robert-Vehicle Closed 0745-20 CL+5 comprehensive (other than collision) 2009 Watson, Hilda-Vehicle collision Closed 0745-20 CL+5 2009 Williams, Estate of Trevell DA-Law Closed 0745-20 CL+5 enforcement 2009 Wilson, Jaqueline-Law enforcement Closed 0745-20 CL+5 2009 Wright, Samuel-Vehicle collision Closed 0745-20 CL+5 2009 Zada, Karla-Tree (other than Closed 0745-20 CL+5 sewer/water related) 2009 Ze is, Jenn-Other Closed 0745-20 CL+5 2009 Zunich, Jay-Vehicle collision Closed 0745-20 CL+5 2009 Potential Claims dated 1-1-09 to 12-Closed 31-09 2009 Bill ick, Reba Sue-Vehicle collision Closed 0745-50 CL+7 2008 Bonn, Zxelan-Tree (other than Closed 0745-50 CL+7 sewer/water related) 2008 Borg, John-Tripp/fall Closed 0745-50 CL+7 2008 Hulsey, Michael-Law enforcement Closed 0745-50 CL+7 2008 Kornescuk, Robert-Other (alleged Closed 0745-50 CL+7 negligence-Carlsbad Paramedics) 2008 Mcintosh, Douglas-Other (flood Closed 0745-50 CL+7 storm water runoff) 2008 Pitta, Gregory-Trip/fall Closed 0745-50 CL+7 2008 Rees, Lilian-Law enforcement Closed 0745-50 CL+7 2008 Rees, Robert-Law enforcement Closed 0745-50 CL+7 2008 Sullivan, Timothy-Tree (other than Closed 0745-50 CL+7 sewer/water related) 2008 Wight, Bruce-Tree (other than Closed 0745-50 CL+7 sewer/water related) 2008 This form documents the destruction of City records in occordonce with the City of Carlsbad Records Management Program. Rev~ed:B/16/2016 Page /4 *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: __ C!em_· -~:..::.:..-'---"-=-----DATE: CERTIFICATE OF DESTRUCTION? ~ES ~ D NO TAB BARCODES DELETED BY: ~ DATE: This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program. ~ «·!~ c"' o• ~CARLSBAD Revised: 8/16/2016 Page /5 Records Destruction List Page 1 Date 08/22/2016 Time 1:03:27 PM Date Inactive Login Name Maria Emery Record ExternaiiD Records Description Number PFLD-15-23173 08/22/2016 HULSEY, MI CHAELI6117/06 074520 PHYSICAL RECORDS RM637 MANAGEMENT-Risk Management PFLD-15-23198 08/22/2016 KORNESCUK, ROBERTI1/21/07 074520 PHYSICAL RECORDS RM788 MANAGEMENT-Risk Management PFLD-15-23220 08/22/2016 RICHARDS, DIANAI12/26/07 reed 074520 PHYSICAL RECORDS RM833 MANAGEMENT-Risk Management PFLD-15-23254 08/22/2016 BORG, JOHNI4/30/08 074520 PHYSICAL RECORDS RM909 MANAGEMENT-Risk Management PFLD-15-23256 08/22/2016 ZEIS, JENNI4/27/08 074520 PHYSICAL RECORDS RM912 MANAGEMENT-Risk Management PFLD-15-23275 08/22/2016 ASBURY, SUZANNEI811 0/08 074520 PHYSICAL RECORDS RM937 MANAGEMENT-Risk Management PFLD-15-23285 08/22/2016 MOODY, CLAUDETTE A.l5117/2008 074520 PHYSICAL RECORDS RM952 MANAGEMENT-Risk Management PFLD-15-23304 08/22/2016 SMELTZER, PAUL F.l12/18/2008 074520 PHYSICAL RECORDS RM975 MANAGEMENT-Risk Management PFLD-15-23316 08/22/2016 GRAND DESIGN BUILDERS, INCil/8/2009 074520 PHYSICAL RECORDS RM988 MANAGEMENT-Risk Management PFLD-15-23326 08/22/2016 NICHOLSON, CHRlSTOPHERil/30/2009 074520 PHYSICAL RECORDS RM998 MANAGEMENT-Risk Management PFLD-15-23332 08/22/2016 GOODRICH TRUSTI2/11/2009 074520 PHYSICAL RECORDS RM1004 MANAGEMENT-Risk Management PFLD-15-23336 08/22/2016 ACCLAIM RESOURCE PARTNERS (WATSON)Il/30/2009 074520 PHYSICAL RECORDS RM1008 MANAGEMENT-Risk Management PFLD-15-23343 08/22/2016 ALAD1TS, JAMESI9/26/2009 074520 PHYSICAL RECORDS RM1015 MANAGEMENT-Risk Management PFLD-15-23351 08/22/2016 CHILDS, THERESAI3/11/2009 074520 PHYSICAL RECORDS RM1023 MANAGEMENT-Risk Management PFLD-15-23355 08/22/2016 DIAZ, ANDRES ESPINOZAI4/10/2009 074520 PHYSICAL RECORDS RM1027 MANAGEMENT-Risk Management PFLD-15-23360 08/22/2016 SEA POINT TENNIS CLUBI5/13/2009 074520 PHYSICAL RECORDS RM1032 MANAGEMENT-Risk Management Records Destruction List Page 2 Date 08/22/2016 Time 1:03:28 PM Date Inactive Login Name Maria Emery Record ExternaiiD Records Description Number PFLD-15-23364 08/22/2016 LEWIS, CLAUDEI4/13/2009 074520 PHYSICAL RECORDS RM1036 MANAGEMENT-Risk Management PFLD-15-23383 08/22/2016 SEARS, TOMI2/9/2009 074520 PHYSICAL RECORDS RM1055 MANAGEMENT-Risk Management PFLD-15-23406 08/22/2016 ACKMAN, JEFFREYI7114/2009 074520 PHYSICAL RECORDS RM1078 MANAGEMENT-Risk Management PFLD-15-23427 08/22/2016 GRAZIANO, ROCKYI9/27/2009 074520 · PHYSICAL RECORDS RM1099 MANAGEMENT-Risk Management PFLD-15-23165 08/22/2016 MciNTOSH, DOUGLASI1/2/06 074520 PHYSICAL RECORDS RM591 MANAGEMENT-Risk Management PFLD-15-23184 08/22/2016 PITTA, GREGORYI9116/06 074550 PHYSICAL RECORDS RM744 MANAGEMENT-Risk Management PFLD-15-23208 08/22/2016 SULLIVAN, TIMOTHYI1 0/22/07 074520 PHYSICAL RECORDS RM805 MANAGEMENT-Risk Management PFLD-15-23249 08/22/2016 WIGHT, BRUCE PHILIPI4/30/08 074520 PHYSICAL RECORDS RM894 MANAGEMENT-Risk Management PFLD-15-23263 08/22/2016 HAFEZI, MATHEWII/21/08 074520 PHYSICAL RECORDS RM922 MANAGEMENT-Risk Management PFLD-15-23277 08/22/2016 FLOYD, STELLAI4/6/08 074520 PHYSICAL RECORDS RM940 MANAGEMENT-Risk Management PFLD-15-23293 08/22/2016 SMELTZER, PAUL105/23/2008 074520 PHYSICAL RECORDS RM960 MANAGEMENT-Risk Management PFLD-15-23309 08/22/2016 TURNER, ROBERTI12/3/08 074520 PHYSICAL RECORDS RM980 MANAGEMENT-Risk Management PFLD-15-23318 08/22/2016 STEPHENS, ALICIAII/5/2009 074520 PHYSICAL RECORDS RM990 MANAGEMENT-Risk Management PFLD-15-23328 08/22/2016 MILLER, BARBARA L.l12/17/2009 074520 PHYSICAL RECORDS RM1000 MANAGEMENT-Risk Management PFLD-15-23334 08/22/2016 PLUSH, BRUCE AND FRANI2111/2009 074520 PHYSICAL RECORDS RM1006 MANAGEMENT-Risk Management PFLD-15-23339 08/22/2016 DAVIS, THOMAS LEON WESLEYI9/3/2008 074520 PHYSICAL RECORDS RM1011 MANAGEMENT-Risk Management Records Destruction List Page 3 Date 08/22/2016 Time 1:03:28 PM Date Inactive Login Name Maria Emery Record ExternaiiD Records Description Number PFLD-15-23345 08/22/2016 MUTSCHELLER, WAYNEI311112009 074520 PHYSICAL RECORDS RM1017 MANAGEMENT -Risk Management PFLD-15-23353 08/22/2016 MAY, HELEN13114/2009 074520 PHYSICAL RECORDS RM1025 MANAGEMENT -Risk Management PFLD-1 5-23357 08/22/2016 SIZEMORE, MORGAN T.l1 1110/2008 074520 PHYSICAL RECORDS RM1029 MANAGEMENT -Risk Management PFLD-15-23362 08/22/2016 LOPEZ, CARLOSI4/26/2009 074520 PHYSICAL RECORDS RM1034 MANAGEMENT -Risk Management PFLD-15-23379 08/22/2016 WRIGHT, SAMUELI6/25/2009 074520 PHYSICAL RECORDS RM1051 MANAGEMENT -Risk Management PFLD-15-23403 08/22/2016 CASKEY, DAVID I8/2/2009 074520 PHYSICAL RECORDS RM1075 MANAGEMENT -Risk Management PFLD-15-23413 08/22/2016 MAHONEY, PATRICK1911 1/2009 074520 PHYSICAL RECORDS RM1085 MANAGEMENT -Risk Management PFLD-15-23 167 08/22/2016 WILLIAMS, ESTATE OF TREVELLIDEDRIA COXI 12/27/01l74520 PHYSICAL RECORDS RM6 11 MANAGEMENT-Risk Management PFLD-15-23 194 08/22/2016 REES, ROBERT AND LILIANII2/2/06 074550 PHYSICAL RECORDS RM770 MANAGEMENT -Risk Management PFLD-15-23210 08/22/2016 BONN, ZXELANII0/7/07 074520 PHYSICAL RECORDS RM809 MANAGEMENT -Risk Management PFLD-1 5-23253 08/22/2016 ERISMANN, FERNANDQI 11/28/07 074520 PHYSICAL RECORDS RM905 MANAGEMENT -Risk Management PFLD-15-23255 08/22/2016 COLONY AT CALAVERA HLLSI3/18/08 074520 PHYSICAL RECORDS RM910 MANAGEMENT -Risk Management PFLD-15-23 265 08/22/2016 ZUNICH, JAYI7/23/08 074520 PHYSICAL RECORDS RM924 MANAGEMENT-Risk Management PFLD-15-23280 08/22/2016 PACIFIC BELL TELEPHONE CO.I8/4/08 074520 PHYSICAL RECORDS RM946 MANAGEMENT -Risk Management PFLD-15-23301 08/22/2016 SMITH, SUSAN MARIEII I/24/2008 074520 PHYSICAL RECORDS RM970 MANAGEMENT -Risk Management PFLD-15-23315 08/22/2016 TOKMAN, ILYAII/5/2009 074520 PHYSICAL RECORDS RM987 MANAGEMENT -Risk Management Records Destruction List Page 4 Date 08/22/2016 Time 1:03:29 PM Date Inactive Login Name Maria Emery Record ExternaiiD Records Description Number PFLD-15-23325 08/22/2016 WATSON, HILDA R.l1/30/2009 074520 PHYSICAL RECORDS RM997 MANAGEMENT-Risk Management PFLD-15-23331 08/22/2016 MOREY, PAVEL Vl2111/2009 074520 PHYSICAL RECORDS RM1003 MANAGEMENT-Risk Management PFLD-15-23335 08/22/2016 TRINIDAD, ANA C.l8/23/2008 074520 PHYSICAL RECORDS RM1007 MANAGEMENT-Risk Management PFLD-15-23342 08/22/2016 ALI, SAlYEDil/30/2009 074520 PHYSICAL RECORDS RM1014 MANAGEMENT-Risk Management PFLD-15-23346 08/22/2016 TAVUI, MALOTUMAUI3111/2009 074520 PHYSICAL RECORDS RM1018 MANAGEMENT-Risk Management PFLD-15-23354 08/22/2016 ZADA, KARLAI411/2009 (RECEIVED) 074520 PHYSICAL RECORDS RM1026 MANAGEMENT-Risk Management PFLD-15-23359 08/22/2016 ERTEL, PAMILLAI5/11/2009 (RECEIVED) 074520 PHYSICAL RECORDS RM1031 MANAGEMENT-Risk Management PFLD-15-23363 08/22/2016 EPPERSON, ROBBYI5119/2009 074520 PHYSICAL RECORDS RM1035 MANAGEMENT-Risk Management PFLD-15-23382 08/22/2016 BRUMLEY, ROBERTI5/25/2009 074520 PHYSICAL RECORDS RM1054 MANAGEMENT-Risk Management PFLD-15-23405 08/22/2016 RAIKOGLO, VERNONI8/5/2009 074520 PHYSICAL RECORDS RM1077 MANAGEMENT-Risk Management PFLD-15-23415 08/22/2016 WILSON, JAQUELINEI4/3/2009 074520 PHYSICAL RECORDS RM1087 MANAGEMENT-Risk Management PFLD-15-23177 08/22/2016 BILLICK, REBA SUEI8/15/06 074550 PHYSICAL RECORDS RM711 MANAGEMENT-Risk Management PFLD-15-23205 08/22/2016 DA PRATO, TERESAI5/6/07 074520 PHYSICAL RECORDS RM801 MANAGEMENT-Risk Management PFLD-15-23221 08/22/2016 BUYS, GEORGIAI12/26/07 reed 074520 PHYSICAL RECORDS RM834 MANAGEMENT-Risk Management PFLD-15-23260 08/22/2016 BARNES, JEANI5/3/08 074520 PHYSICAL RECORDS RM916 MANAGEMENT-Risk Management PFLD-15-23276 08/22/2016 BECKER, DAVIDI8/22/06 074520 PHYSICAL RECORDS RM939 MANAGEMENT-Risk Management Records Destruction List Page 5 Date 08/22/2016 Time 1:03:30 PM Date Inactive Login Name Maria Emery Record ExternaiiD Records Description Number PFLD-15-23290 08/22/2016 DURAY, THOMASI10/28/08 074520 PHYSICAL RECORDS RM957 MANAGEMENT-Risk Management PFLD-15-23305 08/22/2016 O'REILLY, DANIELI12/5/2008 074520 PHYSICAL RECORDS RM976 MANAGEMENT-Risk Management PFLD-15-23317 08/22/2016 LOBERG, ERIK AND KATHYI1/23/2009 074520 PHYSICAL RECORDS RM989 MANAGEMENT-Risk Management PFLD-15-23327 08/22/2016 MCCARTHY, JUSTINI12/23/2008 074520 PHYSICAL RECORDS RM999 MANAGEMENT-Risk Management PFLD-15-23333 08/22/2016 HUMPHREY, KEIR AND SHARER, CATHYI2111 /2009 074520 PHYSICAL RECORDS RM1005 MANAGEMENT-Risk Management PFLD-15-23337 08/22/2016 DIXON, JAMESI2/11/2009 074520 PHYSICAL RECORDS RM1009 MANAGEMENT-Risk Management PFLD-15-23344 08/22/2016 ERCAN, ERHANI02/23/09 074520 PHYSICAL RECORDS RM1016 MANAGEMENT-Risk Management PFLD-15-23352 08/22/2016 MAY, HELEN13113/2009 074520 PHYSICAL RECORDS RM1024 MANAGEMENT-Risk Management PFLD-15-23356 08/22/2016 ALBANO, MARKil/27/2009 074520 PHYSICAL RECORDS RM1028 MANAGEMENT-Risk Management PFLD-15-23361 08/22/2016 NORTH COUNTY TRANSIT DISTRICTII/5/2009 074520 PHYSICAL RECORDS RMI033 MANAGEMENT-Risk Management PFLD-15-23366 08/22/2016 TELACU CONSTRUCTION MANAGEMENT, INCI 074520 PHYSICAL RECORDS RM1038 MANAGEMENT-Risk Management PFLD-15-23387 08/22/2016 AGGSON, VANI5/31/2009 074520 PHYSICAL RECORDS RM1059 MANAGEMENT-Risk Management PFLD-15-23409 08/22/2016 MARTIN, VERNI911 0/09 (RECEIVED) 074520 PHYSICAL RECORDS RM1081 MANAGEMENT-Risk Management PFLD-15-23430 08/22/2016 ADEVA, ALVINI1116/2009 074520 PHYSICAL RECORDS RM1103 MANAGEMENT-Risk Management [ End of Report ][cityof Carlsbad Dataset ECMMaster J 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 105156 Tuesday, November01,2016 5815 EL CAMINO REAL Nov-01-2016 thru Nov-01-2016 352320 *Nothing in this certificate shall be deemed to modify the terms of the parties' Service Agreement(s) or Work Ticket(s). ~~m~l{ (~' ' . . ~ ~~--.,#~ t:J corodata . SSAE 16 Ty~-e II ,O..udil Ccrnp!etad • Cliam lliHirm