HomeMy WebLinkAbout; ; Records Destruction Authorization Form-City Manager; 2013-10-24Sbrcd-it.
3801 Ocean Ranch Blvd
Suite 101
Oceanside CA
92US6
Phone: 760- 598- 5700
SERVICE RECORD SUMMARY
CKRTIKICATE OF DKSTRUCTION
PLEASE KEEP THIS FOR YOUR RECORDS
(THIS IS NOT AN INVOICE)
Customer: 0011889293
CITY OF CARLSBAD- RECORDS .MANAGEMENT
5815 EL CAMINO REAL
CARLSBAD CA 92008- 8801
Order #: 8009700753
Order Date; 24.10.2013
Service Type; SHRED - ON- SITE PURGE
Contact: PAT DOWNIE
Time In: 07:52 AM
Time Out: 10:49 AM
Material Collected
BANKERS/ARCHIVE BOX 141
FILE DRAWER 2
Total: 143
Service Time: 176 Min
Customer Signature: PAT DOWNIE
CSR Signalure: RUBEN JACOBO
RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: I ^
REQUESTING DEPARTMENT: Ql-^^ f^aA^iCjt^ REQUESTER: IjCA ^'/^b
DESTRUCTION APPROVALS:
iVe cert;/y that the records listed below have been rcioinedJor ihe scheduled retention penod, required audits have been
completed, ond no pending or ongoing litigoiion or investigation involving these reuirds is known to px/st.
DEPARTMENT HEAD: RECORDS MANAGEIVIENT: CiTY ATTORNEY:
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS
PERIOD
TAB BARCODE
(if applicable)
ijio- Ajw Ct/f-Z
— _—l..—
Z00Z13
*if more spaces are needed, ciicl< 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:
CERTIFICATE OF DESTRUCTION?
SMEADSOFT BARCODES DELETED BY:
DATE: ^0^f-/3
DATE: 61^1 jl3>
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
Revised: 5/13/2013 ^^^-'CARLSBAD