HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Risk Management; 2014-06-23 (2)RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: MAY 6,2014
REQUESTING
DEPARTMENT:
PAGE 1 OF 15
RISK MANAGEMENT REQUESTER: TERIE ROWLEY
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 litigation or investigation involving these records is known toexist.
DEPARTMENT HEAD: RECORDS MANAGEMENT: CITY ATTORNEY:
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS
PERIOD
SMEADSOFT BARCODE
(if applicable)
RKM27 AAA, Deroze-Claim, Vehicle Collision Closed
2007 0745-20 CL-i-5
RKM27 AAA, Speck-Claim, Vehicle Collision Closed
2007 0745-20 CL+5
RKM27 Acosta, Joe-Claim, Sewer/Water,
Tree Related
Closed
2007 0745-20 CL-i-5
RKM27
Acuna, Justin & Luis-Claim, Vehicle
Comprehensive (other than
collision, tree or law enforcement
related)
Closed
2007 0745-20 CL+5
RKM27 Allen, Helene-Claim, Vehicle
Collision
Closed
2007 0745-20 CL-(-5
RKM27 Anaraki, Saray-Litigated Claim, Law
Enforcement
Closed
2007 0745-50 CL+7
RKM27 Archstone Seascape-Claim,
Sewer/Water, Tree Related
Closed
2007 0745-20 CL-i-5
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY
CERTIFICATE OF DESTRUCTION?
SMEADSOFT BARCODES DELETED BY
m YES • NO
DATE: ^^3 -^/f
DATE
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management
,<t> • " ». Program.
^ CARLSBAD Revised: 5/6/2014
RECORDS DESTRUCTION AUTHORIZATION FORM
DATE:
REQUESTING
DEPARTMENT:
PAGE 2 OF 15
RISK MANAGEMENT REQUESTER: TERIE ROWLEY
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 litigation or investigation involving these records is known to exist.
DEPARTMENT HEAD: RECORDS MANAGEMENT:
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS
PERIOD
SMEADSOFT BARCODE
(if applicable)
RKM27 AT&T-Claim, Sewer/Water (Tree
Related)
Closed
2007 0745-20 CL-I-5
RKM27
Attinger, William C.-Claim,
Sewer/Water (other than tree
related)
Closed
2007 0745-20 CL-I-5
RKM27 Banich, Mike-Claim, Sewer/Water
(Other than tree related)
Closed
2007 0745-20 CL-H5
RKM27 Becker & Annett, Katie & Cec-Claim,
Sewer/Water, tree related
Closed
2007 0745-20 CL-H5
RKM27
Belanger, France-Claim, Vehicle
Comprehensive (other than
collision)
Closed
2007 0745-20 CL+5
RKM27 Bennett, Betty Ann-Claim, Vehicle
Collision
Closed
2007 0745-50 CL+7
RKM27 Berchiolli, Kent & Catharine-Claim,
Vehicle Collision
Closed
2007 0745-20 CL+5
RKM27 Blair, Giles 8t Debra-Claim,
Sewer/Water (tree related)
Closed
2007 0745-20 CL+5
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY
CERTIFICATE OF DESTRUCTION?
SMEADSOFT BARCODES DELETED BY:
WY^ •
DATE: ^'<^Z^Or^
DATE
This form documents the destruction of City records in accordance with the City of Carisbad Records Management
c,„ „. Program.
CARLSBAD Revised: 5/6/2014
RECORDS DESTRUCTION AUTHORIZATION FORM
DATE:
REQUESTING
DEPARTMENT:
PAGE 3 OF 15
RISK MANAGEMENT REQUESTER: TERIE ROWLEY
DESTRuaiON 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 litigation or investigation involving these records is knpvMiJCLexist
DEPARTMENT HEAD: RECORDS MANAGEMENT: CITY ATTORNEY:
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS
PERIOD
SMEADSOFT BARCODE
(if applicable)
. RKM27 Bonas, William-Claim, Law
Enforcement
Closed
2007 0745-20 CL+5
RKM27
Bosco Family Trust-Claim,
Sewer/Water (Other than tree
related)
Closed
2007 0745-20 CL+5
RKM27 Botros, Morrow-Claim, Vehicle
Collision
Closed
2007 0745-20 CL+5
RKM27 Bradley-Cliche, Courtney-Claim,
Vehicle Collision
Closed
2007 0745-20 CL+5
,^ RKM27
Brody, James & Christine-Claim,
Tree (Other than sewer/water
related)
Closed
2007 0745-20 CL+5
*>^RKM27 Brown, Marilyn-Claim, Law
Enforcement
Closed
2007 0745-20 CL+5
RKM27 Brown, Russell-Claim, Law
Enforcement
Closed
2007 0745-20 CL+5
' RKM27 Campbell, Ramon-Claim, Trip/Fall Closed
2007 0745-20 CL+5
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY
CERTIFICATE OF DESTRUCTION?
SMEADSOFT BARCODES DELETED BY:
• YES • NO _
DATE: L^3'^eY^
DATE
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management
.<t/, c, o, Program.
CARLSBAD Revised: 5/6/2014
RECORDS DESTRUCTION AUTHORIZATION FORM
DATE:
REQUESTING
DEPARTMENT:
PAGE 4 OF 15
RISK MANAGEMENT REQUESTER: TERIE ROWLEY
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 litigation or investigation involving these records is knovvpjo exist
DEPARTMENT HEAD: RECORDS MANAGEMENT: CITY ATTORNEY:
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS
PERIOD
SMEADSOFT BARCODE
(if applicable)
R\Mi^\ jCf^mj%j{^\^
RKM27 Chamberlain, Michael-Claim, Vehicle
Collision
Closed
2007 0745-20 CL+5 u
RKM27 Clinnin, John A.-Claim, Other, Slope
Failure
Closed
2007 0745-50 CL+7
RKM27 Cole, Shirley-Claim, Trip/Fall Closed
2007 0745-20 CL+5
RKM27 Cooney, Teresa & Brian-Claim, Tree
(Other than sewer related)
Closed
2007 0745-20 CL+5
RKM27 Crawford, Michael-Claim, Vehicle
Collision
Closed
2007 0745-20 CL+5
RKM27
Crommett, Laura-Claim, Vehicle
Comprehensive (Other than
collision)
Closed
2007 0745-20 CL+5
RKM27 Davis, Louise-Claim, Sewer/water
(tree related)
Closed
2007 0745-20 CL+5
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY:
CERTIFICATE OF DESTRUCTION? ^3^^
SMEADSOFT BARCODES DELETED BY:
• NO
DATE: ^ ^d/y
DATE
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management
A c,„ ,.. Program.
"^^ CARLSBAD Revised: 5/6/2014
RECORDS DESTRUCTION AUTHORIZATION FORM
DATE:
REQUESTING
DEPARTMENT:
5"- 7'/^ PAGE 5 OF 15
RISK MANAGEMENT REQUESTER: TERIE ROWLEY
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 litigation or investigation involving these records is knowntoexist
DEPARTMENT HEAD: RECORDS MANAGEMENT: CITY ATTORNEY
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS
PERIOD
SMEADSOFT BARCODE
(if applicable)
RKM27 Defrancesco, Russell-Claim, Tree
(Other than sewer/water related
Closed
2007 0745-20 CL+5
RKM27 Dennison, Joyce and John-Claim,
Sewer/water (tree related)
Closed
2007 0745-20 CL+5
RKM27 Deroze, Mark-Claim, Vehicle
collision
Closed
2007 0745-20 CL+5
RKM27 Donner, Jr., Paul-Claim, Law
Enforcement
Closed
2007 0745-20 CL+5
RKM28 El Camino Real Partners-Claim,
Sewer/Water, tree related
Closed
2007 0745-20 CL+5
RKM28 Emery, Sharon-Claim, Vehicle
Collision
Closed
2007 0745-20 CL+5
RKM28 Estrada-Ledesma, Maria-Claim,
Vehicle Collision
Closed
2007 0745-20 CL+5
RKM28 Farmer's Ins., Grube-Claim, Vehicle
Collision
Closed
2007 0745-20 CL+5
RKM28 Farmers, Mayo-Claim, Sewer/Water
(tree related)
Closed
2007 0745-20 CL+5
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY
CERTIFICATE OF DESTRUCTION?
SMEADSOFT BARCODES DELETED BY:
^YK • NO
(j,/<^-ihAn/c.Ui3,
DATE
DATE : (^flfUU/
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management
Program.
^ CARLSBAD Revised: 5/6/2014
RECORDS DESTRUCTION AUTHORIZATION FORM
DATE:
REQUESTING
DEPARTMENT:
5
RISK MANAGEMENT
PAGE 6 OF 15
REQUESTER: TERIE ROWLEY
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 litigation or investigation involving these records is known to exist
DEPARTMENT HEAD: RECORDS MANAGEMENT: CITY ATTORNEY
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS
PERIOD
SMEADSOFT BARCODE
(if applicable)
RKM28 Ferreira, Mateo & Jeanne-Claim,
Vehicle Collision
Closed
2007 0745-20 CL+5
RKM28 Ford, Jim-Claim, Vehicle Collision Closed
2007 0745-20 CL+5
^ RKM28
Francis, Estate of John C.-Claim,
Other, relates to plane crash Jan
2006
Closed
2007 0745-20 CL+5
^ RKM28 Garratt, Debra Marie-Claim, Other,
relates to plane crash Jan 2006
Closed
2007 0745-20 CL+5
V. RKM28 Garratt, Jr., James-Claim, Other,
relates to plane crash Jan 2006
Closed
2007 0745-20 CL+5
RKM28 Geico/Billick-Claim, Vehicle Collision Closed
2007 0745-20 CL+5
RKM28 Glover, Cedric-Claim, Vehicle
Collision
Closed
2007 0745-20 CL+5
RKM28 Gonzalez, Ruth Corona-Claim,
Vehicle Collision
Closed
2007 0745-20 CL+5
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY:
CERTIFICATE OF DESTRUCTION?
SMEADSOFT BARCODES DELETED BY:
KT YES • NO
DATE
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management
A -'••>• Program.
CARLSBAD Revised: 5/6/2014
RECORDS DESTRUCTION AUTHORIZATION FORM
DATE:
REQUESTING
DEPARTMENT:
PAGE 7 OF 15
RISK MANAGEMENT REQUESTER: TERIE ROWLEY
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 litigation or investigation involving these records is known to exist
DEPARTMENT HEAD: RECORDS MANAGEMENT: CITY ATTORNEY:
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS
PERIOD
SMEADSOFT BARCODE
(If applicable)
RKM28
Gooley, Donna-Claim, Other, Street
flooding due to contractor work -
not performed by City of Carlsbad
Closed
2007 0745-20 CL+5
RKM28 GOSHIP Air, LLC-Claim, Other,
relates to plane crash Jan 2006
Closed
2007 0745-20 CL+5
RKM28 Grube, Dan-Claim, Vehicle collision Closed
2007 0745-20 CL+5
RKM28 Hays, Jodi-Claim, Other, shoes
damaged by asphalt overlay
Closed
2007 0745-20 CL+5
RKM28
Hernandez Tapia, Angel-Claim,
Vehicle Comprehensive (Other than
collision, tree or law enforcement
related)
Closed
2007 0745-20 CL+5
RKM28 Hogan, Summer-Claim, Law
Enforcement
Closed
2007 0745-20 CL+5
RKM28 Hoke, Marianne-Claim, Law
Enforcement
Closed
2007 0745-20 CL+5
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY:
CERTIFICATE OF DESTRUCTION?
SMEADSOFT BARCODES DELETED BY: _
SO^ES • NO
DATE:
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management
A »• Program.
CARLSBAD Revised: 5/6/2014
RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: 7^/^/
REQUESTING
DEPARTMENT:
PAGE 8 OF 15
RISK MANAGEMENT REQUESTER: TERIE ROWLEY
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 litigation or investigation involving these records is known to exist
DEPARTMENT HEAD: RECORDS MANAGEMENT: CITY ATTORNEY
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS
PERIOD
SMEADSOFT BARCODE
(if applicable)
RKM28 Holliday, Pari-Claim, Vehicle
Collision
Closed
2007 0745-20 CL+5
RKM28 Hope, Douglas-Claim, Vehicle
Collision
Closed
2007 0745-20 CL+5
RKM28 Houston, Earl-Claim, Vehicle
Collision
Closed
2007 0745-20 CL+5
RKM28 Jackson, Donnie-Claim, Vehicle
Collision
Closed
2007 0745-20 CL+5
RKM28
Jellinek As Executrix, Judith-Claim,
Other,' Dangerous Conditions of
Public Property
Closed
2007 0745-20 CL+5
RKM28 Jurewitz, Ross and Lee-Claim,
Sewer/Water (tree related)
Closed
2007 0745-20 CL+5
RKM28 Karoly, Neila-Claim, Sewer/Water
(tree related)
Closed
2007 0745-20 CL+5
RKM28 Kestler, Mary Lou-Claim, Vehicle
Collision
Closed
2007 0745-20 CL+5
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY:
CERTIFICATE OF DESTRUCTION?
SMEADSOFT BARCODES DELETED BY:
GfYES • NO
DATE:
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management
A 1,1. o, Program.
^ CARLSBAD Revised: 5/6/2014
RECORDS DESTRUCTION AUTHORIZATION FORM
DATE:
REQUESTING
DEPARTMENT:
RISK MANAGEMENT
9 OF 15
REQUESTER: TERIE ROWLEY
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 litigation or investigation involving these records is known to exist
DEPARTMENT HEAD: RECORDS MANAGEMENT: CITY ATTORNEY:
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS
PERIOD
SMEADSOFT BARCODE
(if applicable)
RKM28 Kreidman, Jason-Claim, Vehicle
Collision
Closed
2007 0745-20 CL+5
RKM28
Las Brisas Pacificas, Inc.-Claim,
Sewer/Water (other than tree
related)
Closed
2007 0745-20 CL+5
RKM29 Law-Edwards, Martha-Claim,
Trip/Fall
Closed
2007 0745-20 CL+5
RKM29 Lewis, Claude-Claim, Tree(other
than sewer/water related)
Closed
2007 0745-20 CL+5
RKM29 Lewis, Diane-Claim, Trip/Fall Closed
2007 0745-50 CL+7
RKM29 Lewis, Mary-Claim, Sewer/Water
(Tree related)
Closed
2007 0745-20 CL+5
RKM29 Medina, Jennifer-Claim, Law
Enforcement
Closed
2007 0745-20 CL+5
RKM29 Midland, Jack-Claim, Sewer/Water
(other than tree related
Closed
2007 0745-20 CL+5
A
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY
CERTIFICATE OF DESTRUCTION?
SMEADSOFT BARCODES DELETED BY:.
DATE:
DATE
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management
A c,„ o, Program.
^ CARLSBAD Revised: 5/6/2014
RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: b ^7^/^
REQUESTING
DEPARTMENT: RISK MANAGEMENT
PAGE 10 OF 15
REQUESTER: TERIE ROWLEY
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 litigation or investigation involving these records is known to exist.
DEPARTMENT HEAD: RECORDS MANAGEMENT: CITY ATTORNEY:
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS
PERIOD
SMEADSOFT BARCODE
(if applicable)
RKM29 Nobel, Diana-Claim, Trip/Fall Closed
2007 0745-20 CL+5
RKM29 Pearson, Carol & G. Gary-Claim,
Sewer/Water (tree related)
Closed
2007 0745-20 CL+5
RKM29 Pittman, Trevon-Claim, Vehicle
Collision
Closed
2007 0745-20 CL+5
RKM29 Poponyak, Katie-Claim, Vehicle
Comprehensive
Closed
2007 0745-20 CL+5
RKM29 Quiroz, Sherri-Claim, Vehicle
Collision
Closed
2007 0745-20 CL+5
RKM29 Radosevic, Franjo-Claim, Vehicle
Collision
Closed
2007 0745-20 CL+5
RKM29
Raymond, Anthony Intl-RAI-Claim,
Sewer/Water (other than tree
related)
Closed
2007 0745-20 CL+5
RKM29 Rivkin, Jonathan-Claim, Trip/Fall Closed
2007 0745-50 CL+7
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY:
CERTIFICATE OF DESTRUCTION?
SMEADSOFT BARCODES DELETED BY:
• NO
DATE; 4^ 'J3 '^ff
DATE
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management
.^<^>c,,,o, Program.
^CARLSBAD Revised: 5/6/2014
RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: S -^7^/^ PAGE 11 OF 15
REQUESTING RISK MANAGEMENT REQUESTER: TERIE ROWLEY
DEPARTMENT:
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 litigation or investigation involving these records is knowiHoexjst
DEPARTMENT HEAD: RECORDS MANAGEMENT: CITY ATTORNEY:
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS
PERIOD
SMEADSOFT BARCODE
(if applicable)
RKM29 Rivkin, Shelly-Claim, Trip/Fall Closed
2007 0745-20 CL+5
RKM29 Roger, Analisa-Claim, Trip/Fall Closed
2007 0745-20 CL+5
RKM29 Roman, Rafael-Claim, Law
Enforcement
Closed
2007 0745-20 CL+5
RKM29 Ryan, Gail-Claim, Tree (other than
sewer/water related)
Closed
2007 0745-20 CL+5
RKM29
Sachs, Bruce-Claim, Vehicle
Comprehensive (other than
collision, tree or law enforcement
related
Closed
2007 0745-20 CL+5
RKM29
Scalia, Mike-Claim Vehicle
Comprehensive (other than
collision, tree or law enforcement
Closed
2007 0745-20 CL+5
RKM29 Schoonmaker, Nancy Faith-Claim,
Sewer/Water (tree related)
Closed
2007 0745-20 CL+5
V
\
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY
CERTIFICATE OF DESTRUCTION?
SMEADSOFT BARCODES DELETED BY:
£S • NO
DATE:
^ CARLSBAD
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management
Program.
Revised: 5/6/2014
RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: ^^7^/^^
REQUESTING
DEPARTMENT:
PAGE 12 OF 15
RISK MANAGEMENT REQUESTER: TERIE ROWLEY
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 litigation or investigation involving these records is known to exist
DEPARTMENT HEAD: RECORDS MANAGEMENT: CITY ATTORNEY:
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS
PERIOD
SMEADSOFT BARCODE
(if applicable)
RKM29
Schucard, Alice & Eric-Claim,
Sewer/Water (other than tree
related)
Closed
2007 0745-20 CL+5
RKM29
Search Engine Optimization, Inc.-
Claim, Sewer/Water (other than tree
related
Closed
2007 0745-20 CL+5
RKM29
Seller, Gary-Claim, Vehicle
comprehensive (other than collision,
tree or law enforcement related)
Closed
2007 0745-20 CL+5
RKM29 Shafran, Anne M.-Claim, Other,
relates to plane crash 2006
Closed
2007 0745-20 CL+5
RKM29 Shafran, Isabella B.-Claim, Other,
relates to plane crash 2006
Closed
2007 0745-20 CL+5
RKM29 Shafran, Margaret C.-Claim, Other,
relates to plane crash 2006
Closed
2007 0745-20 CL+5
RKM29 Shafran, Reid J.-Claim, Other, relates
1 to plane crash 2006
Closed
2007 0745-20 CL+5
^
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY:
CERTIFICATE OF DESTRUCTION?
SMEADSOFT BARCODES DELETED BY: _ /33ro\3^tA--^
DATE:
DATE:
I I,, o.
^ CARLSBAD
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management
Program.
Revised: 5/6/2014
RECORDS DESTRUCTION AUTHORIZATION FORM
DATE:
REQUESTING
DEPARTMENT:
RISK MANAGEMENT
PAGE 13 OF 15
REQUESTER: TERIE ROWLEY
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 litigation or investigation involving these records is known to exist
f
DEPARTMENT HEAD: RECORDS MANAGEMENT: CITY ATTORNEY:
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS
PERIOD
SMEADSOFT BARCODE
(if applicable)
RKM29 Shafran, Steven.-Claim, Other,
relates to plane crash 2006
Closed
2007 0745-20 CL+5
RKM29 Stephens, Kevin-Claim, Sewer/Water
(Tree related)
Closed
2007 0745-20 CL+5
RKM29 Stevens, Margrethe-Claim, Law
Enforcement
Closed
2007 0745-20 CL+5
RKM29 Streff, Gerry-Claim, Vehicle Collision Closed
2007 0745-20 CL+5
RKM29
Sympson, Kellen and Sierra-Claim,
Vehicle Comprehensive (other than
collision, tree or law enforcement
related. 1 of 2
Closed
2007 0745-50 CL+7
' RKM29
Sympson, Kellen and Sierra-Claim,
Vehicle Comprehensive (other than
collision, tree or law enforcement
related. 2 of 2
Closed
2007 0745-50 CL+7
A
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY:
CERTIFICATE OF DESTRUCTION?
SMEADSOFT BARCODES DELETED BY: _
iSyES • HO
DATE:
DATE
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management
A ' - - Program.
CARLSBAD Revised: 5/6/2014
RECORDS DESTRUCTION AUTHORIZATION FORM
DATE:
REQUESTING
DEPARTMENT:
RISK MANAGEMENT
PAGE 14 OF 15
REQUESTER: TERIE ROWLEY
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 litigation or investigation involving these records is known to exist
DEPARTMENT HEAD: RECORDS MANAGEMENT: CITY ATTORNEY:
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS
PERIOD
SMEADSOFT BARCODE
(if applicable)
RKM29 Taylor, Karen-Claim, Vehicle
Collision
Closed
2007 0745-20 CL+5
RKM29 Thomas, Bruce-Claim, Other,
Storage shed dispute
Closed
2007 0745-20 CL+5
RKM29 Thrifty Car Rental, Driver, Ramos-
Crafton-Claim, Vehicle Collision
Closed
2007 0745-20 CL+5
RKM29
Travelers Indemnity, Ins. Raymond
Anthony-Claim, Sewer/Water (Other
than tree related)
Closed
2007 0745-20 CL+5
RKM29 Urquhart, Ian & Fritzie-Claim, Tree
(Other than sewer/water related)
Closed
2007 0745-20 CL+5
RKM29 USAA Ins., Ferreira-Claim, Vehicle
Collision
Closed
2007 0745-20 CL+5
RKM29 Wardwell, Jeffrey-Claim, Law
Enforcement
Closed
2007 0745-20 CL+5
RKM29 Weeks, John-Claim, Vehicle Collision Closed
2007 0745-20 CL+5
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY
CERTIFICATE OF DESTRUCTION?
SMEADSOFT BARCODES DELETED BY:
YES • NO
DATE
CARLSBAD
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management
Program.
Revised: 5/6/2014
RECORDS DESTRUCTION AUTHORIZATION FORM
DATE:
REQUESTING
DEPARTMENT:
RISK MANAGEMENT
PAGE 15 OF 15
REQUESTER: TERIE ROWLEY
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 litigation or investigation involving these records is known to exist.
DEPARTMENT HEAD: RECORDS MANAGEMENT: CITY ATTORNEY
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS
PERIOD
SMEADSOFT BARCODE
(if applicable)
RKM29 Wilhelm, Jayne-Claim, Trip/Fall Closed
2007 0745-20 CL+5
RKM29 Wilson, Tonia-Claim, Sewer/Water
(Other than tree related)
Closed
2007 0745-20 CL+5
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY:
CERTIFICATE OF DESTRUCTION?
SMEADSOFT BARCODES DELETED BY:
[STYES • NO
DATE: C 'c^3 '^f(^ '
DATE
.^^i ctr Ol
CARLSBAD
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management
Program.
Revised: 5/6/2014
City of Carlsbad
Loss Run Roport
ClaknNatne
J^fMA, DEROZE
Date of
Loss
Date
Received
01/01/2007
and 12/31/2007
Date
Closed Category
Date
Litigate
Loss
Resenre
Expense
Reserve
Loss
Payment
Expense
Payment Incurred Status
01/19/2006 07/18/2006 03/30/2007 VEHICLE COLLISION 0.00 0.00 0.00 0.00 0.00 CLOSED
_'AAA, SPECK
la^'ACOSTA, JOE
Lik'^UNA, JUSTIN AND LU
06/07/2006
09/16/2005
01/15/2007
08/25/2006
09/16/2005
01726/2007
06/26/2007
08/30/2007
08/30^007
VEHICLE COLLISION
SEWER/WATER (TREE
VEHTCLECOM^PREHEI^
0.00
0.00
0.00
0.00
6.00
0.00
6,496.33
7,436.27
0.00
0.00
000
0.00
6,496.33
A436.27
^ aoo
CLOSED
CLOSED
CLOSED
Sjsr'/Km
LLEN, HELENE 09/27/2006 10/05/2006 04/30/2007 VEHICLE COLLISION 0.00 0.00 0.00 0.00 0.00 CLOSED
/VN^RAKI, SARAH 03/03/2006 01/26/2007 04/30/2007
ARCHSTONE SEASCAP 07/01/2006 09/13/2006 04/30/2007
AT&T, \ 06/19/20061 09/05/20061 03/30/2007
U^^'ARC
iS^TT
LAW ENFORCEMENT 03/07/2007
SEWER/WATER (TREE "
SEWER/WATER (TREE ;
0.00
0.00
0.00
0.00
0.00
000
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
CLOSED
CLOSED
CLOSED
rM—I * -rr— r-\\ .TTINGER, WILLIAM C. 01/03/2007i 03/13/2007' 04/03/2007 SEWER/WATER (OTHE
r-t -r-i I A M TT->t—f— rti-i *-i-i-
0.00 0.00 201.16 0.00 201.16 CLOSED
1|£V^ANICH, MIKE
11 j BANK OF AMERICA EXE
iECKER & ANNETT, KA
1(33^iELANGERrFRAI^CE^
02/22/2005
01/24/2006
01/17/2005
05/24/2005i
07/19/2006;
67/07/2065
04/03/2007
01/31/2007
6l708/2007
OTHER
OTHER
SEWER/WATER (TREE
0.00
6.00
0.00
0.00
0.06
0.00
0.00
0.00
785.00!
4,944.99
066
0.00
4,944.99
0.00
785^06
CLOSED
CLOSED
O-OSED
08/12/2006 12/12/2006 01/08/2007 VEHICLE COMPREHEN
r*n #1— /^-t-i II—r-> -i-i I A M /->/^
0.00 0.00 824.63 0.00! 824.63 CLOSED
NNETT, BETTY ANN
16
ERCHIOLLI, KENT & C
BERTUCCI, ANTHONY
09/18/2004
10/17/2006
01/11/2005
03/15/2005
10/24/2006
01/09/2006
07/13/2007 VEHICLE COLLISION
05/31/2007
01/31/2007
VEHICLE COLLISION
OTHER
^^^BCAI
09/27/2005
08/10/2006
0.00
0.00
0.00
0.00
0.00
0.00
0.00|
o.ooj
0.00
0.00;
o.ool
000
0.00'
0.00
0.00
CLOSED
CLOSED
CLOSED
IR, GILES & DEBRA 09/08/2007 09/17/2007 10/23/2007 SEWER/WATER (TREE 0.00 0.00 65.00! 0.00 65.00! CLOSED
^..BoSc
\ 1
j 1
20
[AS, WILLIAM
CO FAMILY TRUST,
BOSCO, JEANNE
01/18/2006
03/11/2005
03/11/2005
06/14/2006
12/21/2006
12/21/2006
01/31/2007
01/08/2007
01/08/2607
LAW ENFORCEMENT
SEWER/WATER (OTHE
i-> -Tl I A M -i-r->i—i— r-> 1—I A -I-i—
SEWER/WATER (OTHE
2nB<3TROS, MORROW
^g,KBFjADLEY-CLICHE, COU
0.00
0.00
0.00
0.00
0.00
0.00
O.OOj
0.00
O.ool
O.OOj
o^ooT
0.00
0.001
0.00
0.00'
CLOSED
CLOSED
CLOSED
07/28/2006
12/12/2005
08/18/2006
06/07/2006
03/30/2007
01/31/2007
VEHICLE COLLISION
VEHICLE COLLISION
0.00
0.00
0.00
0.00
0.00|
0.00!
O.OOi
0.00!
O.OOi
0.00;
CLOSED
CLOSED
BRODY, JOHN & CHRIS
v^^k^OWN, MARILYN
e&j^ROWN, RUSSELL
aSf^AMPBELl. RAMON
08/06/2007
02/11/2006
08/06/2007
08/09/2006
09/17/2007
03/30/2007
TREE (OTHER THAN SE
LAW EN'FcTwJEMENrf"
0.00
0.00
0.00
0.00
6,188.00;
0.00
0.00
0.00
6,188.00
0.00
CLOSED
CLOSED
2e55HAMBERLAIN, MICHA
28 CHRISTIANSON, JOHN
02/11/2006
10/14/2005
08/09/2006
02/22/2006
03/30/2007
03/30/2007
LAW ENFORCEMENT
TRIP/FALL
0.00
0.00
0.00
0.00
O.OOt
0.00
0.00
251.61
0.00
251.61
CLOSED
CLOSED
04/19/2006
02/13/2006
11/09/2006
07/06/2006
05/31/2007
01/31/2007
VEHICLE COLLISION
TRIP/FALL
0.00
0.00
0.00
0.00
0.00
0.00
0.00
oToo
?&>CrLINNIN, JOHN A.
'aO^SoLE, SHIRLEY
O.OOi
0.00
CLOSED
CLOSED
01/11/2005
09/16/2006
01/09/2006
10/23/2006
01/31/2007
05/31/2007
OTHER
TRIP/FALL
08/10/2006 0.00
0.00
0.00
0.00
0.00
6^66
3,734.78
0.60
3,734.781
-I
0.00!
CLOSED
CLOSED
,31>COONEY, TERESA & B
?2j5::RAWFORD, MICHAEL
05/22/2007
09/12/2006
05/24/2007
10/04/2006
06/19/2007
04/30/2007
TREE (OTHER THAN SE
VEHICLE COLLISION
0.00
0.00
0.00
0.00
212.06
0.00
0.00
0.00
212.06!
0.66i
CLOSED
CLOSED
Wednesday, April 17, 2013 LossRunClosed Page 1 of 4
city of Carlsbad
Loss Run Roport
ClalmName
Date of
Loss
aamsaosedlntwnn 01/01/2007
91112/31/2007
Date
Received
>33^CROMMETT, LAURA
Closed Category
Date
Litigate
Loss
Resen/e
Expense
Resen/e
Loss
Payment
Expense
Payment Incurred Status
WfoAViS, LOUISE
ft&-r6EFRANCESC0, RUSS
la&fSENNISON, JOYCE OR
a^^DEROZE, MARK
10/31/2006 12/07/2006 07/31/2007 VEHICLE COMPREHEN
Iir /^^i Ir— r-> -T-1 I A 11 /"./->
0.00 0.00 0.00 0.00 0.00 CLOSED
03/27/2007
10/07/2005:
03/16/2007i
03/28/2007
10/11/2005T
07/31/2007
63/05/2007
SEWER/WATER (TREE
TREEIOTHER THAN SE'
» A*r-r-> A« IA -l-l—r-> rti—i
05/02/2007 11/30/2007:SEWER/WATER (TREE
01/19/2006 01/27/2006 03/30/2007 VEHICLE COLLISION
!aa?6o
0.00
^00
O.OOi
0.00
0.66
0.00
30,508.73
7,875.00
0.00
4,093.40
0.00
6.00
34,602.13
0.00 0.00 0.00 721.65
7,875.00
0.00
CLOSED
CLOSED
CLOSED
721.65 CLOSED
30NNER, JR., PAUL
39 EATON, MONIQUE
L CAMINO REAL PART
uM^EMERY, SHARON 07/31/2006
|42^'STRADA-LEDESMA, M j 04/30/2006 06/14/2006
^FARMERS, INS: GRUBE 03/24/2007' 05/03/20071
i\d<f*^RMERS, MAYO ' 03/27/2007! 05/15/20071
03/31/2006 04/18/2007! 11/30/2007 LAW ENFORCEMENT
10/26/20061 11/29/2006 06/29/2007TsEWER/WATER (TREE
12/20/2006; 02/12/2007' 08/30/2007!sEWERWATER (TREE
0.00
0.00
0.00
0.00
O.OOj
0.00
0.00|
O.ool
i
0.00
0.00
0.00
0.00
0.00
O.OOj
O.OoT
CLOSED
CLOSED
CLOSED
01/29/2007 08/30/2007 VEHICLE COLLISION 0.00 0.00 0.00! 0.00 0.00 CLOSED
06/29/2007
11/30/2007
VEHICLE COLLISION
VEHICLE COLLISION
06/19/2007ISEWERWATER (TREE
|r-*r-i A-t-i—
0.00
0.00
o.oo!
0.00
0.00
0.00
6,000.00j
0.00
3,862.08!
1,308,25
0.00
o.ooi
7,308.25
0.00
3,862.08
CLOSED
CLOSED
CLOSED
FERREIRA, MATEO & J 11/26/2006 03/12/2007 05/18/2007 VEHICLE COLLISION 0.00; 0.00 156.16 0.00, 156,16 CLOSED
46 FLOWER, LAUREN
V^ORD, JIM '
tns4<RANCIS, ESTATE OF J j
01/24/2006
03/26/2007
01/24/2006
07/19/2006 01/31/2007 OTHER
04/03/2007' 10/29/2007lVEHICLE COLLISION
07/21/2006! 01/31/2007!OTHER
0.00
0.00
o.ool
0.00
0,00^
o.ool
0,00
o,oo!
o.ool
0.00
o.ooj
0.00
0.00
0.00
0.00
CLOSED
CLOSED
CLOSED
01/24/2006 07/21/2006 01/31/2007 OTHER 49 FRANCIS, MARY
gO^RRATT, DEBRA MAR 01/24/2006 07/21/2006
M^^RRATT, JR., JAMES I 01/24/20061 07/21/2006!
Ite^^iCO/BILLICK, 08/15/2006 12/08/2006|
0,00 0.00 0,00 0,00 0,00 CLOSED
01/31/2007 OTHER
OI/3I/2OO7T0THER
06/29/2007lVEHICLE COLLISION
0,00
0,00'
o,oo|
0,00
o,oo|
6.06I
0,00
O.ooi
o,oo|
0,00
0,60
6ro6
0,00
0,00
6,66
CLOSED
CLOSED
CLOSED
53 GLOBAL AEROSPACE, I 01/24/2006 07/21/2006
SA-j^OVER, CEDRIC I 07/05/20071 07/12/2007!
01/31/2007 OTHER
08/1 4/2007!VEHTCLE COLLISION
0,00
0.00!
0,00
O.ool
0.00
756.O0I
0.00
0,00
0,00
756,66
CLOSED
CLOSED
I^^ONZALEZ, RUTH COR 06/14/2007; 07/10/2007
gS-i^OLEY, DONNA 11/20/2006| 12/11/2006'
08/06/2007jVEHICLE COLLISION
06/29/2007 OTHER
4ZX56SHIPAIR, LLC, 01/24/2006
[ig^^^RUBE, DAN I 03/24/2007
0,00
0,00
O.OOi
O.ool
1,700,86|
0,6a
0,00
0,00
1,700,86
0,00'
CLOSED
CLOSED
07/21/2006
05/07/2007
01/31/2007OTHER
11/30/2007 VEHICLE COLLISION
5^|fC\YS, JODI j 09/19/2006:09/26/2006,03/30/2007
' ^P^RNANDEZ TAPIA, AN 03/28/2007' 03/29/2007^ 05/17/2007
0,00'
o,oo|
0,00
0,00
0,00
o,ool
0,00
0,00
0,00
o,66l
CLOSED
CLOSED
§J-<FfoGAN, SUMMER 12/02/2006
I S^'^KE, MARIANNE . 05/13/2006
OTHER
VEHICLE COMPREHEN
//"t-l-i ir-r^ -f-i I A 1
0,00
0,00!
0,00
0,06
0,00
236,60l
0,00
o!66
0,00j
236,60
CLOSED
CLOSED
eS^lHOLLIDAY, PARI
\^yf(6pE, DOUGLAS
07/09/2007! 10/29/2007ILAW ENFORCEMENT
08/09/20061 03/30/2007 LAW ENFORCEMENT
0,00
o,oo|
0,00!
o,o6|
0,00
o,ool
O.OOi
0.60
0.00
o.ool
CLOSED
CLOSED
07/28/2006 05/07/2007 07/31/2007 VEHICLE COLLISION
05/13/20061 07/05/20061 01/31/2007tvEHICLE COLLISION
0.00
O.ool
0,00
0,00^
0,00
aoo
0,00
0,00
0,00
0,00
CLOSED
CLOSED
Wednesday, April 17, 2013 LossRunClosed Page 2 of 4
city of Carlsbad
Loss Run Roport
Cjatj ClalmName
Date of
Loss
lUmsaoiiidlntwiMi 01/01/2007
and 12/31/2007
Date Date
Received Closed Category
UAxA^ - 2- ^ i^<^ /Vvv,j<=^
Date
Litigate
Loss
Reserve
Expense
Reserve
Loss
Payment
Expense
Payment Incurred Status
'HOUSTON, EARL
^^ACKSON, DONNIE
10/03/2006! 10/31/2006 05/31/2007yEHICLE COLLISION 0.00 0.00: 0.00 0.00 0.00 CLOSED
10/14/2006 10/27/2006 06/29/2007:VEHICLE COLLISION 0.00 0.00! 0.00 0.00 0.00 CLOSED
67 JAXAIR, LLC, 01/24/2006! 07/21/2006 01/31/2007 OTHER 1 ! olooj 0.00! oooj 0,00 o7oQ\ CLOSED
68<JELLINEK AS EXECUTR
\^ iix* 11 ii-si-r-i 1 1
01/24/2006| 07/19/2006 01/31/2007 OTHER '3' "] 0.00 o,o6| o7oo aoo ooo" CTOSED
69 JELLINEK TRUSTEE, JU
.r-n-t-i • 1
01/24/2006 07/19/2006 01/31/2007 OTHER 0.00 0,00 0,00 0.00 0,00 CLOSED
70 JELLINEK, JUDITH 01/24/2006 07/19/2006 01/31/2007 OTHER 0.00 0,00 0,00 0.00 0,00 CLOSED
71 JELLINEK, PETER
^2 JONES, SANAA
01/24/2006 07/19/2006 01/31/2007 OTHER
! i
07/13/2006 01/05/2007 08/30/2007 VEHICLE COLLISION
0,00
0,00'
aoo
o,oo!
0,00
0,00
0,00|
0,00
0,00[ CLOSED
0,00 CLOSED
7g^REWITZ, ROSS AND
7,4,^ROLY, NEILA . 10/26/2006 11/29/2006
75.^STLER, MARY LOU 04/06/20071 04/16/2007
' 7;g,,J<f(EIDMAN, JASON 06/22/2007 09/26/2007
|77 I LA COSTA DE MARBEL
^g^W^SBRISAS^pXcinCAS ' 09/28/2005 03/28/2006
' ^9^^:^W-EDWARDS, MART ' 09/13/2007' 09/17/2007
eoinifWiS, CLAUDE I 08/13/2007 08/13/20071
§1^>-t^WIS, DIANE 07/23/2005 '
08/17/2006! 02/20/2007 07/31/2007!SEWERWATER (TREE aoo aoo 0,00! 0,00 0,00 CLOSED
06/29/2007
11/30/2007
10/23/2007
SEWER/WATER (TREE
VEHfcLE^COLLISION
VEHICLE COLLISION
O.OOj
O.oo'
0,00
0,00j
0,00
6.o6l
0.00|
o.ooi
961.47
aoO|
0.00
aoa
0.00
0.00
961.47'
CLOSED
CLOSED
CLOSED
02/11/2003 05/14/2003 07/31/2007 OTHER 12/18/2003 0.00 O.oo: 100,000.00 129,729.46 229,729.46 CLOSED
02/07/2007:SEWER/WATER (OTHE
jr-> -Tl lAM -rrM—I— rtr-1 n -ri—
11/26/2007 TRIP/FALL
08/27/2007iTREE (OTHER THAN SE
0.00
O.oo'
ooot
0,00
aoo
o,oo|
90,306,50
367l22'
i5aoo|
8,464,67
0,00
o,oo!
98,771,17;
367.22
150.00l
CLOSED
CLOSED
CLOSED
01/06/2006 11/26/2007 TRIP/FALL 07/19/2006 aoo 0.00 5,000.00 0.00
^82^WIS, MARY
I 83JH9IEDINA, JENNIFER
j(a4<1vnDLAND, JACK
^aPl^LE, DIANA
^se>^i
vfB7 PITT, TAYLOR
I ^8„J»rfTMAN, TREVON
03/28/2007
11/16/2006
01/03/2007
05/24/2007;
05/17/20071
01/24/2007
06/26/2007 SEWER/WATER (TREE
11/30/2007|uW ENFORCEMENT
02/12/2007|SEWER/WATER (OTHE
0,00
OOO
6766
i-> -l-l i A M -i-i-> I—I— r->i—I A -l-l—
EARSON, CAROL AND
ig^>DPONYAK, KATIE
?QXf(j|ROZ, SHERRI
a3/(^D0SEVlc, FRANJO
g^^i^YMOND ANTHONY I
9&^VI0IV|', JONATHAN
94/^IVKIN, SHELLY
-4-
10/10/2006!
05/23/2002
07/13/2006^
07/13/2006'
12/15/2006
07/09/2003
07/31/2007 TRIP/FALL
06/29/2007lsEWER/WATER (TREE
0,00
0,00
0,00
0,00!
^.ooT
10,118,45
O.oo]
44O.O0I
0.00
0.00
0.00
5,000.00
0.00
0,00
0.00
0.001
0.00
0.06
10,118.45
0.00
440.00
CLOSED
01/05/2007 08/30/2007jVEHICLE COLLISION
01/05/20071 08/30/2007 VEHICLE COLLISION
O.OOj
6.66
O.OOj
0.00;
0.00;
;
0.00
0.00
0.00
0.00
0.00
0,00
0.00
07/26/2006!
09/01/2006;
09/29/2006 04/3a/2007!VEHICLE COMPREHEN
11/14/2006 05/31/2007 VEHICLE COLLISION
09/05/2006 j
12/04/2006
09/08/2006
OI/I8/2OO7!
03/30/2007
06/29/2007
0.00
0.00
0.00
O.ool
0.00
0.00'
0.00
aool
0.00
0.00
CLOSED
CLOSED
CLOSED
CLOSED
CLOSED
CLOSED
CLOSED
CLOSED
CLOSED
VEHICLE COLLISION
SEWER/WATER (OTHE
03/01/2003
03/01/2003
08/26/20031
08/26/20031
9§}^0GEH. ANNALISA
I 96LTOMAN, RAFAEL
01/31/2007
01/31/2007
TRIP/FALL
TRIP/FALL
0.00|
O.ool
0.00
0.00
O.OOI
23,997.00^
0.00
139.5a
0.00
24,136,50
CLOSED
CLOSED
12/04/2003 aoo
0,00
0,00
0,00
0,00!
0,00|
248,60
aool
248,60
0,00
CLOSED
CLOSED
04/17/2007
04/11/2007
05/23/2007
05/24/2007!
12/31/2007
12/31/2007
TRIP/FALL
LAW ENFORCEMENT
0,00
0,00
0,00
0,00
0,00
oool
0,00
0,00
0,00
0,00
CLOSED
CLOSED
Wednesday, April 17, 2013 LossRunClosed Page 3 of 4
City of Carlsbad
Loss Run Roport
OaiiB Oossd butwiMi 01/01/2807
and 12/31/2007
CJaj aimName
Date of
Loss
Date
Received
Date
Closed Category
Date
Litigate
Loss
Reserve
Expense
Reserve
Loss
Payment
Expense
Payment Incurred Status
RYAN, GAIL 07/11/2007 10/29/2007 12/17/2007 TREE (OTHER THAN SE 0,00 0.00 2,550.94 0.00 2,550.94 CLOSED
W'SACHS, BRUCE
4j98'j SCALIA, MIKE
IAf|-|->A»«A-|-|-|-> rtl-i A -|-|-|-\
iOer SCHOONMAKER, NANC
1 i-i-i • 1 iu^K SC
04/19/2007 04/30/2007 11/30/2007 VEHICLE COMPREHEN
- : - ^1* II—1-» -Tl I A M r^/^
02/10/2007 03/12/2007 05/17/2007 VEHICLE COMPREHEN
fvivirr-//^Ti IJ—r»-TJ I A-fct
04/06/2005 04/08/2005 03/30/2007 SEWER/WATER (TREE
0.00
0.661
0.00;
0.00
O.oo]
0,00
aoo
929,61
565,08!
aoo
o766|
6.00!
0.00
92961
565.08
CLOSED
CLOSED
CLOSED
HUCARD, ALICE & E 01/03/2007 01/10/2007 02/06/2007iSEWEFl/WATER (OTHE 0.00 aoo: 1,137.00 0.00 1,137.00 CLOSED
t -l-l I A M -rr->i— 1— r-i I—I A -TI—
102 SCHULTZ, ROBERT 01/11/2005 01/09/2006
I03<SEARCH ENGINE OPTI 12/04/2006! 06/01/2007
WA^E\LER, GARY 05/16/2007! 05/21/2007
i
01/31/2007PTHER
07/03/2007jSEWEFWVATER (OTHE
12/31 /2007IVBHICLE^COMPREHEN
i*"*!! fl— //~\-f-i If—r-t -f-i I A M rs.^
08/10/2006! 0.00
0.00
0.00
0.00!
oooj
0,00
0,00
2,406,24
0,00
0,00
I
0,00:
aoo
0,00
2,406,24
0,00
CLOSED
CLOSED
CLOSED
HAFRAN, ANNE M, 01/24/2006! 07/24/2006 01/31/2007OTHER 0,00 aoo aoo 0,00 0,00 CLOSED
|v06^H, 01/24/2006
01/24/2006
01/24/20061
SHAFRAN, ISABELLE B,
4,9?^HAFRAN, MARGARET
ioS^HAFRAN, REID J,
MJSf^HAFRAN, STEVEN 01/24/2006
I Ifl'^EPHENS, KEVIN 03/17/2007
i iL>^TEVENS, MARGRETH ' 04/15/2007
i 12>SfREFF, GERRY 01/02/2007
07/24/2006j
07/24/2006
0712412006
01/31/2007pTHER
OI/3I/2OO7I0THER
01/31/2007t6THER
0,00
0,00
0,06
0.00,
0.00;
0,00'
0.00;
O.OOj
oool
0,00
0.00
0.00
0.00
0.00
0.00
CLOSED
CLOSED
CLOSED
07/24/2006 01/31/2007 OTHER 0,00; 0,00! 0,00 0.00 0.00 CLOSED
03/19/2007
05/03/2007]
OI/O2/2OO7I
06/29/2007jSEWER/WATER (TREE
06/19/2007 LAW ENFORCEMENT
02/27/2007TvEHICLE COLLISION
0.00 --I 0.00
aool
aoo
aoo;
8,134.53
1,27560^
1,321.311
1,082.40
0,00
o7o6t
9,216.93
1,275.00
1,321.3^
CLOSED
CLOSED
CLOSED
l,1>«^YMPSON, KELLEN AN
nw..-^MPSON, KELLENAN"
3>mYL0R, KAREN
pg>;PffoMAS, BRUCE
\7j^R\FTY CAR RENTAL,
12/14/2006 01/02/2007 08/28/2007 VEHICLE COMPREHEN
> '•— f^-l-l II—l-l -l-l I A M
06/22/2007, 0.00 0.00 0.00 aoo 0.00 CLOSED
11/20/2006 01/02/2007 08/28/2007 VEHICLE COMPREHEN 06/22/2007
05/30/2007 06/12/2007 08/07/2007iVEHICLE COLLISION I
10/23/2006 10/24/20061 05/31/2007|OTHEIR
0,00
6.O0I
aool
0.00
0,00'
oool
0,00
1,826,79^
aoo
aoo
218.40j
0,00!
0.00
2,045 19
0.00
CLOSED
CLOSED
CLOSED
iisJ^A •/|—n i-»AU/->r> i^nAi—r ,
.VELERS INDEMNIT
.MrN. i->A\/>*^nr^ A n-i-i I
06/22/2007 08/16/2007 09/25/2007!VEHICLE COLLISION
12/04/2006' 05/03/20071 06/29/2007jsEWEF[yWATER (OTHE
0.00
0,00'
aoo
aoo!
4,141,49
81,187,65!
0,00
O.ool
4,141,49
81,187,65
CLOSED
CLOSED
I llg^RQUHART, IAN AND F
1^9j<JSAA, INS: FERREIRA
12/27/2006 01/22/2007 02/27/2007 TREE (OTHER THAN SE
! »Air-nAAiA-rr-jr* irtr-i AT^I~» .
11/26/2006 01/12/2007 05/17/2007 VEHICLE COLLISION
I^KSVARDWELL, JEFFREY 06/18/2006
ig2^EEKS, JOHN ! 06/28/2006
iaa^lLHELM, JAYNE 10/15/2006
\;^4^{LS0K TONIA 01/03/2007
aoo
6,00!
aoo
0,00
270,00j
1,463,86'
0,00!
0,00
270,00
1,463,86
CLOSED
CLOSED
08/22/2006 02/28/2007 LAW ENFORCEMENT
07/13/20061 01/31/2007IVEI-IICLE COLLISION
0.00
6.00
0.00
0.00!
aoo
o.ool
0.00
aool
0.00
O.OOi
CLOSED
CLOSED
01/16/2007
01/31/2007
12/31/2007
02/27/2007
TRIP/FALL
SEWERWATER (OTHE
! -0.00
0.00'
0,00
6166
0,00
363,99
0,00
0,00'
0,00,
363.99
CLOSED
CLOSED
' Totals aoo 0.00 412,218.01 154,937.71 567,155,72
Wednesday, April 17, 2013 LossRunClosed Page 4 of 4
»i!iM<inii«jj.iimi.mCT
0G36 - San Diego
9455 Waples St. Suite 110
San Diego, CA 92121
Phone # (858) -678-0460
Fax # (858) -678-0894
Certificate of Destruction
City of Carlsbad
1635 FARADAY AVE
CARLSBAD, CA 92008-7314
Document # 8005499713
Document Date 06/23/2014
Cintas Route/SSR R0G36.0046/Luis Anzueto
Customer* 10213041
Service Type Purge
Customer Group On-Site
Next Service Date
Material #
SV0000326
Description
Purge Svc (P/On)-Legal (Large) Box
Quantity
996.00 EA
Order Notes
Quantity Serviced
il2 sm]
Has 100- 150 Boxes at: 5816 El Camino Real, Carlsbad, 92008. Hours: 8
am - 5 pm. Contact is Pat Downie 760-602-2738. Please call ahead of
time if you will be there between 11:30 and 1 pm. There will be a box
truck here collecting blue prints as well. Will invoice. Scheduled per
Sales Rep. Liz.
MANUAL PUSH 20140617 212016
This certificate is to certify tiiat Cintas Document Management shreds confidential data per customer's instructions for the above-mentioned company.
The following services are NAID certified: Hard Drive Destruction, Mobile Destruction and Offsite Destruction. The following services are not NAID
certified: Non-paper Destruction.
Service Representative Signature Date (f> 13 h
Page 1 of