HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Library & Cultural Arts; 2012-03-22 (2)''•^0^' CITY OF
CARLSBAD
Records Management
Page 1 of 1
RECORDS DESTRUaiON AUTHORIZATION
DEPARTMENT REQUESTING DESTRUaiON:
Person(s) Completing Form: /
APPROVALS FOR DESTRUaiON
Department Head Date
Date Records Manager
City Attorney Date
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.
BOX
NO.
RECORDS DESCRIPTION DATED RRS NO. RRS
PERIOD
SMEADSOFT
BARCODE
(if applicable)
APPROVED By
City Attorney
H=HOLD
/ SuiUMQl ^\lbrs C^fS -^00 7 S'S
•
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY:
CERTIFICATE OF DESTRUCTION?
SMEADSOFT BARCODES DELETED BY:
YES • NO
DATE: ibj^Z^
DATE:
This form documents the destruction of City records in accordance with the City of Carlsbad Records
Management Program
Revised 12/23/2009
WE RECYCLE USAinc:
p. O. Bm 2m7
Vista. CA 920852077
RHONE 760-598-57OQ
SERVICE LOCATION: BILLED TO:
L liv Of Carfsbsfil-Reforcis Managem^^'^*
5815 Et CafB*n<3UPt»Bal
**N0 SUR-CHi«^E
Carfsbad, CA §2WS
CERTIFICATE REFERS TO INVOICE NO.: f)9i 0631499
3/22/2012
PURGE
DATE:
This is to certify that Shred-it destroyed confidential information
for the above mentioned company by
TRUCK NO.:
f f7 (J
CUSTOIVIER SERVICE REP.:
TRUCK NO.
o
TOTAL TIME:
CLIENT:
PRINT CUSTOMER'S
NAME:
This year, through Shred-it's
recycling program, your firm
has saved 0 trees from destruction.
CERTIFICATE OF
DESTRUCTION
THANK YOU FOR
YOUR BUSINESS.
HRS. MIN.:
SECURING YOUR OFFICE
AND THE ENVIRONMENT