HomeMy WebLinkAbout; ; Records Destruction Authorization Form-CMWD; 2012-03-22<^^5^ CITY OF
^ CARLSBAD
RECORDS DESTRUCTION AUTHORIZATION
Qy
Records Management
Page 1 of 1
DEPARTMENT REQUESTING DESTRUCTION:
Person(s) Completing Form:
PROVALS FOR DESTRUCTION
Department Head
/A/Records Manager
Date'
City Attorney
Date
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
n/a Reports & Studies, general: HVAC test &
balance report
1990 1000-70 20 n/a
n/a General info: CMWD ^6^(t{^^sp^A^^€ACe 1990 1200-10 CU + 2 n/a
— 7^ iVa cert ot insurance 1992 -0470-33 CU + 2 ^T/a ifi^
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY
CERTIFICATE OF DESTRUCTION?
SMEADSOFT BARCODES DELETED BY:
:2ii2:^^-El-
YES • NO
DATE
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 ahrecl-li USA Inc.
P. O. Box 2077
Vista. CA 92065207
PHONE 760-5% . . UU
CERTIFICATE REFERS TO INVOICE NO.: Qq^^ Q^l,^^qr^
PURGE
DATE:
SERVICE LOCATION: BILLED TO:
1. v>f Carfsbsfi^-Re^ords MaD^gem?'*^^
5815 Ef CaminoJ^al j
**H0 SUR-CH^E ^
Carlsbad, CA §2IK}e
This is to certify that Shred-it destroyed confidential information
for the above mentioned company by
^ 4
TRUCK NO.: TRUCK NO.:
O
CUSTOMER SERVICE REP.: j ^'^^i/^-'^f 1)
TOTAL TIME:
CLIENT:
PRINT CUSTOMER'S
NAME: ^ ,^
HRS. MIN. /7
This year, through Shred-it's
recycling program, your firm
has saved i trees from destruction.
CERTIFICATE OF
DESTRUCTION
THANK YOU FOR
YOUR BUSINESS.
SECURING YOUR OFFICE
AND THE ENVIRONMENT