HomeMy WebLinkAbout; ; Records Destruction Authorization Form-City Manager; 2007-06-04RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
Department Requesting Destruction: C lfl/1 (fLaatfef
Approvals for Destruction
Depdrtmentffiad
4/4/07
Date
Manager Date
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.
Person(s) Completing Form:
No.RECORDS DESCRIPTION DATED BOX
No.
RRS No.RRS
Period
BARCODE APPROVED By
City Attorney
H=HOLD
'le*r • v » . I01 ft?-4
Current
42- /f
RECORD DESTRUCTION COMPLETED BY :
CERTIFICATE OF DESTRUCTION? YeS No
SMEADLINK BARCODES DELETEI>BY:
Cg,DATE : £ A/D
DATE;
This form documents the destruction of City records in accordance with the California Public Records Act
Revised 08/25/2005
Shi WLV FORCE
SECURE DOCUMENT DESTRUCTION
Client materials are to be destroyed off-site. Client will
receive official Certificate of Destruction upon completion
of service.
-E^Jliis CERTIFICATE OF DESTRUCTION certifies the complete
destruction of all material contained as described below on the
date and at the time recorded herewith.
Date / Time of Pick up:_AM PM Date / Time of Destruction: " ^-AM
Billing Address Service Address
u
Contact:Phone Number: (_
Type
Quantity
Service
Rate
Total
File Boxes
tffiAto
^^ao
^<2<
Bankers
Boxes
ShredForce
Executive
100
ShredForce
250
Qther^
fafyj^qt^A^j
\
/r^
&<*>
Other Other
SHREDFORCEID#:.
Balance Due: $.
Amount Paid: $.
Signature:
Please Invoice Client
Check Number:
Authorized Representative:
Comments:
TB: Hours:
Authorized Signatun
Other:
SHREDFORCE PO Box 891 San Marcos, CA 92079 (800) 444-6209
09/05