HomeMy WebLinkAbout; ; Records Destruction Authorization Form-City Council; 2007-06-04RECORDS DESTRUCTION REQUEST
City Clerk/Records Management
Page 1 of 1
Department Requesting Destruction: O fTM CourxCiL—
ftApprovals for Destruction
4/211
Date
5T-/ -
Records Manager Date
S- 1-
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.
This form documents the destruction of City records in accordance with the California Public Records Act
Revised 08/25/2005
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SHREDfQ/KT
SECURE DOCUMENT DESTRUCTION
Client materials are to be destroyed off-site. Client will
receive official Certificate of Destruction upon completion
of service.
Jtiis 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: " -iJ. 'AM
Billing Address Service Address
Contact:Phone Number: L
SHREDFOflCE ID#:.
Balance Due: $_
Amount Paid: $.
/Oc?5^SHREDFOf?C£Signature:
Please Invoice Client
Check Number:
Credit Car*
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Authorized Representative:
Comments:
TB: Hours:
Authorized Signature^.
Other:
Type
Quantity
Service
Rate
Total
File Boxes
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ao
*\f)n^ls
Bankers
Boxes
Shred Force
Executive
100
ShredForce
250
Other^
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&&
/$* -~~~"
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Other Other
SHREDFORCE • PO Box 891 • San Marcos, CA 92079 • (800)444-6209
09/05