HomeMy WebLinkAbout; ; Records Destruction Authorization Form-City Clerk; 2019-01-24RECORDS DESTRUCTION AUTHORIZATION FORM
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DATE: 12/1/2018
REQUESTING DEPARTMENT: CITY CLERK REQUESTER: HEIDI DEWITT
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.
1 CLOSED CLAIMS AGAINST CITY 2010-0745-20 2012
CITY ATTORNEY:
RRS TAB BARCODE
PERIOD (if applicable)
CL+S
*If more spaces ore needed, click in the last box in right hand corner of table and hit "tab". This will create more fields in the table.
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY: ~c/dU
CERTIFICATE OF DESTRUCTION? '129... YES O NO
SMEADSOFT BARCODES DELETED BY: ___________ _
DATE:
DATE: _____ _
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
«~'> CITT o, Revised: 12/31/2018 ~ CARLSBAD
CERTIFICATE OF DESTRUCTION & RECYCLING
This certificate is presented to: CITY OF CARLSBAD -RECORDS MANAGEMENT DIVISION
Per the express request of Client, Corodata has received the Material referred to below and has/will destroy and then
recycle said Material in accordance with its standard procedures. As the parties have agreed, Corodata will not
inventory, record or track any information contained within or related to the Material.
Account #(s)
Certificate #
Date Issued
Service Locations
Date Range of Service
Work Ticket(s)
Quantity/Item
SD012455
109525
Monday, January 28, 2019
5815 EL CAMINO REAL
Jan-24-2019 thru Jan-24-2019
553347
62 -62 Boxes for Destruction (standard)
• Nothing in this cerlificate shall be deemed to modify the terms of the parlies' SeNice Agreement(s) or Work Ticket(s).
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