HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Parks & Recreation; 2021-07-15Corodata 7/15/2021
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RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: 6/14/2021 ----"'"----'------
REQUEST l NG DEPARTMENT: P&R REQUESTER: CHARLENE BUCICALEW
DESTRUCTION APPROVALS:
We certify that the records iisted below have been retained for the scheduled retention peri~d, required audits have been
completed, and no pending or ongoing litigation or investigation involving these records is known to exist.
/{JJL~--" ,,fb W(V-l11 /Ja:e-v~~ er~ EAD/OIVISION MANAGER DATE \ ( ' RECORDS MANAGEMENT
06/16/2021
DATE CITY ATTORNEY DATE
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS TAB BARCODE
PERIOD (if applicable)
Correspondence -ROUTINE
(Content relates in a substantive
way to the conduct of the public's ~ St..e-a.,ftachd. 5 boxes business) CW-110 2 years (e.g. Administrative, Chronological, 1970-2019
General Files, Letters, Memorandums,
Reading FIie, Working Flies, etc.)
*(See attached for documentation)
Copies or duplicates of any record When No ~ 5 t e. a. /;tJw1 td, 5 boxes *(See attached for documentation) 1970-2019 CW-105 Longer
Required
*If more spaces ore needed, click In the last box In right hand corner of table and hit "tab". This wlll create more fields In the table.
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY: __________ _ DATE: _____ _
CERTIFICATE OF DESTRUCTION? 0 YES 0 NO
TAB BARCODES DELETED BY: DATE:
This form documents the destruction of City records In accordance with the City of Carlsbad Records Management Program.
(city of
Carlsbad Revised: 2021
Pag e /1
RECORDS . DESTRUCT ION AUTHORIZAT IO.N FORM
DATE: 3 /It /'2--o
REQUESTING DEPARTMENT: _Yi~a~r_.\_;_5 ____ _ REQuEsTER: {)a rb :h:~/\.e.~
DESTRUCTION APPROVALS:
We certify that the records fisted 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.
*For documentation purposes only!
RECORDS MANAGEMENT: DATE
BOX NO. RECORDS DESCRIPTION DATED RRS NO.
11
CITY ATTORNEY: . DATE
0
TAB BARCODE
(if applicable)
*If more spaces are needed, clicl< 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: __________ _ DATE: _____ _
CERTIFICATE OF DESTRUCTION? 0 YES 0 NO
SMEADSOFT BARCODES DELETED BY: -------------DATE: _____ _
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
{cityof
Carlsbad Revised: 12/17/2019
RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: I~\ <,;/1 4
REQUESTING DEPARTMENT: f ('L ' ~ 4
DESTRUCTION APPROVALS:
We cettify that the records listed beiow 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.
*For documentation purposes only! .
RECORDS MANAGEMENT: DATE
BOX NO. RECORDS DESCRIPTION DATED RRS NO.
CITY ATTORNEY: DATE
TAB BARCODE
(if applicable)
*If more spaces are needed, cl/clc in the last box in right hand corner of table and hit "tab". This wJ/1 create more fields In the table.
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY: DATE: ------------------
CERTIFICATE OF DESTRUCTION? 0 YES 0 NO
SMEADSOFT BARCODES DELETED BY: ___________ _ DATE: ------
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
{ City of
Carlsbad Revised: 12/17/2019
I
RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: _fl~-/L_,__o--'-(_W ___ _
REQUESTING DEPARTMENT: _ _,_f+-m=~~~-___ _
I
REQUESTER:
DESTRUCTION APPROVALS:
We cettify 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 TAB BARCODE
PERIOD
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*If more spaces are needed, click In the last box In right hand corner of table and hit "tab". This w/11 create more fields In the table.
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY: __________ _ DATE: ------
CERTIFICATE OF DESTRUCTION? 0 YES 0 NO
SMEADSOFT BARCODES DELETED BY: ___________ _ DATE: ------
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
( City of
Carlsbad Revised: 12/17/2019
RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: . I ,I l / '?JJ
REQuEsT1NG DEPARTMENT: f ~ f?_,.., Mm, 0 REQUESTER:
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.
*For documentation purposes only!
RECORDS MANAGEMENT: CITY ATTORNEY:
BOX NO, RECORDS DESCRIPTION DATED RRS NO. RRS TAB BARCODE
PERIOD (if applicable)
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*If more spaces are 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: _________ _ DATE: ____ _
CERTIFICATE OF DESTRUCTION? 0 YES . 0 NO
SMEADSOFT BARCODES DELETED BY: __________ _ DATE: _____ _
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
«~' CITY or Revised: 5/24/2018 -~ CARLSBAD ·
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RECORDS DESTRUCTION AUTHORIZAT ION FORM
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DATE: 1 / f/ to
REQUESTING DEPARTMENT: P 1 ,,__ MM/ hi REQUESTER: ~/ K :Wvpfhlt}W~
DESTRUCTION APPROVALS:
We certify that the records 1/sted 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.
W}/J,..___,_ A_~ _ -~--s; \}J J •For documentation purposes only!
v O !Jfl'ARTMENT HEAD: r ( . RECORDS MANAGEMENT: CITY ATTORNEY:
BOX NO, RECORDS DESCRIPTION DATED RRSNO. RRS
PERIOD
11.Jft'
TABBARCODE
(if applicable)
*If mare spaces are needed, click In the last boK In right hand earner of table and hit "tab". This wl/1 create mare fields In the table.
To be fllled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY: _________ _ DATE: ____ _
CERTIFICATE OF DESTRUCTION? 0 YES . 0 NO
SMEADSOFT BARCODES DELETED BY: __________ _ DATE: ------
This form documents the destruction of City records In accordance with the City of Carlsbad Records Management Program.
<.:'~t cm ., Revised: 5/24/2018 -~ CARLSBAD
·=-.....:....r~-==-~=-==•====-•================·-=· =========·=· ===---== ·====--=
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RECORDS DESTRUCTION AUTHORIZATION FORM
DATE:
REQUESTING DEPARTMENT: REQUESTER:
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.
( *For documentation purposes only! ------
RECORDS MANAGEMENT: CITY ATTORNEY:
BOX NO, RECORDS DESCRIPTION DATED RRSNO. RRS TAB BARCODE
PERIOD (if applicable)
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"If more spaces are needed, click in the last box In right hond 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: _________ _
CERTIFICATE OF DESTRUCTION? 0 YES 0 NO
DATE: ------
SMEADSOFT BARCODES DELETED BY: __________ _ DATE: _____ _
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
«~' cm o, ,. Revised: 5/24/2018 ~ CARLSBAD ·
r
· RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: l~/ ··W -~r, -+,-------
REQUESTING DEPARTMENT: p 9 (l /(T) D1 t rJ REQUESTER:
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.
Z+-( ________ *_F_o_r_d_ocumentation purposes only!
RECORDS MANAGEMENT: CITY ATTORNEY:
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS TAB BARCODE
~-PERIOD (if applicable)
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*If more spaces are 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: _________ _ DATE:~·-----
CERTIFICATE OF DESTRUCTION? 0 YES . 0 NO
SMEADSOFT BARCODES DELETED BY: ___________ _ DATE: _____ _
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
«~" cm o, Revised: 5/24/2018 ~ CARLSBAD .
--,-·1 ,-'· ----.-.--• .... .:..,
RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: ~~ I 1 / ,;i,O
REQUESTING DEPARTMENT: $ ~ t'.5 ~ ~«
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.
*For documentation purposes only!
RECORDS MANAGEMENT: CITY ATTORNEY:
BOX NO, RECORDS DESCRIPTION DATED RRS NO. RRS TAB BARCODE
PERIOD (if applicable)
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*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: _________ _ DATE: _____ _
CERTIFICATE OF DESTRUCTION? 0 YES 0 NO
SMEADSOFT BARCODES DELETED BY: __________ _ DATE: ------
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
<<~f-rn, o, Revised: 5/24/2018 ~ CARLSBAD -
7
RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: (2-/ !,o (tdl_ ,
REQUESTING DEPARTMENT: crie.... Mm 10 REQUESTER: ~1rUJyJn-v CW{ fut-
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.
*For documentation purposes only! +-------------RECORDS MANAGEMENT: CITY ATTORNEY:
BOX NO, RECORDS DESCRIPTION DATED RRS NO. RRS TAB BARCODE
PERIOD (if applicable)
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*If more spaces are needed, click In the last box in right hand come of table and hit "tab". This will c ate more fields in the table. ('Z,
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY: _________ _ DATE: ------
CERTIFICATE OF DESTRUCTION? ' 0 YES . 0 NO
SMEADSOFT BARCODES DELETED BY: ___________ _ DATE: _____ _
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
«i~ CITY or Revised: 5/24/2018 ~ CARLSBAD ·
7
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RECO RDS DESTRUCTION AUTHORIZATION FORM
DATE: _\2---<-=(1.o-'-=--+--'I ,._____., ___ _
REQUESTING DEPARTMENT: --'-f1µ~:;:___:Af}4,,1,LLM.!..LI...:.IW_::__ __ _ REQUESTER: ----l-E-:-' --1.-L-=-=l(.-=-vfrlri~=buJ=-=JSJ.=--e~1t::---
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.
*For documentation purposes only! -------------RECORDS MANAGEMENT: CITY ATTORNEY:
BOX NO, RECORDS DESCRIPTION DATED RRS NO. RRS TAB BARCODE
PERIOD (if applicable)
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*If more spaces are needed, c/Jck in the last box In r,ght hand corner of table and htt "tab". Thts will create more flelds m the table.
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY: _________ _ DATE: _____ _
CERTIFICATE OF DESTRUCTiqN? 0 YES . 0 NO
SMEADSOFT BARCODES DELETED BY: __________ _ DATE: _____ _
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
<&-ii:, CITY or Revised: 5/24/2018 ~ CARLSBAD .
• J
RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: ) d d,'
REQUESTING D EPARTMENT: _.__(.J_,(dl£/_'-'---'-"'-,l-'-(_5~----
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.
*For documentation purposes only! -------------
RECORDS MANAGEMENT:
BOX NO, RECORDS DESCRIPTION DATED RRSNO. RRS
PERIOD
\
(
CITY ATTORNEY:
TABBARCODE
(if applicable)
*If more ~pace~ are_nf!eded, c/Jc~ Ip the Ja~t ~x)n rlq_fit h~[ld corner of..tabl';.fnd hi~ 11t~b1'. This w/11 creoj more fields In the table.
To be filled out once records have been destroyed ..
RECORD DESTRUCTION COMPLETED BY: _________ _ DATE: _____ _
CERTIFICATE OF DESTRUCTl<?N? 0 YES . 0 NO
SMEADSOFT BARCODES DELETED BY: __________ _ DATE: _____ _
This form documents the destruction of City records In accordance with the City of Carlsbad Records Management Program.
✓-~r, cm DJ Revised: 5/24/2018 ·~ CARLSBAD
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RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: s/ 1-t I 12-v
. REQUESTING DEPARTMENT: ~arks -~~~-------REQUESTER: ~ rh 0-l/lvu=:~
DESTRUCTION APPROVALS:
We ce,tify 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 kn·own to exist.
*For documentation purposes only!
DEPARTMENT HEAD: DATE RECORDS MANAGEMENT: DATE CITv°ATTORNEY: DATE
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS TAB BARCODE
~ PERIOD . (if applicable)
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*If more spaces are needed, click in the last box in right hand corner of table and hit "tab". This wlll create more fields In the table.
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY: DATE: ------------------
CERTIFICATE OF DESTRUCTION? 0 YES 0 NO
SMEADSOFT BARCODES DELETED BY: --------------DATE: ____ _
This form documents the destruction of City records in ac_cordance with the City of Carlsbad Records Management Program.
("cityof
Carlsbad Revised: 12/17/2019
Account #(s)SD012455
Certificate #100061
Date Issued Monday, July 19, 2021
Service Locations 5815 EL CAMINO REAL
Date Range of Service Jul-15-2021 thru Jul-15-2021
Work Ticket(s)839982
Quantity/Item
1 -CALL 20 MINUTES RPIOR TO
ARRIVAL - 760-271-6841
77 -77 Boxes for Destruction (standard)
* Nothing in this certificate shall be deemed to modify the terms of the parties¶Service Agreement(s) or Work Ticket(s).
CERTIFICATE OF DESTRUCTION & RECYCLING
This Certificate is presented to: CITY OF CARLSBAD - R
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.
E•Jcoro data SSAE16
Type II Audit Completed • HIPA'A
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