HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Parks & Recreation; 2021-07-15 (10)--
Corodata 7/15/2021
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RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: MAY 28, 2021
REQUESTING DEPARTMENT: PARKS & REC REQUESTER: KYLE LANCASTER
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.
M//4 ~~ f ~, ~ s/LB ,,_A_a:c--__ D._&-_w-JU(l., __ · _06_11_612_0_21
(j~ MEAD/DIVISION MANAGER DATE l RECORDS MANAGEMENT DATE
BOX NO; RECORDS DESCRIPTION DATED RRS NO.
2KL Parks Div Personnel Files CY 2004-14 CW-210
~/C.~
c.e (17/?tJ 2d
CITY ATTORNEY DATE
RRS
PERIOD
3 Yr-Sep
TAB BARCODE
(if applicable}
*If more spaces are needed, click In the last box In right hand corner of table and hit "tab". This wll/ 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
Page /1
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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