HomeMy WebLinkAbout; ; Records Destruction Authorization Form-City Clerk; 2022-01-27This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
Revised: 2021
Page | 1
DATE: JANUARY 20, 2022
REQUESTING DEPARTMENT: CITY CLERK REQUESTER: MARIA EMERY
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.
DEPT. HEAD/DIVISION MANAGER DATE RECORDS MANAGEMENT DATE CITY ATTORNEY DATE
*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? YES NO
TAB BARCODES DELETED BY: _____ _______________________________ DATE: ______________
BOX NO. RECORDS DESCRIPTION DATED RRS NO. RRS
PERIOD
TAB BARCODE
(if applicable)
1 BOX Public Comment Records (submitted by members of the public; pertains to items not on the Agenda)
2016 CC-205 2 YEARS SEE ATTACHED
CLOSED CLAIMS 2016 CW-085
Copies - When No Longer Required (Upon Settlement
SEE ATTACHED
Economic Interest Filings (FPPC 700 Series Forms - Statement of Economic Interests): ALL (B&Cs, Consultants, Planning Commission, Employees) 2014 CC-075 7 YEARS SEE ATTACHED
RECORDS DESTRUCTION AUTHORIZATION FORM
1/25/2022 01-25-2022 1-25-22
CORODATA 1/27/2022
X
MARIA EMERY 1/27/2022
C cityof
Carlsbad
□ □
Name Template
Name
Label Line
4
2016; Public Comment Information;Physical
Folder
BOARDS AND COMMISSIONS; STATEMENTS OF
ECONOMIC INTERESTS;
Physical
Folder 2014
CONSULTANTS; STATEMENTS OF ECONOMIC INTERESTS;Physical
Folder 2014
EMPLOYEES; STATEMENTS OF ECONOMIC INTERESTS;Physical
Folder 2014
PLANNING COMMISSION; STATEMENTS OF ECONOMIC
INTERESTS;
Physical
Folder 2014
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1/20/2022about:blank
CERTIFICATE OF DESTRUCTION & RECYCLING
This certificate is presented to: CITY OF CARLSBAD -RECORDS MANAGEMENT DIVISION
Per the express request of Cl ient, 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
101434
Friday, January 28, 2022
5815 EL CAMINO REAL
Jan-27-2022 thru Jan-27-2022
920995
1 -driver call Kathryn Ronq uillo 20 minutes
before he arrives at so
she can meet you
41 -41 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)
t•Jcor odata SSAE16
Type II Audit Completed HIP~