HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Fire; 2022-04-21RECORDS DESTRUCTION AUTHORIZATION FORM
DATE: JANUARY 10, 2022
REQUESTING DEPARTMENT: FIRE REQUESTER: Marie Jones-Kirk-----------
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.
� � /2-1'2-DEPARTMENT HEAD: DATE RECORDS MANAGEMENT: DATE CITY ATTORNEY: DATE
BOX NO. RECORDS DESCRIPTION DATED RRSNO. RRS TAB BARCODE
PERIOD {if applicable)
FD033 EOC Exercises FR-085 10 years
*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
SMEAPSOFT BARCODES DELETED BY: __________ _ DATE: _____ _
This form documents the destruction of City records In accordance with the City of Carlsbad Records Management Program.
Ccityof Carlsbad Revised: 12/28/2021
Prior to 2011
03-30-2022 3/31/2022
N/A
CORODATA 4/21/2022X
-- --
Account #(s)SD012455
Certificate #101558
Date Issued Friday, April 22, 2022
Service Locations 5815 EL CAMINO REAL
Date Range of Service Apr-21-2022 thru Apr-21-2022
Work Ticket(s)958844
Quantity/Item
1 -CALL 20 MINUTES RPIOR TO
ARRIVAL - 760-271-6841
46 -46 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 - 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.
E•Jcoro data SSAE16
Type II Audit Completed • HIPA'A
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