HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Parks & Recreation; 2022-08-11This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
Revised: 2021
Page | 1
DATE: 06/16/2022
REQUESTING DEPARTMENT: PARKS & RECREATION REQUESTER: ADRIANA ALVAREZ
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)
2 boxes Copies or duplicates of any record CW-105
Copies - When No Longer Required
N/A
RECORDS DESTRUCTION AUTHORIZATION FORM
2018-2020
06-20-2022 7/18/226/17/22
CORODATA 8/11/2022
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Carlsbad
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Account #(s)SD012455Certificate #101838Date IssuedMonday, August 15, 2022Service Locations5815 EL CAMINO REALDate Range of ServiceAug-11-2022 thru Aug-11-2022Work Ticket(s)1004451Quantity/Item74 - 74 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 & RECYCLINGThis Certificate is presented to: CITY OF CARLSBAD - RECORDS MANAGEMENT DIVISIONPer 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.tJcorodata m ~,~ SSAE16 Type II Audit Completed HIP.NA