HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Housing & Homeless Services; 2023-03-23 (3)This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
Revised: 2021
P a g e | 1
DATE: 12/29/22
REQUESTING DEPARTMENT:HOUSING &HOMELESS
SERVICES REQUESTER:NICOLE PIANO-JONES
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
BOX NO. RECORDS DESCRIPTION DATED RRS NO.
RRS
PERIOD
TAB BARCODE
(if applicable)
CDBG2.22 Brother Benno Center FY 2014-15 HS-010 Min. 5
Years H0004907
CDBG2.22 City of Carlsbad
Administration
FY 2014-15 HS-010 Min. 5
Years H0004919
CDBG2.22 CSA San Diego County Fair
Housing Program
FY 2014-15 HS-010 Min. 5
Years H0004918
CDBG2.22 Interfaith Community Services FY 2014-15 HS-010 Min. 5
Years H0004911
CDBG2.22 City of Carlsbad Housing
Reserve Fund
FY 2014-15 HS-010 Min. 5
Years H0004920
CDBG2.22 Boys & Girls Club Teen Scene
Program
FY 2014-15 HS-010 Min. 5
Years H0004906
CDBG2.22 Catholic Charities La Posada
de Guadalupe
FY 2014-15 HS-010 Min. 5
Years H0004909
CDBG2.22 Community Resource Center
Homelessness Prevention
FY 2014-15 HS-010 Min. 5
Years H0004910
CDBG2.22 Senior Meal
Program
FY 2014-15 HS-010 Min. 5
Years H0004914
CDBG2.22 YMCA OZ Youth Shelter FY 2014-15 HS-010 Min. 5
Years H0004916
CDBG2.22 Casa de Amparo Food
Program
FY 2014-15 HS-010 Min. 5
Years H0004908
CDBG2.22 Meals on Wheels FY 2014-15 HS-010 Min. 5
Years H0004912
CDBG2.22 North County Community
Services Food Bank
FY 2014-15 HS-010 Min. 5
Years H0004913
RECORDS DESTRUCTION AUTHORIZATION FORM
DocuSign Envelope ID: 36046109-38E2-4FE2-B824-D8CFED663C97
DATE:
REQUESTING DEPARTMENT:
DESTRUCTION APPROVALS:
12/29/22
HOUSING & HOMELESS
SERVICES REQUESTER: NICOLE PIANO-JONES
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.
/)A 414 J /)A j/1 I 1/17/2023
DEPT. HEA~/DIVISION MANAGER DATE
{'"city of
Carlsbad
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-
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The Angel's Depot-
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1/17/2023 1/18/2023
RECORDS MANAGEMENT DATE CITY ATTORNEY DATE
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This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
Revised: 2021
P a g e | 2
*If more spaces are needed
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY:___________________________DATE:______________
CERTIFICATE OF DESTRUCTION?YES NO
TAB BARCODES DELETED BY:_____ _______________________________ DATE:______________
CDBG2.22 Solutions for Change
Employment Training
FY 2014-15 HS-010 Min. 5
Years H0004917
CDBG2.22 FY 2014-15 HS-010 Min. 5
Years H0004915
CDBG2.22 Interfaith Community Services
Housing and Basic Needs FY 2013-14 HS-010 Min. 5
Years H0004708
CDBG2.22 City of Carlsbad
Administration FY 2013-14 HS-010 Min. 5
Years H0004772
CDBG2.22 City of Carlsbad
Administration FY 2012-13 HS-010 Min. 5
Years H0004782
CDBG2.22 City of Carlsbad Pedestrian
Crossing Chestnut FY 2013-14 HS-010 Min. 5
Years H0004779
CDBG2.22 Hospice of North County FY 2012-13
FY 2013-14
HS-010 Min. 5
Years H0004625
CORODATA 3/23/2023
X
MARIA EMERY 3/23/2023
DocuSign Envelope ID: 36046109-38E2-4FE2-B824-D8CFED663C97
C ciryof
Carlsbad
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Women's Resource Center
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, click in the last box in right hand earner af table and hit "tab". This will create mare fields in the table.
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RECORDS DESTRUCTION REPORT
Maria Emery
DATE: 1/18/2023
TEMPLATE NAME: Physical Folder
TOTAL RECORD COUNT: 20
COMMENTS:
ENTRY ID REVIEW DATE NAME FILE NUMBER
4354971 01/17/2023 BOYS AND GIRLS CLUB; TEEN SCENE
PROGRAM; CDBG
056530
4354970 01/17/2023 BROTHER BENNO CENTER; ; CDBG 056530
4354967 01/17/2023 CASA DE AMPARO; FOOD PROGRAM; CDBG
(2)
056530
4354965 01/17/2023 CATHOLIC CHARITIES; LA POSADA DE
GUADALUPE; CDBG (3)
056530
4354972 01/17/2023 CITY ADMINISTRATION; ; CDBG 056530
4354943 01/17/2023 CITY OF CARLSBAD; ADMINISTRATION;
CDBG
056530
4355223 01/17/2023 CITY OF CARLSBAD; DOWN PAYMENT;
CDBG
056530
4354939 01/17/2023 CITY OF CARLSBAD; HOUSING RESERVE
FUND; CDBG (2)
056530
4354961 01/17/2023 COMMUNITY RESOURCE CENTER;
HOMELESS PREVENTION; CDBG (2)
056530
4354945 01/17/2023 CSA SAN DIEGO COUNTY; FAIR HOUSING
PROGRAM; CDBG
056530
4355103 01/17/2023 HOSPICE OF THE NORTH COAST; ; CDBG 056530
4354959 01/17/2023 INTERFAITH COMMUNITY SERVICES; ; CDBG 056530
4354992 01/17/2023 INTERFAITH COMMUNITY SERVICES;
HOUSING AND GENERAL; CDBG
056530
4354957 01/17/2023 MEALS ON WHEELS; ; CDBG 056530
4354955 01/17/2023 NORTH COUNTY COMMUNITY SERVICES;
FOOD BANK; CDBG (2)
056530
4354977 01/17/2023 PEDESTRIAN RAILWAY CROSSING; AT
CHESTNUT AVENUE; CDBG
056530
4354947 01/17/2023 SOLUTIONS FOR CHANGE; EMPLOYMENT
TRAINING; CDBG
056530
4354954 01/17/2023 THE ANGEL'S DEPOT; SENIORS MEAL
PROGRAM; CDBG (3)
056530
·tyof
lsbad
Ca li fornia
4354952 01/17/2023 WOMEN'S RESOURCE CENTER; ; CDBG (2)056530
4354950 01/17/2023 YMCA OZ; YOUTH SHELTER; CDBG (3)056530
Account #(s)SD012455
Certificate #102247
Date Issued Friday, March 24, 2023
Service Locations 5815 EL CAMINO REAL
Date Range of Service Mar-23-2023 thru Mar-23-2023
Work Ticket(s)1109694
Quantity/Item 40 -40 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•Jcorodata -tl HIPA'A
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