HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Housing & Homeless Services; 2023-03-23 (2)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
*If more spaces are needed fields in the table.
BOX NO. RECORDS DESCRIPTION DATED RRS NO.
RRS
PERIOD
TAB BARCODE
(if applicable)
CDBG3.22 Catholic Charities La Posada
de Guadalupe FY 2015-16 HS-010
Min. 5
Years H0005024
CDBG3.22 Brother Benno Brother Benno
Center
FY 2015-16 HS-010 Min. 5
Years H0005023
CDBG3.22 Interfaith Community Services
Housing & General Assistance
FY 2015-16 HS-010 Min. 5
Years H0005026
CDBG3.22 Community Resource Center
Homelessness Prevention &
Intervention
FY 2015-16 HS-010 Min. 5
Years H0005025
CDBG3.22 Casa de Amparo Campaign for
Kids
FY 2015-16 HS-010 Min. 5
Years H0005031
CDBG3.22
Alternatives to Abuse
FY 2015-16 HS-010 Min. 5
Years H0005029
CDBG3.22 Seniors
Emergency Meal Box
FY 2015-16 HS-010 Min. 5
Years H0005028
CDBG3.22 Meals on Wheels Meal
Delivery Service
FY 2015-16 HS-010 Min. 5
Years H0005027
CDBG3.22 City of Carlsbad Program
Administration
FY 2015-16 HS-010 Min. 5
Years H0005033
CDBG3.22 Center for Social Advocacy
Fair Housing Program
FY 2015-16 HS-010 Min. 5
Years H0005032
CDBG3.22 City of Carlsbad Housing
Reserve Fund
FY 2015-16 HS-010 Min. 5
Years H0005034
CDBG3.22 YMCA Youth Outreach
Program
FY 2015-16 HS-010 Min. 5
Years H0005030
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 a/4 J, /)A j/1 I 1/17/2023
DEPT. H~AD/DIVISION MANAGER DATE
1/17/2023
RECORDS MANAGEMENT DATE CITY ATTORNEY
-
-
-
-
-
Women's Resource Center-
The Angel's Depot-
-
-
-
-
-
, click in the last bax in right hand corner of table and hit "tab". This will create more
{'"city of
Carlsbad
1/18/2023
DATE
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
To be filled out once records have been destroyed.
RECORD DESTRUCTION COMPLETED BY:___________________________DATE:______________
CERTIFICATE OF DESTRUCTION?YES NO
TAB BARCODES DELETED BY:_____ _______________________________ DATE:______________
CORODATA 3/23/2023
X
MARIA EMERY 3/23/2023
DocuSign Envelope ID: 36046109-38E2-4FE2-B824-D8CFED663C97
C ciryof
Carlsbad
□ □
RECORDS DESTRUCTION REPORT
Maria Emery
DATE: 1/18/2023
TEMPLATE NAME: Physical Folder
TOTAL RECORD COUNT: 12
COMMENTS:
ENTRY ID REVIEW DATE NAME FILE NUMBER
4354758 01/16/2023 BROTHER BENNO; BROTHER BENNO
CENTER; CDBG (2)
056530
4354741 01/16/2023 CASA DE AMPARO; CAMPAIGN FOR KIDS;
CDBG
056530
4354755 01/16/2023 CATHOLIC CHARITIES; LA POSADA DE
GUADALUPE; CDBG (2)
056530
4354740 01/16/2023 CENTER FOR SOCIAL ADVOCACY; FAIR
HOUSING PROGRAM; CDBG (2)
056530
4354735 01/16/2023 CITY OF CARLSBAD; HOUSING RESERVE
FUND; CDBG
056530
4354738 01/16/2023 CITY OF CARLSBAD; PROGRAM
ADMINISTRATION; CDBG
056530
4354753 01/16/2023 COMMUNITY RESOURCE CENTER;
HOMELESS PREVENTION & INTERVENTION;
CDBG
056530
4354752 01/16/2023 INTERFAITH COMMUNITY SERVICES;
HOUSING & GENERAL ASSISTANCE; CDBG
056530
4354750 01/16/2023 MEALS ON WHEELS; MEAL DELIVERY
SERVICE; CDBG (2)
056530
4354748 01/16/2023 THE ANGEL'S DEPOT; SENIORS EMERGENCY
MEAL BOXES; CDBG
056530
4354746 01/16/2023 WOMEN'S RESOURCE CENTER;
ALTERNATIVES TO ABUSE; CDBG
056530
4354744 01/16/2023 YMCA; STREET OUTREACH PROGRAM;
CDBG
056530
·tyof
lsbad
Ca li fornia
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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