HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Public Works; 2023-06-15This 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: 05/09/2023
REQUESTING DEPARTMENT:PUBLIC WORKS FACILITIES REQUESTER:ABIGAIL MCKINNEY
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
To be filled out once records have been destroyed.
BOX NO. RECORDS DESCRIPTION DATED RRS NO.
RRS
PERIOD
TAB BARCODE
(if applicable)
2 boxes
Invoices Copies for Carlsbad
Senior Center 1987-1990 CW-105
When
no
longer
required
Correspondence ROUTINE for
Carlsbad Senior Center 1987-1990 CW-110 2 Years
Correspondence -TRANSITORY /
PRELIMINARY DRAFTS for
Carlsbad Senior Center
1987-1990 CW-115
When
no
longer
required
RECORDS DESTRUCTION AUTHORIZATION FORM
05-11-2023 5/18/2023
DocuSign Envelope ID: 58E68F20-22E4-4C14-892C-D28910629ADD
DATE: 05/09/2023
REQUESTING DEPARTMENT: PUBLIC WORKS FACILITIES REQUESTER: ABIGAIL MCKINNEY
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.
~ 5/10/2023
DEPT. HEAD/DIVISION MANAGER DATE RECORDS MANAGEMENT DATE CITY ATTORNEY DATE
, click in the last box in right hand corner of table and hit "tab". This will create more fields in the table.
I
{'"city of
Carlsbad
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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
RECORD DESTRUCTION COMPLETED BY:___________________________DATE:______________
CERTIFICATE OF DESTRUCTION?YES NO
TAB BARCODES DELETED BY:_____ _______________________________ DATE:______________
Corodata 6/15/2023
x
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DocuSign Envelope ID: 58E68F20-22E4-4C14-892C-D28910629ADD
C ciryof
Carlsbad
□ □
Account #(s)SD012455
Certificate #102455
Date Issued Monday, June 19, 2023
Service Locations 5815 EL CAMINO REAL
Date Range of Service Jun-15-2023 thru Jun-15-2023
Work Ticket(s)1153680
Quantity/Item 116 -116 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.
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