HomeMy WebLinkAbout; ; Records Destruction Authorization Form-Construction Management & Inspection; 2023-09-07This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
Revised: 2021
Page | 1
DATE: 6/6/2023
REQUESTING DEPARTMENT: CM&I REQUESTER: KARI KOZLOWSKI
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)
13095204
Capital Improvement Projects
(CIP) Land Development Projects
(LDE)- Where Construction
Management & Inspection is the
Lead
MS 07-03, SDP 00-06A, PD 09-02,
PD 09-05, PD 09-04, PD 08-07
2011
PW-000
PW-005
PW-010
+10 years
or after
funding
agency
audit, if
require
whichever
is longer
13095205
Capital Improvement Projects
(CIP) Land Development Projects
(LDE)- Where Construction
Management & Inspection is the
Lead
CUP 08-19, PD 09-03, PD 08-11,
PD 06-18, MS 05-13, MS 04-04,
PD 08-04, 6612, PD 10-01, 6608,
MS 07-02
2012
PW-000
PW-005
PW-010
+10 years
or after
funding
agency
audit, if
require
whichever
is longer
RECORDS DESTRUCTION AUTHORIZATION FORM
B.Taj 6/8/2023 06-22-2023 6/26/23
C cityof
Carlsbad
N/A
N/A
This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
Revised: 2021
Page | 2
*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: ______________
C cityof
Carlsbad
□ □
CORODATA 09/07/2023
X
-- --
Account #(s)SD012455
Certificate #102710
Date Issued Tuesday, September 12, 2023
Service Locations 5815 EL CAMINO REAL
Date Range of Service Sep-07-2023 thru Sep-07-2023
Work Ticket(s)1197252
Quantity/Item 50 -50 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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