HomeMy WebLinkAbout; ; Records Destruction Authorization Form-City Clerk; 2024-01-25 (2)This form documents the destruction of City records in accordance with the City of Carlsbad Records Management Program.
Revised: 2021
Page | 1
DATE: 12/5/2023
REQUESTER: MARIA EMERY REQUESTING DEPARTMENT: CITY CLERK
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)
1 BOX
Economic Interest Filings (FPPC 700 Series Forms - Statement of Economic Interests): ALL (B&Cs, Consultants,
Planning Commission, Employees)
2015-2016 CC-075 7 yrs SEE ATTACHED
Closed Claims 2017-2018 CW-085
Copies - When No Longer Required (Upon Settlement)
N/A
RECORDS DESTRUCTION AUTHORIZATION FORM
12-6-23 12-06-2023 12/11/2023
CORODATA 1/25/2024
X
MARIA EMERY 1/26/2024
C cityof
Carlsbad
□ □
RECORDS DESTRUCTION REPORT
Maria Emery
DATE: 12/5/2023
TOTAL RECORD COUNT: 5
COMMENTS: City Clerk Physical Folder destruction
ENTRY ID REVIEW DATE Template NAME
4392017 2023/12/05 Physical Folder 2015 Statements of Economic Interest; Boards and
Commissions;
4392021 2023/12/05 Physical Folder 2016 Statements of Economic Interest; Boards and
Commissions;
4390434 2023/12/05 Physical Folder 2016 Statements of Economic Interest; Consultants;
4392019 2023/12/05 Physical Folder 2016 Statements of Economic Interest; Employees;
4368459 2023/12/05 Physical Folder CONSULTANTS; STATEMENTS OF ECONOMIC
INTERESTS; ; 2015
0
d
Ca li fornia
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.
Account #(s)SD012455
Certificate #103065
Date Issued Friday, January 26, 2024
Service Locations 5815 EL CAMINO REAL
Date Range of Service Jan-25-2024 thru Jan-25-2024
Work Ticket(s)1261435
Quantity/Item 73 -73 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).
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