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HomeMy WebLinkAbout2015-08-06 CC Form 700 & InsuranceDate: '1I30Is- Department: r C RECORDS DESTRUCTION AUTHORIZATION FORM The records listed below (or on the attached list) are scheduled to be destroyed, as indicated on the Records Retention Schedule. The records are not the subject of any claim, litigation, investigation, or audit. (List records here, or attach a list) File # Records Description Start Date End Date Box # Retention Retention # Period © . C • . 1�1�31 " soon . -.. _. Shredding is Required (Records contain private information) f PM VOCs -M BE 'RGDP1 1� DOCUMENTS HAVE BEEN REVIEWED AND APPROVED FOR DESTRUCTION Department Head I Division Manager City Clerk N City Attorney g 4i 2-a,s Date Date Date (Complete after destruction has been performed, if done by City Employees. If destruction is performed by a commercial vendor, have them provide you with a certificate.) HEREBY CERTIFY that the items listed above have been destroyed in accordance with City policies and procedures: Employee Performing Destruction @1998-2008 Gladwell Governmental Services, Inc Date Employee Department Start End Steven Zeiger Public Works 2/28/2000 10/12/2007 Becky Simon Public Works 9/14/2006 9/20/2007 Scott Schneider Public Works 3/23/2001 8/26/2007 Robert Scarborough Public Works 11/10/1997 8/1/2007 Robert Dragon Public Works 8/8/1980 7/17/1987 Meherdad Namiranian Public Works 11/10/1998 5/14/2006 Cheng Yeo Public Works 3/13/1989 3/1/2007 Andrew Preston Public Works 6/7/1989 3/2/2007 Glenn Nunley Public Works 7/10/2000 3/13/2007 Terry Kraus Public Works 6/24/1994 8/8/2007 Scott Clark Public Works 5/9/1990 3/9/2007 Doris Toy Public Works 11/10/1998 3/1/2007 Matt Smith Public Works 2/4/2004 3/2/2007 David Hulbert Public Works 9/24/2003 4/3/2007 James Forsythe Public Works 11/7/1986 3/8/2007 Karen Chew Public Works 11/14/2005 4/2/2007 Jerry W. Hyde Public Works 8/8/1980 8/2/1993 Edwin A. Anchordoguy Public Works 6/24/1994 1995 David Hattem Public Works 3/15/1996 11/11/1997 Steven Fesler Public Works 6/24/1994 7/6/2004 Edward Labasan Public Works 6/24/1994 7/8/2004 Thomas Rothenberger Public Works 8/8/1980 9/30/2004 John Tune Public Works 3/6/1998 3/12/2007 Vern Doughty Public Works 9/22/2004 3/12/2007 Dave Davenport Public Works 7/17/2007 7/23/2007 Cal Zachman Public Works 3/3/1986 9/10/2007 Art Gibney Public Works 1/5/2006 3/2/2007 Celevante Dario Public Works 12/20/2007 12/24/2007 Suvra Chakrabarti Public Works 9/14/2006 3/13/2007 Bill Voigt Public Works 10/10/2002 3/2/2007 Nader Mansourian Public Works 6/24/1994 4/2/2007 Linda Zeng Public Works 12/18/1996 3/1/2007 Janet Nibbi Public Works 9/23/1996 3/2/2007 Richard Landis Public Works 12/18/1996 3/2/2007 Willie Lagleva Public Works 10/10/2002 3/7/2007 Jude Dictado Public Works 8/31/1998 3/14/2007 Diane Decicio Public Works 3/6/1998 3/2/2007 Employee Department Start End Thomas Simms Police Department 5/19/2006 11/30/2006 John Rohrbacher Police Department 9/23/1992 5/5/2006 David Starnes Police Department 2/8/2006 3/6/2007 Lynne Ohlson Police Department 10/6/2000 1/8/2007 John Nunez Police Department 10/10/2002 3/1/2007 Rita Mayer Police Department 2/16/2001 3/17/2006 Erik Masterson Police Department 10/5/2006 3/8/2007 Michael Keller Police Department 2/26/2001 3/2/2007 Daniel Hulett Police Department 8/1/2004 10/19/2003 Margo Rohrbacher Police Department 9/23/1992 3/11/2007 Jeff Franzini Police Department 7/18/2003 3/1/2007 Christian Diaz jPolice Department 10/5/2006 3/1/2007 Lynette Keller jPolice Department 10/5/2006 3/2/2007 Employee Department Start End Jim Slaughter Information Technology 1/22/1999 2/5/1999 Jim Fetter Information Technology 3/6/1998 10/2/1998 Gordon Lee Information Technology 10/22/1999 2/11/2000 Eusebio Joves Information Technology 4/2/1997 8/29/2004 Mark Rinkel Information Technology 1/22/1999 3/29/2007 Jim l layes Information Technology 3/3/2006 3/5/2007 Getty Ejigou Information Technology 4/1/2006 4/2/2007 Craig Luedeman Human Resources 8/8/1980 1/10/1983 Pamela Waterstone Human Resources 4/17/2007 4/17/2007 Adela Gonzalez Human Resources 6/8/2005 6/13/2005 Jane Fleenor Human Resources 1/5/2006 9/15/2006 Daryl Chandler Human Resources 6/18/1987 6/30/2004 Hugh Sadler Human Resources 10/17/1983 5/7/1986 Sharon Andrus Human Resources 9/23/1992 5/27/2006 Dennis Shives Finance 3/12/1998 9/10/2004 Cindy Mosser Finance 8/16/2004 11/27/2006 Van Bach Finance 10/4/2006 10/5/2006 Andrew Thompson Finance 10/4/2006 10/4/2006 Daniel Lee Parking Services 7/19/2007 8/10/2007 David Johnson Parking Services 12/5/2005 5/12/2006 Joanna Pallock Parking Services 10/4/2006 3/8/2007 Mark Miller Parking Services 5/4/2006 4/2/2007 Chad Lynn Parking Services 11/6/2001 12/10/2005 Howard "Jake" Ours Redevelopment/ED 8/18/1983 6/30/1999 Edward Ward Redevelopment/ED 6/7/1983 6/7/1983 Robert Selmi Redevelopment/ED 4/8/1981 4/8/1981 Brigitte Moran Redevelopment/ED 9/29/1998 3/4/2002 Nancy Mackle Redevelopment/ED 9/29/1998 3/1/2007 Katie Korzun Redevelopment/ED 3/8/1990 3/2/2007 Stephanie Lovette Redevelopment/ED 7/20/1999 3/28/2007 Brian Auger Redevelopment/ED 1 4/12/2002 4/2/2007 Employee Department Start End Gail Lockman Library 9/23/1992 8/5/2004 Vaughn Stratford Library 9/23/1992 8/4/2004 Kay Noguchi Library 8/3/2004 11/18/2004 David Dodd ILibrary 1 11/16/2004 3/8/2007 Employee Department Start End Keith Schoenthal Fire 8/16/1983 4/2/2007 John Mazza Fire 8/8/1980 4/5/1982 Steven Riggs Fire 9/29/1998 9/29/2006 John Montenero Fire 6/20/2005 9/17/2007 Ian Madfes Fire 10/4/2006 3/21/2007 Merritt "Ritt" Hewitt, Jr. Fire 9/23/1992 3/23/2007 Steven Davis Fire 4/6/2005 1/11/2007 Bradley Mark Fire 9/23/1992 3/15/2007 Roxanna Atkins Fire 10/4/2006 8/18/2007 Jim Lydon Fire 1/2/2007 1/2/2007 Jeff Buscher Fire 5/18/2005 2/23/2007 Steven Rupnow Fire 12/13/2007 12/14/2007 Christopher Gray Fire 9/17/2007 9/19/2007 Employee Department Start End Chantry Bell Community Development 7/14/1987 3/25/2004 Robert Brown Community Development 4/27/1998 3/5/2007 Damon DiDonato Community Development 9/17/2001 3/16/2006 Sean Gallegos Community Development 7/19/2005 9/21/2006 Micah Hinkle Community Development 1/31/2000 7/21/2006 Linda Jackson Community Development 10/18/1989 3/28/2007 Lee Johnson Community Development 1/23/2003 3/2/2007 Ulla -Britt Jonsson Community Development 2/14/2001 6/6/2006 William Meeker Community Development 10/6/2004 4/4/2007 Mindy Nguyen Community Development 10/5/2006 3/12/2007 Kristie Wheeler (Richardson) Community Development 2/6/2001 7/2/2004 William Tuikka Community Development 10/19/1987 1/31/2003 Emi Theriault Community Development 10/3/2001 10/16/2002 Dean Parsons Community Development 2/10/1998 4/6/2001 Alicia Giudice Community Development 6/24/1998 3/8/1998 Sheila Delimont Community Development 8/7/1990 1/24/2000 Louise Patterson Community Development 2/6/1991 10/8/1999 Dialys (Dee) Velazquez Community Development 1/14/2003 3/20/2007 Stuart Blakesley Community Development 11/28/2006 3/6/2007 Joseph Curley Community Development 4/12/1985 6/30/2005 Stan Fernandez Community Development 8/1/2000 7/28/2007 Greg Fortune Community Development 4/17/2007 4/17/2007 Joseph Garcia Community Development 10/11/2002 1/30/2007 Linda LeVeque Community Development 3/3/2006 3/8/2007 Lynda Ferris Community Development 1/14/1999 3/10/2005 Irving Godinez Community Development 10/1/2001 3/8/2002 Michael Jacobs Community Development 9/1/1998 3/26/1999 Daniel Kantor Community Development 2/26/1991 3/2/2004 Robert Wheeler Community Development 7/9/1980 3/29/1988 Carole Kearn Community Development 6/23/2000 12/5/2002 Michael Lantier Community Development 3/6/2007 3/12/2007 Jessica LeViste Community Development 7/19/2006 4/2/2007 Sonia Martinez Community Development 10/8/2001 7/17/2002 Sean Nikas Community Development 7/11/2002 3/6/2003 Tino Padilla Community Development 6/19/2003 1/10/2007 Robert Taylor Community Development 8/24/1999 2/28/2000 Fred Vincenti Community Development 7/10/1980 10/14/2004 Nimat Shakoor-Grantham Community Development 4/8/1997 10/31/1998 Daniel Fink Community Development 4/14/1997 8/6/1998 David McGibbon Community Development 4/12/1985 4/12/1985 Oscar Bramblett Community Development 4/12/1985 4/12/1985 Herman O. Ballert Community Development 5/3/1986 5/3/1986 Penelope Starr Community Development 11/30/1987 11/30/1987 Curtis Johnston Community Development 3/23/1990 3/23/1990 Jane Pirrung Community Development 5/1/1987 5/1/1987 Paul Jensen Community Development 4/7/1987 4/7/1987 Sarjit Dhaliwal Community Development 11/17/2006 11/20/2006 Kraig Tambornini Community Development 6/24/1998 5/17/2007 Caron Parker Community Development 7/9/2006 3/6/2007 Steve Stafford Community Development 3/24/2006 3/24/2007 Raffi Boloyan Community Development 7/18/2000 3/9/2007 Stephen Buffenbarger Community Development 6/28/2005 3/19/2007 William 'Brian" Sheridan Community Development 11/5/1999 3/28/2007 Larry Salvisberg Community Development 11/4/1997 3/22/2007 Florie Robnett Community Development 4/1/1997 7/27/1997 Django "DJ" Heckler Community Development 4/17/2007 4/17/2007 Robert Geno Community Development 11/8/2006 11/8/2006 Thomas Ahrens Community Development 12/6/2004 4/2/2007 Employee Department Start End Jim Schutz City Manager's Office 1/2/2007 1/4/2007 Dana Melnichek City Manager's Office 3/13/2007 3/13/2007 Steven Hancock City Manager's Office 1/25/2007 1/25/2007 Terri Hardesty City Manager's Office 8/27/2007 8/27/2007 Michael Angeli City Manager's Office 10/4/2006 7/4/2007 Lydia Romero City Manager's Office 6/22/1998 4/17/2007 Adela Gonzalez City Manager's Office 2/17/2006 2/17/2006 Steven Rathbone City Manager's Office 5/8/2006 9/5/2006 Patricia Roberts City Manager's Office 3/2/2001 6/23/2006 Suzanne Golt City Manager's Office 4/7/1987 4/7/1987 Employee Department Start End Robert Hess Community Services 10/1/1985 3/7/2001 Donald Streeper Community Services 3/9/1982 7/3/2002 Jay Ingram Community Services 1/23/2003 8/24/2007 Dave Donery Community Services 2/12/1999 3/7/2007 William Scharf Community Services 2/12/1992 3/15/2007 Nancy Percy Community Services 9/16/1991 9/16/1991 Suzanne Alexander Community Services 9/24/1985 9/24/1985 Carol Jacobs-Courtz Community Services 8/8/1980 3/5/2007 Gary Burns Community Services 9/29/1998 3/22/2007 Rochelle Grechman-Dibley Community Services 9/29/1998 3/12/2007 Kelly McGrath/Albrecht Community Services 2/7/2002 3/26/2007 Carlene McCart Community Services 4/13/1998 3/1/2007 Employee Department Start End Patricia Roberts City Clerk's Office 2/15/1996 2/28/2000 Marilou Taylor City Clerk's Office 12/3/1993 4/26/1995 Sizanne Drake City Clerk's Office 9/20/1990 8/15/1993 Rosa Lola Sniffen City Clerk's Office 6/25/1990 6/15/1990 Norma Jupp City Clerk's Office 5/9/1984 5/31/1984 Sylvaine Bessie City Clerk's Office 1/9/1984 4/15/1984 Regina Buchanan City Clerk's Office 8/8/1980 12/15/1983 Jeanne Leoncini City Clerk's Office 8/8/1980 12/11/2007 Esther Beime City Clerk's Office 9/25/2000 3/9/2007 Employee Department Start End Peter Muzio City Attorney's Office 11/15/1983 1/15/1985 Edmond Duggan City Attorney's Office 8/8/1980 11/15/1983 Clark "Gus" Guinan City Attorney's Office 1/7/1994 3/1/2007 David Walker City Attorney's Office 11/4/1991 2/10/1994 Tessie Belue City Attorney's Office 2/1/1989 4/1/1992 James Flageollet City Attorney's Office 11/3/1988 1/31/1989 Mary Casey City Attorney's Office 10/8/1986 4/9/1990 Stewart Andrew City Attorney's Office 1/1/1983 4/1/1986 William Bullard City Attorney's Office 8/8/1980 1/14/1983 Eric Davis City Attorney's Office 2/16/1994 3/1/2007 Laura Stitt Sheedy City Attorney's Office 4/5/1991 4/5/1991 Ver. 3.0 RECORDS RETENTION SCHEDULE: CITY CLERK Page CC -4 Office of Record_ Retention No. Records Description Retention I Disposition Comments / Reference Image: Destroy (OFR) Inactive Active (Records Total Vital? Media 1=Import Paper after (in office) Center) Retention Options M=Mfr Imaged & S=Scan QC'd? If the record is not listed here, refer to the Retention for City -Wide Standards Retentions begin when the act is completed, and imply a full file folder (e.g. last document + 2 years), since destruction is normally performed by file folder. Litigation, com lainis, claims, p ublic records act re quests, audits and/or investigations suso end normal retention periods retention resumes after settlement or com letion . Committee Rosters / Boards, City Clerk CC -009 Commissions and Committees 2 years 2 years Mag, Ppr GC §34090 (Maddy Act) Economic Interest Filings City maintains original City Clerk CC -010 (FPPC 700 Series Forms - 2 years 5 years 7 years Mag, Mfr, S / I Yes statements; GC §81009(e)&(g); Statement of Economic OD, Ppr GC §81009(0&(g); 2 CCR Interests). ALL 4 years 18615(d) City Clerk CC -011 FPPC Form 801 (Gift to 4 years Mag, Ppr Must post on website; 2 CCR Agency Report) 18944-.2(c)(3)(G) FPPC Form 802 (Event Ticket Should post on website for 4 City Clerk i CC -012 j/ Pass Distributions Agency 7 years I 7 years Mag, Ppr years; GC §81009(e) - Report) _ Must post on website; 2 CCR FPPC Form 806 (Agency L City Clerk CC -013 Report of Public Official 2 years 2 years Mag, Ppr 18705.5; GC §34090 Appointments) SAN RAFAEL, CA. ©1995-2012 Gladwell Governmental Services, Inc. - all rights reserved Do not duplicate or distribute without prior written permission from GGS (909) 337-3516 Adopted: 02/04/13 Updated: 10/24/13 Ver. 3.0 RECORDS RETENTION SCHEDULE: CITY CLERK Page CC -8 Office of Retention No. Records Description Retention I Disposition Comments / Reference Record Inactive Image: Destroy (OFR) Active (Records Total Vital? Media 1=Import Paper after (in office) Center) Retention Options M=Mfr Imaged & S=Scan QC'd? If the record is not listed here, refer to the Retention for City -Wide Standards Retentions begin when the act is completed, and imply a full file folder (e.g. last document + 2 years), since destruction is normally performed by file folder. Litigation, complaints, claims, public records act requests, audits and/or investigations sus end normal retention eriods retention resumes after settlement or completion). Insurance Certificates (where Department preference to City Clerk CC -030 they cannot be matched to an 11 years 11 years Mag, Ppr cover all statute of limitations; agreement) P CCP §337 et. seq., GC §34090 City Clerk CC -031 List of City Council Members 2 years P Mag, Mfr, S / I Yes: After Department preference; GC and Mayors OD, Ppr QC & OD §34090 Minutes (City Council, Mag, Mfr, City Clerk CC -032 Redevelopment / Successor P P Yes (all) OD, Ppr S No GC §34090 Agency / Oversight Board) When No Municipal Code Administration, When No Preliminary drafts not retained City Clerk CC -033 Distribution, etc. Longer Longer Mag, Ppr in the ordinary course of Required Required business; GC §34090 Municipal Code and History Mag, Mfr, City Clerk CC -034 File (always retain 1 2 years P P OD, Ppr S No GC §34090 supplement) Department Preference; Statute of Limitations: Public official misconduct is discovery of offense + 4 Oaths of Office - Council, Separation + Separation + Mag, Mfr, years, retirement benefits is City Clerk CC -035 Board and Commission 6 years 6 years OD, Ppr S No 6 years from last action; Members, Employees statewide guidelines propose Termination + 6 years; GC §§36507, 34090; PC §§801.5, 803(c); 29 USC 1113 SAN RAFAEL, CA. ©1995-2012 Gladwell Governmental Services, Inc. - all rights reserved Do not duplicate or distribute without prior written permission from GGS (909) 337-3516 Adopted: 02/04/13 Updated: 10/24/13