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2017-08-03 CC Insurance Certs
Date: 08/02/2017 Department: City Clerk 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 insurance Certificates # Period Shredding is Required (Records contain private information) DOCUMENTS HAVE BEEN REVIEWED AND APPROVED FOR DESTRUCTION Department Head / Division Manager City Clerk �.- 0 �9�- +'PFC City Attorney -.1-114 Date 9't31t 7 - 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: X7"1. 19eaz '_ Employee Performing Destruction ©1998-2008 Gladwell Governmental Services, Inc. D ate