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HomeMy WebLinkAbout2017-08-03 CC Insurance CertsDate: 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
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ate