RES-2020-077RESOLUTION NO. 2020- 0 7 7
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF
ANAHEIM AUTHORIZING THE DESTRUCTION OF
CERTAIN CITY RECORDS MORE THAN TWO YEARS OLD
(CITY ADMINISTRATION,. CITY CLERK, COMMUNITY &
ECONOMIC DEVELOPMENT, COMMUNITY SERVICES,
CONVENTION, SPORTS & ENTERTAINMENT, FINANCE,
FIRE & RESCUE, HUMAN RESOURCES, PLANNING &
BUILDING, POLICE AND PUBLIC WORKS)
WHEREAS, Sections 34090 et seq., of the Government Code of the State of
California authorize the destruction of certain records, documents, instruments, books and papers
(hereinafter "records") of the City upon approval of the legislative body of the City and with the
written consent of the City Attorney, provided that said records do not fall within certain
specified categories; and
WHEREAS, the following described records under the charge of the Interim City
Manager, City Clerk, Community & Economic Development Director, Community Services
Director, Executive Director of Convention, Sports & Entertainment, Finance Director/City
Treasurer, Fire Chief, Human Resources Director, Planning & Building Director, Chief of Police
and Director of Public Works ("custodians of records") are more than two years old and are
documents which are authorized for destruction under the provisions of Section 34090 et seq., of
the Government Code without making a copy thereof, and
WHEREAS, the custodian of records of each record described herein has
determined that said documents are no longer needed or required; and
WHEREAS, the City Council concurs in the determination of the custodian of
records and finds that said records are no longer needed; and
WHEREAS, the City Attorney of the City of Anaheim does by the approval of
this resolution hereby give written consent for the destruction of the listed records.
NOW, THEREFORE, BE IT RESOLVED by the City Council of the City of
Anaheim that the custodian of the described records in Exhibit "A" "B" "C" "D""E" "F" "G"
"H", "I", "J" and "K" of the City of Anaheim be, and is hereby, authorized to destroy
immediately, in a lawful manner and without making any copies thereof, the records under the
custodian's charge, as more particularly described in Exhibit "A" "B" "C" "D" "E" "F" "G"
"I", "J" and "K" attached hereto and incorporated herein by this reference.
. BE IT FURTHER RESOLVED that upon destruction of the foregoing records, a
certificate of destruction shall be executed and the original thereof filed in the office of the City
Clerk together with a copy of this resolution.
THE FOREGOING RESOLUTION is approved and adopted by the City Council
of the City of Anaheim this 1 4th day of July , 2020, by the following roll call
vote:
AYES:Mayor Sidhu and Council Members Faessel, Barnes, Brandman,
Kring, and O'Neil
NOES: Council Member Moreno
ABSENT: None
ABSTAIN: None
ATTEST:
CITY CLERK Ot THE CITY OF ANAHEIM
APPROVED AS TO FORM:
ROBERT FABELA, CITY ATTORNEY
By:
Wir M. Vor e
Depu ty Attorney
138324/bmorley
2
EXHIBIT A
RECORDS DESTRUCTION -2020
CITY ADMINISTRATION
RECORD SERIES
TOTAL
RETENTION
YEARS TO
DESTROY
Biographies — VIP
2Y
1973-2004
City Council Correspondence / Mayor Correspondence
2Y
2004-2017
Committees, Ad Hoc % Internal (employees)
2Y
2017
Contracts and Agreements - Administration Files
CL + 10Y
2004-2009
Correspondence — Letters, Memos
2Y
2017.
Personnel Files — Department Level Copies .
T + 3Y
2016
Proclamations / Commendations / Certificates /
Recognitions
2Y
2017
Project Files
2Y
2005-2017
Sister City Commission: Agendas, Agenda Packets
2Y
2017. .
Subject Files
2Y
2017
The above records are no longer needed in the. normal course of business and timing. of
destructi is in accordance with the adopted Record Retention Schedule. .
x Date: 7 .%
Zarci
Interim City Manager
0:Ia19.11a:�
RECORDS DESTRUCTION -2020
OFFICE OF THE CITY CLERK
The above records are no longer needed in the normal course of business and timing of
destruct' rdance with the adopted Record Retention Schedule.
7 ly f b
Date:
eresa Bass
City Clerk
TOTAL
YEARS TO
RECORD SERIES
RETENTION
DESTROY
Action Agendas (City Council, Successor Agency to the
2Y
2005-2006
Redevelopment Authority, Housing Authority, Public
Financing Authority, Housing & Public Improvements
Authority)
Agenda Packets (City Council, Successor Agency to the
Redevelopment Authority, Housing Authority, Public
5Y
2014
Financing Authority, Housing & Public Improvements
Authority)
Applications for Boards, Commissions, or Committees
ET + 2Y
1996-2015
(Appointed)
Applications for Boards, Commissions, or Committees
2Y
1996-2015
(Not Apointed)
Billing: Monthly Billing, Fringe Billing
5Y
2014
Claims
CL + 5Y
2014
Contracts / Agreements — Non -Infrastructure / General
CL + 10Y
1977-2009
Correspondence — Letters, Memos
2Y
2011-2017
Insurance Certificates (not tied to contracts)
5Y
2014
Passport Transmittals
2Y
2017
Public Records Act Requests
2Y
2017
Statement of Economic Interests / Filings: Designated
7Y
2010-2011
Employees
Subpoenas (Duces Tecum)
2Y
2017
Time Cards / Time Sheets / Timecard Entry
l0Y
2009
The above records are no longer needed in the normal course of business and timing of
destruct' rdance with the adopted Record Retention Schedule.
7 ly f b
Date:
eresa Bass
City Clerk
EXHIBIT C
RECORDS DESTRUCTION -2020
COMMUNITY & ECONOMIC DEVELOPMENT DEPARTMENT
Thea ove re %ac
e 1
dZot*is inrd n
X
led in the
adopted 1
John oW o5Tc each—�
Direc Xof Community & Economic Development
al course of business and timing of
1 Retention Schedule.
Date:
TOTAL YEARS TO
RECORD SERIES
RETENTION DESTROY
Contracts & Agreements — Administrative Files
CL + 10Y 2009
Workforce Development Participant Case Files
5Y 2014
Thea ove re %ac
e 1
dZot*is inrd n
X
led in the
adopted 1
John oW o5Tc each—�
Direc Xof Community & Economic Development
al course of business and timing of
1 Retention Schedule.
Date:
EXHIBIT D
RECORDS DESTRUCTION -2020
COMMUNITY SERVICES DEPARTMENT
RECORD SERIES
TOTAL
RETENTION
YEARS TO DESTROY
Accident Reports: Public or City Property
2Y
2017 & prior
Accounts Payable, Invoices: Backup
l0Y
2009 & Prior
Boards, Commissions & Committees: Agendas,
Agenda Packets (Community Services Board,
Cultural & Heritage Commission, Parks &
Recreation Commission, Library Board, Senior
Citizen Commission, Youth Commission)
2Y
2017 & Prior
Case Management Files
CL + 5Y
2014 & Prior
Collection Agency Statements/ Reports — Library
5Y
2014
Correspondence — Letters, Memos
2Y
2017 & Prior
Daily Vehicle Inspections / Daily Equipment Checks
2Y
2017 & Prior
DMV -Pull Notices, Waivers for Pull Notices
S
2019 & Prior
Donation Accounts
5Y
2014
Facility Use Permit & Equipment Applications,
Books, Waivers
2Y
2017 & Prior
FPPC Form 801 Gift to Agency Report)
4Y
2015 & Prior
Grants: Library Grants
CL+5Y
2012
Incident Reports
2Y
2016 & Prior
Inspections: Park Bicycle Ways, Curbs,
Playgrounds, Sidewalks, etc.
l OY
2009 & Prior
Insurance Certificates not tied to contracts
5Y
2014 & Prior
LiveScan Response Analysis Sheets — Not Hired /
Unsuccessful Volunteers
3Y
2016 & Prior
Maintenance, Landscaping, Golf Cart Reports
2Y
2017 & Prior
Personnel Files — Department -Level Copies
T + 3Y
2016 & Prior
Personnel Work Schedules
2Y
2017 & Prior
Pesticide and Herbicide Permits, Application Records
2Y
2017 & Prior
Public Records Act Requests
2Y
2017 & Prior
Registration Forms, includes Hold Harmless
2Y
2017 & Prior
Reports and Studies
5Y
2014 & Prior
Requests for Proposals/Qualifications (RFPs, RFQs,
Bid Specifications)
5Y
2014 & Prior
Sign -In Sheets
2Y
2017 & prior
Special Events / Special Event Contracts
CL + 2Y .
2017 & prior
Subject Files
2Y
2017 & prior
Tee Time Reservations
2Y
2017 & prior
Time Cards/Time Sheets/Timecard Entry
l0Y
2009 & Prior
Volunteers & Reserves — Successful Applicants
T & 3Y
2016 & Prior
EXHIBIT D
RECORDS DESTRUCTION -2020
COMMUNITY SERVICES DEPARTMENT
The above records are no longer needed in the normal course of business and timing of destruction is in
accordance with the adopted Record Retention Schedule.
X
rence J. co
Director
Date: 2�
EXHIBIT E
RECORDS DESTRUCTION-2020
CONVENTION, SPORTS & ENTERTAINMENT DEPARTMENT
RECORD SERIES TOTAL YEARS TO
RETENTION DESTROY
Billing: Monthly Billing,Fringe Billing 5Y 2012-4/2015
Computer Leases L+2Y 2003-2006
Correspondence 2Y 1970-2017
Event Files 5Y 1998-2013
Incidents CL+7Y 2007- 5/2013
Journal Vouchers/Journal Entries 5Y 2012-2014
Monthly Accounts Payable Purchasing Card Statements 5Y 2011-2014
and Backup
Parking Citations/Permit Parking Citations 2Y 2014-2017
Parking Lot Summary Sheets 5Y 2011-2014
Personnel Files—Department Level Copies & Medical T+30Y 1980-1989
Records
Schedules—Events, Work Hours 2Y 2005-2017
Timecards/Time Sheets/Timecard Entry 10Y 2008
The above records are no longer needed in the normal course of business and timing of
destruction is in accordance with the adopted Record Retention Schedule.
x
Date: .1
Tom lvforton
Executive Director
EXHIBIT F
RECORDS DESTRUCTION -2020
FINANCE DEPARTMENT
TOTAL
YEARS TO
RECORD SERIES
RETENTION
DESTROY
1099's Issues / 1096, etc.
5Y
2014 & Prior
Accounts Receivable Invoices, Credit Card Slips for
FY2014 &
Receivables - Includes DUI Invoices
SY
Prior
Accounts Payable Checks / Invoices and Backup
l0Y
FY2009 &
Prior
FY20 &
Armored Car Manifests / Receipts
2Y
prior
Bank Statements, Bank Reconciliations (Pooled Cash
5Y
FY2014 &
Only)
nor
Cash Reconciliations: Adjustments, Receipts
5Y
FY2014 &
prior
Cost Allocation Report
7Y
FY2012 &
prior
Customer Account Adjustment Backup
2Y
FY2017 &
prior
Depositor Trust Fund Receipts
CL + 5Y
CL + 5Y
Employee Payroll File (Includes W -4s)
T + 5Y
T + 5Y
Escheat
5Y
FY2014 &
prior
External Audit Work Papers / Audit Schedules for
5Y
FY2014 &
External Audits
prior
Fixed Asset Working Papers
5Y
FY2014 &
prior
Formal Bids - Successful
5Y
FY2014 &
prior
Journal Vouchers / Journal Entries
5Y
FY2014 &
prior
Miscellaneous Receipts
5Y
FY2014 &
prior
Monthly Accounts Payable Purchasing Card Statements
5Y
FY2014 &
and Backup
prior
Notices to Bill
5Y
FY2014 &
prior
PERS Summary, Annual / CalPERS Annual Report
15Y
FY2004 &
prior
Provider Reports - Financial Reports / Statements /
5Y
FY2014 &
Quarterly Detail Disbursement Report, etc.
I prior
Purchase Orders & Master Agreements
5Y
FY2014 &
prior
EXHIBIT F
RECORDS DESTRUCTION -2020
FINANCE DEPARTMENT
Reports: Annual State or Federal: State Controller's
l0Y
FY2009 &
Report, etc.
prior
Time Cards / Time Sheets / Timecard Entry
l0Y
FY2009 &
prior
The above records are no longer needed in the normal course of business and timing of
destruction is in accordance with the adopted Record Retention Schedule.
x 9b r pcb0 mh M®rrenO Date: 7 /14120 20
orah k Mcfreno
Finance Director / City Treasurer
EXHIBIT G
RECORDS DESTRUCTION -2020
ANAHEIM FIRE & RESCUE
The above records are no longer needed in the normal course of business and timing of
destruction is in accordance with t e adopted Record Retention Schedule.
x Date:
Pat 15,ussell
Fire Chief
TOTAL
YEARS TO
RECORD SERIES
RETENTION
DESTROY
Accounts Payable, Invoices: Backup
l0Y
2006-2007
Cash Reconciliations: Adjustments, Receipt
5Y
2008-2011
1/1/2010-
Correction Notices (Prevention)
5Y
12/30/2010
Notices to Bill
5Y
1991-2004
Patient Care Reports / PCRs / Paramedic Release Forms:
20Y
1995-1999
JUVENILES
Programs and Projects (Paramedic Membership Program
2Y
1995; 2012
Applications; Ready Set Go Home Assessment)
The above records are no longer needed in the normal course of business and timing of
destruction is in accordance with t e adopted Record Retention Schedule.
x Date:
Pat 15,ussell
Fire Chief
EXHIBIT H
RECORDS DESTRUCTION -2020
HUMAN REOURCES DEPARTMENT
The above records are no longer needed in the normal course of business and timing of
dest on is in accordance with the adopted Record Retention �S./chedule.
Date: r' , �C)
Linda N. Andal
Human Resources Director
TOTAL
YEARS TO
RECORD SERIES
RETENTION
DESTROY
Classification and/or Compensation Studies
3Y
1988-2009
Subject Files (Computer Loan Program)
2Y
2010-2011
Deferred Compensation Participant Files — Retired
CL + 4 Y
2015
Employees
Deferred Compensation Participant Files — Separated
CL + 7 Y
2012
Employees
Job Descriptions / Job Classifications / Job Specifications
5Y
1966-2011
(Obsolete)
The above records are no longer needed in the normal course of business and timing of
dest on is in accordance with the adopted Record Retention �S./chedule.
Date: r' , �C)
Linda N. Andal
Human Resources Director
EXHIBIT I
RECORDS DESTRUCTION-2020
PLANNING & BUILDING DEPARTMENT
RECORD SERIES TOTAL YEARS TO
RETENTION DESTROY
Code Enforcement/Abatement Case Files CL+2Y 2009—2014
Correspondence 2Y 2016
Graffiti Removal Consent Forms/Authorizations 2Y 2006—2016
Public Records Act Requests 2Y 2017
Returned Checks(NSF, etc.) 5Y 2014
Subpoenas (Duces Tecum) 2Y 2017
The above records are no longer needed in the normal course of business and timing of
destruction is in accordance with the adopted Record Retention Schedule.
x Date: 5I0
Ted i e
Planning& Building Director
EXHIBIT J
RECORDS DESTRUCTION -2020
POLICE DEPARTMENT
RECORD SERIES
TOTAL
RETENTION
YEARS TO
DESTROY
Citation Log Books (numbers/ranges) - Parking, Traffic
2Y
2017
Citations — Administrative Initial Reviews, Refunds
2Y
2016-2017
Citations — Parking
2Y
2015-2017
Citations - Traffic (Notice to Appear)
7Y
2012-2012
Collection Officer Receipts
2Y
2017
Correspondence letters & memos
2Y
2016
Emergency Cost Recovery / DUI Claims
7Y
2012
Internal Affairs Investigations / Disciplinary Files /
Complaints / In -Custody Deaths, Major Incident
Response Team (MIRT), and Officer Involved
Shootings
CL + 5Y
2009 -
4/30/2015
Latent Print Packets/Makes (Crime Scene Miscellaneous,
not Major)
11Y
2008
Monthly Statistics
2Y
2016
OSHA Inspections & Citations, Log 200 and Log 300,
301, 301A, etc
5Y
2014 & prior
Personnel Background Packet — unsuccessful —
employees, reservists, volunteers
3Y
2016 & prior
Personnel Files — Department — Level Copies
T + 3Y
2013 & prior
Personnel Files — Department — Level Medical Records
T + 30Y
1988 & prior
Personnel Work Schedules
2Y
2016
Photo Negatives (Crime Scene Miscellaneous, not Major)
1 lY
1988-1994,
1998
Pursuit Critiques
2Y
2016
Ride -A -Long Waiver Forms
2Y
2017-
3/31/2018
Suspension Notices (Non -Re ort Related)
2Y
2017
Traffic Hearing Officer Records
2Y
2017
Training Requests & Approvals
2Y
2016
Training requests- (Approved/Denied)
2Y
2016
Vehicle Accident reports (copies)
2Y
2016
Verbal Notice by Peace Officer,'DMV or Court
Employee
2Y
2017
Work Request Log and Call for Service Log
11Y
2008
The above records are no longer needed in the normal course of business and timing of
destruction is in accordance with the adopted Record Retention Schedule.
Ax Date: b - 0-20
Jorge Cisneros
Chief of Police
EXHIBIT K
RECORDS DESTRUCTION -2020
DEPARTMENT OF PUBLIC WORKS
RECORD SERIES
TOTAL
RETENTION
YEARS TO
DESTROY
Accident Reports: Public or City Property
2Y
2003-2009
Billing: Monthly Billing, Fringe Billing
5Y
2010
Capital Improvement Projects (CIP)-
Administrative/Construction File (State & Federal Funds)
CL + I0Y
2010
Committees, Ad Hoc / Internal (employees)
2Y
2009-2011
Correspondence — Letters, Memos
2Y
2010
Daily Vehicle Inspection / Daily Equipment Checks
2Y
1999-2003
DMV Pull Notices, Waivers for Pull Notices
S
2009
OSHA Inspections & Citations, Log 200 and Log 300, 301,
301A, etc.
5Y
1999-2012
Personnel Files- Department -Level Copies
T+3Y
2010-2016
Proposals, Bid Responses (Successful)
5Y
2010
Proposals, Bid Responses (Unsuccessful)
2Y
2017
Public Records Act Requests
2Y
2017
Reports and Studies
5Y
1999-2003
Rideshare / AQMD Reports
3Y
1992-2016
Right of Way Permits (Temporary) - RCP, Street
Permits, Temporary Construction, Utility Cuts, etc.
5Y
2013-2014
Safety Inspection Reports
5Y
2002-2009
Subpoenas (Ducus Tecum)
2Y
2016-2017
Surveys / Questionnaires
2Y
2010-2017
Time Cards / Time Sheets / Timecard Entry
l0Y
2009
Training
7Y
2003-2007
Transportation Permits -Wide Load Permits, Debris Boxes,
etc.
2Y
2017
Waste Disposal Contract Administration
CL
2011-2014
The above records are no longer needed in the normal course of business and timing of
destruction is in accordance with the adopted Record Retention Schedule.
x Date:
Rudy E Ian
Public Works Director
CLERK'S CERTIFICATE
STATE OF CALIFORNIA )
COUNTY OF ORANGE ) ss.
CITY OF ANAHEIM )
I, THERESA BASS, City Clerk of the City of Anaheim, do hereby certify that the foregoing is the
original Resolution No. 2020-077 adopted at a regular meeting provided by law, of the Anaheim
City Council held on the 141 day of July. 2020 by the following vote of the members thereof:
AYES: Mayor Sidhu and Council Members Faessel, Barnes, Brandman,
Kring, and O'Neil
NOES: Council Member Moreno
ABSENT: None
ABSTAIN: None
IN WITNESS WHEREOF, I have hereunto set my hand this 15th day of July. 2020.
CITY CL RK OF THE CITY OF ANAHEIM
(SEAL)
IZES-202,0,Lo77
Southern California Shredding
20492 Crescent Ba( Drive #112
Lake Forest, CA. 92630
Phone(949)305-5511
} «= E-Mail: info@socalshredding.com
Service Receipt/Destruction Certificate
Date: ` ', Acct# /Or2-9 Type: 0 Regular 0 Call-In
Name:
Loc/Address: - .
Con: 64-Gal: 96-Gal:
Boxes: Weight:
Material Type: D Paper ❑ Other:
Pick-Up/Del:Console 64-Gal 96-Gal
Total Price: U t.,)0
Payment: Check# Cash:
C.0 (Visa,MC,AMEX)#
Exp: CVC: . Zip:
Representative: .0,Jl1Ia
}23x313 Allot '0 331 1bEASEPRINT)
Driver: !
We acknowledge receipt of aaisiid sdiceslin tle f o8p hown and agree to pay for all
services received. So Cal.Shredding certifies the materdlIrescribed above will be shredded
in compliance with NAID,Federal,State and Local Laws.
❑ ON-SITE 0 Off:Site®1?1\91y t�;clur Lake Forest, CA. Facility
DATE-TIME OF DESTRUCTION t�
NOTES:
RES 2oZD- �7 Z
Southern California Shredding
20492 Crescent Bay Drive#112
-;*A' Lake Forest, CA. 92630
Phone(949)305-5511
4-4V N:- E-Mail: info@socalshredding.corn
Service Receipt/Destruction Certificate
Date:7- `r Acct#0.:610;) Type: 0 Regular 0 Call-In
Name: pc, / 1 c, 1,4-"04(E
Loc/Address:
Con: * 64-Gal: 96-Gal:
Boxes: ram- t Weight:
Material Type: o Paper o Other:
Pick-Up/Del: Console 64-Gal 96-Gal
.-.yyecti
Total Price: 4'7^it
Payment: Check# Cash:
C.0 (Visa,MC,AMEX)#
Exp: CVC: Zip:
•
Representative: (A
W13NvNb J0 At,(RI.EASEPRINT)
Driver: C�" ( VY x'"4 4113 A110 JO 331110
We acknowledge receipt of the listed services in the amount shown and agree to pay for all
services received. So Cal.ShOglig1ce tji iesIht nt'1' s. 6ianj�cribed above will be shredded
in compliance with NAID,Federal,State and oca
❑ ON-SITE 0 Off-Site—Destruction at our Lake Forest, CA.Facility
DATE-TIME OF DESTRUCTION
NOTES:
1
Southern California Shredding
20492 Crescent Bay Drive #112
k���` Lake Forest, CA. 92630 RECEIVED
�� z� ti Phone(949) 305-5511
E-Mail: info@socalshredding.com
2020 DEC -9 P I: 50
Service Receipt/ Destruction Certificate
OFFICE OF CITY CLERK
Date: Acct# Type: 0 Regular 0 Call-In CITY OF ANAHEIM
Name:
Loc/Address:
Con: 64-Gal: 96-Gal:
2
Boxes:
�?' ` C1� ,ihx a_t.) Weight:
Material Type: ❑ Paper ❑ Other:
Pick-Up/Del: Console 64-Gal 96-Gal
Total Price:
Payment: Check# Cash:
C.0 (Visa,MC, AMEX)#
Exp: CVC: Zip:
Representative:
(PLEASE PRINT)
Driver:
We acknowledge receipt of the listed services in the amount shown and agree to pay for all
services received. So Cal.Shredding certifies the material described above will be shredded
in compliance with NAID,Federal,State and Local Laws.
0 ON-SITE 0 Off-Site—Destruction at our Lake Forest, CA. Facility
DATE—TIME OF DESTRUCTION 1 ` LI . L 4.� / , i • 2}v
NOTES: ‘')C) .., \(S L_
Ir
1
-/1> .BUFF
ANAHEIM POLICE DEPARTMENT
Jorge Cisneros, Chief of Police
Date: December 10, 2020
To: Nicole Van Train, Records Manager
From: Regina Almanza, Senior Secretary
RE: Destruction
On December 10, 2020 I deleted the following electronic files for the
!1 City's annual records destruction:
2013 Credit Card Statements
2014 Credit Card Statements.
Thank you,
{
425 S.Harbor Blvd
Anaheim,CA 92805
T: (714)765-1900
F: (714) 765-1690
www.anaheimpd.org
Community, Teamwork, Excellence
Sothern California Shredding
• 20492 Crescent Bay Drive#112
4 - Lake Forest, CA. 92630
` ' •• Phone(949)305-5511
E-Mail:info@socalshredding.com
Service Receipt/ Destruction Certificate
Date: \ 13 2 r Acct# %`')C X4,(1)0 Type:,.R.Ttegular ❑ Call-In
Name: , Iti1 e, .tom it' i 0 t • G
Loc/Address:
Con: 64-Gal: 96-Gal:
1 �:
Boxes: "` ' Weight:
Material Type:,Q Paper ❑Other:
Pick-Up/Del: Console 64-Gal 96-Gal
Total Price: ,
, •
Payment: Check# Cash:
C.0(Visa,MC,AMEX)#
Exp: CVC: Zip:
•
Representative:,:
(PLEASE PRINT)
Driver: J'
Weacknowledgereceipt of the listed services in the amount shown and agree to pay for all
services received So Cal.Shredding certifies the material described above will be shredded
in compliance with NAID,Federal,State and Local Laws.
EZON-,SITE ❑ Off-Site—Destruction at our Lake Forest, CA. Facility
DATE-TIME OF DESTRUCTION
NOTES: