HomeMy WebLinkAboutDisposition Forms_Certificate of Destruction_03/27/2010 i NVO i CE #:7455 PO Box 1 768
STU/AN j , FL 34995
T ALL POINTS w 772-283 -41 52
e 8O❑- 696 -8483
mobile shredding FAX: 772-324 -8495
s
THE ON - SITE DOCUMENT SHREDDING FACILITY
CONTACT:� �� DATE: I OCHE ❑CHARGE
PHONE #:N \k ,l �`� t �% ASH
QUANTITY: DESCRIPTION: UNIT PRICE: TOTAL:
DOCUMENT
DESTRUCTION
(Z., -Q
PLEASE PAY
THIS AMOUNT:
CERTIFICATE OF DESTRUCTION:
I /WE HEREBY CERTIFY THAT THE DOCUMENTS LISTED ABOVE HAVE BEEN FULLY AND COMPLETELY
DESTROYED BY SHREDDING ON THE DATE SHOWN fH CUST INSTRUCTIONS AND
ACCORDING TO FACTA, HIPPA & GLBA REGULATIONS FOR ABOVED M NTI❑NED COMPANY.
L
OA
CUs ME S GENT APMS OPER ATOR
. 1 PALM CITY THANK YOU FOR THE OPPORTUNITY TO SERVE YOU Ft?'Stuart/MartinCounty
' " I Chamber of Commerce