15-E — Bellflower City Council, March 9, 2026

15-E
TO: Honorable Mayor and Members of the City Council

ATTENTION: Ryan Smoot, City Manager

FROM: Mayra Ochiqui, City Clerk

SUBJECT: Consideration and possible action to adopt Resolution No. 26-06 – A Resolution authorizing the destruction of obsolete records from all City Departments.

DATE: March 9, 2026

EXECUTIVE SUMMARY

On May 27, 2025, the City Council adopted Resolution No. 25-17, updating the City’s Retention Schedule and establishing the criteria and procedures for the destruction of obsolete records.

If adopted, Resolution No. 26-06 (“Resolution”) will authorize the destruction of obsolete records from all City Departments, as listed in Exhibit A of the Resolution.

RECOMMENDATION TO CITY COUNCIL

1) Adopt Resolution No. 26-06; or

2) Alternatively, discuss and take other action related to this item.

FISCAL IMPACT

The cost to destroy records is $7.00 per box (Retrieval: $2.50; Destruction: $4.50). This Resolution includes a proposed destruction of 98 boxes of obsolete records. The cost to destroy the obsolete records identified in Resolution No. 26-06 will be approximately $686.00 to be paid from Records Management Account No. 010-43620-1200.

DISCUSSION

On May 27, 2025, the City Council adopted Resolution No. 25-17, updating the City’s Retention Schedule and establishing the criteria and procedures for the destruction of obsolete records. Obsolete records must be destroyed on a routine and periodic basis in order to maintain the efficient operation of the City and save on record storage expenses.

Page 1 of 2 ends

-1-

Staff Report – Destruction of Obsolete Records
March 9, 2026

Page 2 of 2 ends

DISCUSSION – Continued

Resolution No. 26-06 is based on the policies and procedures in place and, if adopted, will authorize the destruction of obsolete records from all City Departments as listed in Exhibit A of the Resolution. If approved, this destruction will bring all identified and catalogued citywide records under compliance with the City’s adopted Retention Schedule and Records Management Program.

ATTACHMENT

Resolution No. 26-06....................................................................................................... 3

-2-

CITY OF BELLFLOWER

RESOLUTION NO. 26-06

A RESOLUTION AUTHORIZING THE DESTRUCTION OF

OBSOLETE RECORDS FROM ALL CITY DEPARTMENTS

THE CITY COUNCIL RESOLVES AS FOLLOWS:

SECTION 1. Recitals. The City Council finds and declares as follows:

A. Keeping and maintaining public records that are unnecessary or duplicative results in the consumption of significant public resources including money, time, and space;

B. The City’s Charter, Government Code §§ 34090, et seq. and the City’s Records Retention Schedule (Resolution No. 2 5-17) establish methods by which the City may approve the destruction of unneeded documents; and

C. It is in the public interest to reduce the City’s cost for storing documents while, at the same time, ensuring that the City preserves those records that are required to conduct City business.

SECTION 2. Factual Findings. As used in this Resolution, “record” has the same definition as set forth in Government Code § 6252.

SECTION 3. Pursuant to the City’s Charter, Government Code § 34090 and the City’s Records Retention Schedule (Resolution No. 25-17), the City Council approves the destruction of those records listed in the attached Exhibit “A,” which is incorporated by reference, and authorizes the City Clerk to destroy such records.

SECTION 4. This Resolution does not affect any penalty, forfeiture, or liability incurred before, or preclude prosecution and imposition of penalties for any violation occurring before, this Resolution’s effective date. Any such amended part will remain in full force and effect for sustaining action or prosecuting violations occurring before the effective date of this Resolution.

SECTION 5. Upon destroying any documents in accord with this Resolution, the City Clerk is directed to complete a certificate verifying the destruction of such records and file the certificate with the City’s official records.

SECTION 6. Limitations. The City Council’s analysis and evaluation of the project is based on the best information currently available. It is inevitable that in evaluating a project that absolute and perfect knowledge of all possible aspects of the project will not exist. One of the major limitations on analysis of the project is the City Council’s lack of knowledge of future events. In all instances, best efforts were made to form accurate assumptions. Somewhat related to this are the limitations on the City's ability to solve what are in effect regional, state, and national problems and issues. The City must work within the political framework within which it exists and with the limitations inherent in that framework.

Page 1 of 2 ends

-3-

City of Bellflower
Resolution No. 26-06

Page 2 of 2 ends

SECTION 7. Summaries of Information. All summaries of information in the findings, which precede this section, are based on the substantial evidence in the record.

The absence of any particular fact from any such summary is not an indication that a particular finding is not based in part on that fact.

SECTION 8. Construction. This Resolution must be broadly construed to achieve the purposes stated in this Resolution . It is the City Council’s intent that the provisions of this Resolution be interpreted or implemented by the City and others in a manner that facilitates the purposes set forth in this Resolution.

SECTION 9. Severability. If any part of this Resolution or its Application is deemed invalid by a court of competent jurisdiction, the City Council intends that such invalidity will not affect the effectiveness of the remaining provisions or applications and, to this end, the provisions of this Resolution are severable.

SECTION 10. Electronic Signatures. This Resolution may be executed with electronic signatures in accordance with Government Code §16.5. Such electronic signatures will be treated in all respects as having the same effect as an original signature.

SECTION 11. The Mayor, or presiding officer, is authorized to affix its signature to this Resolution signifying its adoption by the City Council of the City of Bellflower, and the City Clerk, or its duly appointed deputy, is directed to attest.

SECTION 12. Effective Date. This Resolution will become effective immediately upon adoption and will remain effective unless repealed or superseded.

PASSED, APPROVED, AND ADOPTED BY THE CITY COUNCIL OF THE CITY OF BELLFLOWER THIS 9TH DAY OF MARCH 2026.

________________________________
Sonny R. Santa Ines, Mayor
ATTEST:

________________________________
Mayra Ochiqui, City Clerk

APPROVED AS TO FORM:

_________________________________
Karl H. Berger, City Attorney

ATTACHMENT:

Exhibit A – Obsolete Records Authorized for Destruction -4-

-5-

-6-

-7-

-8-

-9-

-10-

-11-

-12-

-13-

-14-

-15-

-16-

-17-

-18-

-19-

-20-

-21-

-22-

Detailed Listings

Obsolete Records Authorized for Destruction
-23-

CITY OF BELLFLOWER

REQUEST FOR

AUTHORITY TO TRANSFER INACTIVE RECORDS
RECORDS OF: Administration
Department)

Page 1 of 5 ends

FILE TOTAL'

TYPE INACTIVE
ITEM FILE NAME AND C -Copies RETENTION INCLUSIVE DATES DESTROY BOX NO. FUNCTION/CATEGORY O -Originals TIME IN FILE AFTER NO.

NUMBER

FROM TO
1 Niemer, Kimberly A. O Term. + 10 1/24/ 94 5/ 5/95 5/ 5/08 27 Resigned 530-10
2 Schumaker, Keith G. O Term. + 10 12/20/85 4/7/95 4/7/08 27 Resigned 530-10
3 Welch, Cora M. O Term. + 10 7/22/88 4/25/95 4/25/08 27 Resigned 530-10
4 Harrison, Marian O Term. +10 2/14/94 9/15/95 9/15/08 27 Resigned 530-10
5 Harrison, Marian O Term. + 10 2/14/94 9/15/95 9/15/08 27 Workman's Compensation 145-70
6 Howse, Patricia A. O Term. + 10 9/11/78 9/1/95 9/1/08 27 Resigned 530-10
7 Chamberlain, Mary Ann O Term. + 10 1123/95 12/29/95 12/29/08 27 Retired 530-10
8 Reyes, David 530-10 O Term. + 10 6/ 19/95 9/22/95 9/22/ 08 27 Resigned
9 Ross, Gary S. O Term. + 10 2/1/95 6/795 6/7/08 27
Terminated 530-10
10 Ross, Gary S. O Term. + 10 2/1/95 6/7/95 6/7/08 27
Workman's Compensation 145-70
-24-

CITY OF BELLFLOWER

REQUEST FOR

AUTHORITY TO TRANSFER INACTIVE RECORDS
RECORDS OF: Administration
Department)

Page 2 of 5 ends

FILE TOTAL

TYPE INACTIVE
ITEM FILE NAME AND C -Copies RETENTION INCLUSIVE DATES DESTROY BOX NO. FUNCTION/CATEGORY O -Originals TIME IN FILE AFTER NO.

NUMBER

FROM TO
11 Tristan, Yvette O Term. + 10 7/6/89 9/1/95 9/1/08 27 Terminated 530-10
12 Schicora, Michael G. O Term. + 10 5/18/91 5/18/95 5/18/08 27 Terminated 530-10
13 Torres, Esther O Term. + 10 9/13/93 9/1/95 9/1/08 27 Resigned 530-10
14 Schrader, Allen L. O Term. +10 4/7/95 4/14/95 4/14/08 27 Resigned 530-10
15 Perez, Ana G. O Term. + 10 2/14/95 8/4/95 8/4/08 27
Terminated 530-10
16 Juarez, Carlos 0 Term. + 10 11/28/94 1/11/95 1/11/08 27 Terminated 530-10
17 Hefner, Trever H. O Term. + 10 6/1/95 8/24/95 8/24/08 27 Terminated 530-10
18 Halma, Gladys M. O Term + 10 10/19/95 7/1/95 7/1/08 27 Resigned 530-10
19 Halbaier, Joshua M. O Term + 10 6/12/93 5/25/95 5/25/08 27 Terminated 530-10
20 Helms, Catherine M. O Term + 10 8/3/81 6/30/95_ 6/30/08 27 Terminated 530-10
-25-

CITY OF BELLFLOWER

REQUEST FOR

AUTHORITY TO TRANSFER INACTIVE RECORDS
RECORDS OF: Administration
Department)

Page 3 ends

FILE TOTAL

TYPE INACTIVE
ITEM FILE NAME AND C -Copies RETENTION INCLUSIVE DATES DESTROY BOX NO. FUNCTION/CATEGORY O -Originals TIME IN FILE AFTER NO.

NUMBER

FROM TO
21 Gehrts, Pamela O Term. + 10 2/1/95 12/1/95 12/1/08 27 Resigned 530-10
22 Cole, Shannon O Term. + 10 6/13/94 8/24/95 8/24/08 27 Terminated 530-10
23 Negrete, Kenneth M. O Term. + 10 1/16/95 4/15/95 4/15/08 27 Resigned 530-10
24 Venegas, Gerardo O Term. +10 9/8/90 11/16/95 11/1/08 27 Terminated 530-10
25 Van Kekerix. Leonard O Term. + 10 7/13/87 9/11/95 9/11/08 27 Terminated 530-10
26 Rogers, Matthew E. O Term. + 10 6/10/85 11/24/95 11/24/08 27 Resigned 530-10
27 Rogers, Matthew E. O Term. + 10 6/10/85 11/24/95 11/24/08 27 Workman's Compensation 145-70
28 Vinh, Khai O Term + 10 6/26/95 8/4/95 8/4/08 27
Terminated 530-10
29 Mao, Kelly K. O Term + 10 1/4/93 6/16/95 6/16/08 27
Resigned 530-10
30 Mohr, Kevin.C. O Term + 10 6/13/95 8/18/95 8/18/08 27 Resigned 530-10
-26-

CITY OF BELLFLOWER

REQUEST FOR

AUTHORITY TO TRANSFER INACTIVE RECORDS
RECORDS OF: Administration
Department)

Page 4 of 5 ends

FILE TOTAL

TYPE INACTIVE
ITEM FILE NAME AND C -Copies RETENTION INCLUSIVE DATES DESTROY BOX NO. FUNCTION/CATEGORY O -Originals TIME IN FILE AFTER NO.

NUMBER

FROM TO
31Martinez, Anthony F. 0 Term. + 10 3/6/95 4/25/95 4/25/08 27 Resigned 530-10
32 Arendas, Ronald O Term. + 10 6/15/91 8/6/95 8/6/08 27 Resigned 530-10
33 Jones, Shawn M. 0 Term. + 10 2/15/90 9/21/95 9/ 21/08 27 Terminated 530-10
34 Bougere, Keith A. 0 Term. + 10 6/13/94 9/2/95 9/2/08 27 Resigned 530-10
35 Kelly, Sarah 0 Term. + 10 12/24/94 8/31/95 8/ 31/08 27 Resigned 530-10
36 Knapp, William M. 0 Term. + 10 5/16/94 1/23/95 1/23/08 27 Resigned 530-10
37 Devine, Robert T. O Term. + 10 6/13/94 5/4/95 5/4/08 27 Terminated 530-10
38 Johnson, Korey B. 0 Term. + 10 4/14/94 6/5/95 6/ 5/08 27 Terminated 530-10
39 John, Kenneth 0 Term. + 10 10/6/90 6/9/95 6/ 9/08 27 Resigned 530-10
40 Jackson, Timothy L. 0 Term. + 10 6/24/95 8/24/95 8/24/08 27 Terminated 530-10
-27-

CITY OF BELLFLOWER
RECORDS OF: Administration
Department)

REQUEST FOR

AUTHORITY TO TRANSFER INACTIVE RECORDS

Page 5 of 5 ends

Approved:

Department Head
Approved: ko- Z0,4100 Zet-
I
Approved: ,
ity Administrator)
Date:

Date: I /9ri
Date:

FILE TOTAL

TYPE INACTIVE
ITEM FILE NAME AND C -Copies RETENTION INCLUSIVE DATES DESTROY BOX NO. FUNCTION/CATEGORY O -Originals TIME IN FILE AFTER NO.

NUMBER

FROM TO
417Reveles, Ricardo J.

Resigned 530-10 :1 O Term + 10 2/16/89
I
3/28/95
I
3/28/ 08
I
27 I —i
Approved:

Department Head
Approved: ko- Z0,4100 Zet-
I
Approved: ,
ity Administrator)
Date:

Date: I /9ri
Date:
-28-

CITY OF BELLFLOWER

Page 1 ends

REQUEST FOR

AUTHORITY TO TRANSFER INACTIVE RECORDS
RECORDS OF: Administration
Department)
ITEM
NO.

FILE NAME AND

FUNCTION/CATEGORY
NUMBER
FILE
TYPE
C -Copies .:

O -Originals
TOTAL

INACTIVE

RETENTION
TIME'

INCLUSIVE DATES

IN FILE

DESTROY
AFTER
BOX
NO.

FROM TO
1 McConnell, William O. 530-010 O Term. + 10 04/28/58. 11/06/87 11/6/00 34 2 Bruyere, Carol E. 530-010 O Term. + 10 11/29/ 76 11/30/8-7 11/30/00 34 3 Miller, Rita K. 530-010 O Term. + 10 01/18/77 01/30/87 1/30/87 34 4 Stewart, Theodore E. 530-010 O Term. + 10 08/07/72 07/ 03/ 87 7/3/00 34 S.. ... xx ....
x
r
x< .._. ? r. .. ._.. ., x. .v. ... ..< < ,. n ..: .. ......._[fit ., .. $ ,. :.-,.....< • .. iu+
4 5 Solid Waste Handling at School District Facilities 210-30 C/O 5 years 05/17/94 05/31/94 5/ 31/ 01 34 6 Southeast Mosquito Abatement 105-10 C/O 5 years 01/ 01/75 12/30/94 12/30/01 34 7 Sakamoto, Michael A. 530-10 O Term. + 10 12/02/80 05/06/88 5/ 6/01 34 8 Whiting, Francis 530-10 O Term. + 10 08/01/62 04/30/88 4/30/01 34

9. Sherwin, James W. 530-10 O Term. + 10 09/ 26/77 06/10/88 6/10/01 34 10 Enke, John 530-10 O Term. + 10 12/01 /69 01 / 01 /88 1 / 1 /01 34 -29-

CITY OF BELLFLOWER
RECORDS OF: Administration
Department)

REQUEST FOR

AUTHORITY TO TRANSFER INACTIVE RECORDS

Page 2 of 2 ends

Approved:

Department Head)
Date:
r rDate:

Date:

FILE TOTAL

TYPE INACTIVE
ITEM FILE NAME AND C -Copies RETENTION INCLUSIVE DATES DESTROY BOX NO. FUNCTION/CATEGORY O -Originals TIME IN FILE AFTER NO.

NUMBER

FROM TO
11 Proposition 62 Information 410-05 C 5 years 10/01/95 10/01/95 10/1/02 34 12 Collins, Raymond 530-10 O Term. + 10 09/10/68 11/08/ 89 11/8/02 34 13 Brassard, Mike G. 530-10 O Term. + 10 04/17/84 11/08/ 89 11/8/02 34 14 Morales, Paulo M. 530-10 O Term. + 10 07/12/80 01/06/89 1/6/02 34 15 Rever, Louis H. 530-10 O Term. + 10 05/27/69 07/17/89 7/17/02 34 Approved:

Approved:

Department Head)
Date:
r rDate:

Date:
-30-

CITY OF BELLFLOWER

REQUEST FOR

AUTHORITY TO TRANSFER INACTIVE RECORDS
RECORDS OF: Administration
Deaartment)

Page 1 of 2 ends

ITEM
NO.

FILE NAME AND

FUNCTION/CATEGORY
NUMBER
FILE
TYPE
C -Copies
O -Originals
TOTAL

INACTIVE

RETENTION
TIME

INCLUSIVE DATES

IN FILE

DESTROY
AFTER
BOX
NO.

FROM TO
1 Rivera, James M. 530-010 O Term. + 10 06/18/94 11/17/94 11/17/07 35 2 Trader, Ted R. 530-010. O Term. + 10 12/01/86 07/01/94 7/1/07 35 3 Schoeman, Gary D. 530-010 O Term. + 10 05/15/93 06/30/ 94 6/30/ 07 35 4 Schmidt, Kimberly D. 530-010 O Term. + 10 09/19/92 05/01/94 5/1/07 35 5 Ortega, Veronica 530-01-0 O Term. + 10 10/23/ 89 03/18/94 3/18/07 35 6 Ortega, Veronica 145-070 O Term. + 10 10/23/ 87 03/18/94 3/18/07 35 7 Owens, Stacey 530-010 O Term. + 10 06/10/83 12/26/94 12/26/07 35 8 Zwiep, Jeffrey T. 530-010 0 Term. + 10 06/12/93 04/07/94 4/7/07 35 9 Zwiep, Gregory P. 530-010 O Term. + 10 06/26/89 02/10/94 2/10/07 35 10 Vance, Maridee J. 530-010 O Term. + 10 06/29/94 12/22/ 94 12/22/07 35 11 Recio, Lucie 530-010 O Term. + 10 03/14/94 04/21/94 4/21/07 35 . 12 Rodriguez, Diane E. 530-010 O Term. + 10 05/11!93 04/13/94 4/13/07 35 13 Thomas, Billy L. 530-010 O Term. + 10 09/23/94 10/21/94. 10/21 /07 35 14 Thomas, Billy L. 145-070 O Term. + 10 09/23/94 10/21/94 10/21/07 35 15 Saucedo, Jose A. 530-010 O Term. + 10 03/28/94 07/14/94 7/14/07 35 16 Whitney, Chad G. 530-010 0 Term. + 10 12/29/90 09/15/94 9/15/07 35 -31-

CITY OF BELLFLOWER

REQUEST FOR

AUTHORITY TO TRANSFER INACTIVE RECORDS
RECORDS OF: Administration
Department)

Page 2 of 2 ends

ITEM
NO.

FILE NAME AND

FUNCTION/CATEGORY
NUMBER
FILE
TYPE
C -Copies
O -Originals
TOTAL

INACTIVE

RETENTION
TIME

INCLUSIVE DATES

IN FILE

DESTROY
AFTER
BOX
NO.

FROM TO
17 Gates, Guy O. Jr. 530-010 O Term. + 10 06/28/92 10/10/95 10/ 10/08 35 18 Gates, Guy O. Jr. 145-070 O Term. + 10 06/ 28/92 10/10/95 10/ 10/08 35 19 Whitney, Marcus A. 530-010 O Term. + 10 07/25/92 03/25/ 95 3/25/ 08 35 20 Hyun, Bing H. 530-010 O Term. + 10 07/ 02/90 02/10/95 2/10/08 35 21 Haines, Tamara M 530-010 O Term. + 10 05/01/95 10/27/95 10/27/08 35 22 Williams, Brent A. 530-010 O Term. + 10 06/01/95 11/30/95 11/30/08 35 23 Clemens, Jeffrey T. 530-010 O Term. + 10 08/24/93 1 03/ 24/ 95 3/24/08 35 Approved: Date:

Dep rtment Head)
Approved: Date:
it Cle
Approved. Date:

City Ad inistrator)
-32-

Docusign
Enve
lope ID: 54477BCC-1C29-46E9-84E8-3737E3752FD0
A

UTHORITY TOTRA NSFER INACTIVE RECORDS
A
ND RECORDS INVENTORY LIST 1Department:Human
Resource
sRete ntion Period:List tion3years
Gene
ral DescriptionofRecords:

Recruitmen
t FilesDestructio nDEligibilityate:12/31/2025FORCITYCLERK'S OFFICE USEBoxNo.AD868BarcodeNo.62057955 ITEMNO.DESCRIPTIO

N OF SPECIFIC RECORDS OR FILES

INCLUSIVE DATES

IN FILE

FROM TO
1 Code
Enfo
rcement
Inspecto
r I (FT) (Eligibility List Dated 09/13/2022)08/23/2022 09/13/2022 2 M
ainte
nance
Assistan
t
Co
ntinuous 2022 01/31/2022 12/31/2022
3 M
aintenance
Assistant
Continuo
us 2021 07/07/2021 07/07/2022
4 Maintenanc
e Worker I FT (Eligibility List Dated: 10/23/2021)10/13/2022 10/02/2021 5 M
aintenance Worker I — PT (Eligibility Dated: 10/21/2022)08/25/2022 10/21/2022 6 Pro
gram Coordinator (PT) (Eligibility List Dated: 01/05/2022)01/05/2022 01/31/2022 7 Community
Service
s
O
ffice
r (Eligibility List Dated: 09/29/2022)10/10/2022 10/20/2022 8 Recreatio
n
Co
ordinato
r — FT (Eligibility List
Date
d: 05/17/2022)02/24/2022 05/26/2022
9 Mainte
nance Worker I — PT (Eligibility List
Date
d: 07/26/21)05/24/2021 07/26/2021
10 Maintenance
Worker I (Eligibility List Dated:02/21/2021)10/27/2020 02/01/2021 11 Manage
ment
Assista
nt (CC) (Eligibility List Dated: 03/11/2021)11/24/2020 03/11/2021 12 M
anageme
nt Analyst I — HR (Eligibility List Dated 03/24/2021)01/14/2021 03/24/2021 13 Management
An
alyst II/
Sr.

Management
Ana
lyst (Eligibility List Dated : 07/26/2021)06/01/2021 07/26/2021 SIGNATURES ON NEXT PAGE]
-33-

DocusignEnvelope
ID: 54477BCC-1C29-46E9-84E8-3737E3752FD0
A

UTHORITY TOTRA NSFER INACTIVE RECORDS
A
ND RECORDS INVENTORY LIST 2Deartment:p Human
Reso
urces Retention Period:List Creation3yearsGeneral
Descriptio
nof
Reco
rds:

Recruitme
nt Files DestructionEligibility 12/31/2025FORCITYCLERK'SOFFICE USEBoxNo.AD868BarcodeNo.62057955 ITEM
NO.

DESCRIPTION
OF

SPECIFIC RECORDS OR FILES

INCLUSIVE DATES

IN FILE

FROM TO
I
AUTHO

RIZE THE RECORDS CONTAINED HEREIN TO BE TRANSFERRED
TO

THE OFFSITE STORAGE FACILITY AND CITY COUNCIL
APPROVED RECORDS RETENTION APPLIED.

Signed by:
tan, S MOOT
64D890215FE4C5.Date:
4/28/2025 I 4:40 PM PDT
-34-

docusign
Certificate Of Completion
Envelope Id: 54477BCC-1C29-46E9-84E8-3737E3752FD0
Subject: Sign with Docusign: Authority to Transfer Records - Recruitment Files - AD868.pdf, Authorit.-.

Source Envelope:

Document Pages: 7 Signatures: 5
Certificate Pages: 1 Initials: 0
AutoNav: Enabled
Envelopeld Stamping: Enabled
Time Zone: (UTC-08:00) Pacific Time (US & Canada)
Record Tracking
Status: Original
4/28/2025 3:36:26 PM
Signer Events
Ryan Smoot
[email protected]
City Manager
Security Level: Email, Account Authentication
None)
Electronic Record and Signature Disclosure:

Not Offered via Docusign
In Person Signer Events
Editor Delivery Events
Agent Delivery Events
Intermediary Delivery Events
Certified Delivery Events
Carbon Copy Events
Witness Events
Notary Events
Envelope Summary Events
Envelope Sent
Certified Delivered
Signing Complete
Completed
Payment Events
Holder: City Clerk
[email protected]
Signature
swn.d by:

Swot
00215FEAC5
Signature Adoption: Pre -selected Style
Using IP Address:

Signed using mobile
Signature
Status
Status
Status
Status
Status
Signature
Signature
Status
Hashed/Encrypted
Security Checked
Security Checked
Security Checked
Status
Status: Completed
Envelope Originator:

City Clerk
16600 Civic Center Drive
16600 Civic Center Drive
Bellflower, CA 90706
[email protected]
IP Address:

Location: DocuSign
Timestamp
Sent: 4/28/2025 3:38:07 PM
Viewed: 4/28/2025 4:40:21 PM
Signed: 4/28/2025 4:40:49 PM
Timestamp
Timestamp
Timestamp
Timestamp
Timestamp
Timestamp
Timestamp
Timestamp
Timestamps
4/28/2025 3:38:07 PM
4/28/2025 4:40:21 PM
4/28/2025 4:40:49 PM
4/28/2025 4:40:49 PM
Timestamps
-35-

Docusign Envelope ID: 54477BCC-1O29-46E9-84E8-3737E3752FD0

AUTHORITY TO TRANSFER INACTIVE RECORDS
AND RECORDS INVENTORY LIST 1
Department:Human Resources
Retention Period:List Creation
3 years
tionGeneralDescription
of Records:

Recruitment and Test Files
Destruction
Elicibility Date:
12/31/2025

FOR CITY CLERK'S OFFICE USE
Box No.AD870
Barcode No.62057953
ITEM
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES

INCLUSIVE DATES

IN FILE

FROM TO
1 Management Intern PT (Eligibility List Dated 12/07/2021)10/10/2021 12/07/2021 2 Program Assistant (Eligibility List Dated 06/22/2021)04/26/2021 06/22/2021 3 Community Services Officer PT 2021 (Eligibility List Dated 05/21/2021)04/09/2021 05/21/2021 4 Administrative Assistant PT (Eligibility List Dated 09/21/2021)07/28/2021 09/21/2021 5 Maintenance Crew Leader (Eligibility List Dated 05/05/2021)04/07/2021 05/05/2021 6 Executive Assistant II — Planning (Eligibility List Dated 06/30/2021)06/03/2021 06/30/2021 7 Maintenance Worker I FT (Eligibility List Dated 04/29/2021)04/07/2021 04/29/2021 8 Testing File (Bilingual)03/16/2021 10/14/2022
9 Maintenance Assistant Continuous - 2020 07/07/2021 08/16/2021 10 Management Intern (Eligibility List Dated 05/17/2021)04/06/2022 05/18/2022 11 Maintenance Worker I — PT (Eligibility List Dated 03/24/2022)01/31/2022 08/22/2022

I AUTHORIZE THE RECORDS CONTAINED HEREIN TO BE TRANSFERRED TO THE OFFSITE STORAGE FACILITY AND CITY COUNCIL APPROVED F 0 S RETENTION APPLIED.

Approved:

Approved;
riftv, SK,66
B4DB94215FE4C5
Depart t Hd
htVci /a,
Date:
4/28/2025 I 4:40 PM PDT
Date: yl 72-Z
-36-

Odocusign
Certificate Of Completion
Envelope Id: 54477BCC-1 C29-46E9-84E8-3737E3752FD0
Subject: Sign with Docusign: Authority to Transfer Records - Recruitment Files - AD868.pdf, Authorit...

Source Envelope:

Document Pages: 7 Signatures: 5
Certificate Pages: 1 Initials: 0
AutoNav: Enabled
Envelopeld Stamping: Enabled
Time Zone: (UTC-08:00) Pacific Time (US & Canada)
Status: Completed
Envelope Originator:

City Clerk
16600 Civic Center Drive
16600 Civic Center Drive
Bellflower. CA 90706
[email protected]
IP Address:

Record Tracking
Status: Original
4/28/2025 3:36:26 PM
Holder: City Clerk
[email protected]
Location: DocuSign
Signer Events Signature Timestamp
Ryan Smoot
[email protected]
City Manager
Security Level: Email, Account Authentication
None)
Electronic Record and Signature Disclosure:

Not Offered via Docusign
Sipmed by.

Swot
C6.OBB0215FEaC5
Signature Adoption: Pre -selected Style
Using IP Address:

Signed using mobile
Sent: 4/28/2025 3:38:07 PM
Viewed: 4/28/2025 4:40:21 PM
Signed: 4/28/2025 4:40:49 PM
In Person Signer Events Signature Timestamp
Editor Delivery Events Status Timestamp
Agent Delivery Events Status Timestamp
Intermediary Delivery Events Status Timestamp
Certified Delivery Events Status Timestamp
Carbon Copy Events Status Timestamp
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent
Certified Delivered
Signing Complete
Completed
Payment Events
Hashed/Encrypted
Security Checked
Security Checked
Security Checked
Status
4/28/2025 3:38:07 PM
4/28/2025 4:40:21 PM
4/28/2025 4:40:49 PM
4/28/2025 4:40:49 PM
Timestamps
-37-

AUTHORITY TO TRANSFER INACTIVE RECORDS

AND RECORDS INVENTORY LIST
1 Department:HUMAN RESOURCES
Retention Period:FINAL

RESOLUTION
5YRS
General Description
of Records:
2020 CLAIMS - LIABILITY CLAIMS AGAINST THE CITY (HR004) Destruction
Eligibility Date:
12/31/2025

FOR CITY CLERK'S OFFICE USE
Box No.AD875
Barcode No.62057600
ITEM
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES

INCLUSIVE DATES

IN FILE

FROM TO
1 MICHEL & MILIA, LLC 09/15/2016 01/02/2020
2 EMARIE GOMEZ 04/02/2019 02/20/2020
3 ALFREDO PEREZ 12/10/2019 02/26/2020
4 HYUN DONG 07/31/2019 03/2020/20
5 SERGIO GARNICA 01/03/2020 03/26/2020
6 OSCAR VILLALTA 12/15/2019 03/26/2020
7 BETTY MORSE 12/26/2019 03/26/2020
8 JOE CASARES 07/15/2019 04/26/2020
9 LUISIANA PARADES 02/21/2018 04/01/2020
10 TAWNY SALDANA 11/26/2019 05/12/2020
11 JULIAN EDMONDS 10/24/2019 08/12/2020
12 YUN YEA SONG 06/05/2019 09/09/2020
13 VICKIE MCDANIEL 04/24/2020 09/14/2020
14 HOWARD SETTLER 08/07/2020 10/20/2020
15 ANTONISHA DAVIS 08/06/2020 11/30/2020
-38-

AUTHORITY TO TRANSFER INACTIVE RECORDS

AND RECORDS INVENTORY LIST
2 Department:HUMAN RESOURCES
Retention Period:FINAL

RESOLUTION
5YRS
General Description
of Records:2020 CLAIMS - LIABILITY CLAIMS AGAINST THE CITY (HR004) Destruction
Eligibility Date:
12/31/2025

FOR CITY CLERK'S OFFICE USE
Box No.AD875
Barcode No.62057600
ITEM
NO.DESCRIPTION OF SPECIFIC RECORDS OR FILES

INCLUSIVE DATES

IN FILE

FROM TO
16 CHRYSTAL HOPPER 08/06/2020 11/30/2020
17 CHRYSTAL HOPPER 08/06/2020 11/30/2020
18 LLUVITZA CHAVEZ 11/08/2020 12/21/2020
19 BRUCE CAMPBELL 07/28/2016 12/02/2020
20 AAA JENNIFER IGERCIC 08/27/2020 12/30/2020
21 BELLFLOWER HOME GARDEN WEATER CO.07/01/2020 12/03/2020

I AUTHORIZE THE RECORDS CONTAINED HEREIN TO BE TRANSFERRED TO THE OFFSITE STORAGE FACILITY AND CITY COUNCIL APPROVED RECORDS RETENTION APPLIED.

Approved: Date: 03/63/2C
Dep ment Head)
Approved:Date: 3l Lii?Ps
-39-

G,
pF BGLLFLpw

R AUTHORITY TO TRANSFER INACTIVE RECORDS

AND RECORDS INVENTORY LIST
wwo
maetflS*
Department: I
City Clerk Retention Period: 7 years
Destruction
12/31/2025
General Description Eligibility Date:
of Records:

Fair Political Practices Commission (FPPC) Records - 2018 FOR CITY CLERK'S_OFFICE USE Box No. CC546
SKU No.RF018923829

ITEM INCLUSIVE DATES
NO. DESCRIPTION OF SPECIFIC RECORDS OR FILES IN FILE

FROM TO
2018 FPPC Annual File— Includes correspondence, log, Real Property Interest List, Local Agency Biennial Notice, Forms 1 501 (candidates without a committee), 806 (Agency Report of Public Official Appointments), 496 (Independent Expenditure 1/ 1/2018 12/31/2018 Reports), and other miscellaneous forms
Leaving Office Statements of Economic Interests (Form 700s) 2 Brown, C. Wayne 5/ 9/2013 4/ 2/2018
3 Campbell, Troy L. 11/9/2015 4/ 2/2018
4 Chanan, Stacey A. 7/21/2015 4/2/2018
5 Chung, Connie 5/7/2012 7/16/2018
6 Clarke, Jason Phillip 9/2/2015 7/16/2018
7 Delewalla Noorali 5/23/2013 7/23/2018
8 Dellalonga, James Anthony 2/28/2018 7/25/2018
9 Franzen, George E.5/14/2012 7/ 6/2018
10 Gomez, Richard J. 8/15/2017 2/28/2018
11 McConnell, Cristina R. 5/31/2013 4/2/2018
12 Nguyen, James Lu 3/30/2017 6/22/2018
13 Riera, Dennis Ray 10/25/2017 3/30/2018
14 Schnablegger, Joseph Ronald (Left office 10/1/2018) 4/14/2003 8/6/2018 15 Smith, Jeffery Lawrence 5/29/2013 4/2/2018
-40-

AUTHORITY TO TRANSFER INACTIVE RECORDS 2
oR a"

AND RECORDS INVENTORY LIST
o+
a
maetHa
Department:City Clerk Retention Period: 7 years
Destruction
12/31/2025
General Description Eligibility Date:
of Records: Fair Political Practices Commission (FPPC) Records - 2018 FOR CITY CLERK'S OFFICE USE Box No. CC546
SKU No.RF018923829

ITEM INCLUSIVE DATES
NO. DESCRIPTION OF SPECIFIC RECORDS OR FILES IN FILE

FROM TO
16 Smith, Patricia A. 5/2/2013 7/ 5/2018
17 Snow, Charles Robert(Bob) 5/15/2013 4/2/2018
18 Sorensen, William Harold 5/15/2013 4/2/2018
19 Struiksma. Leo J. 6/10/2003 9/10/2018
20 Thompson, Russell James 3/26/2018 12/12/2018
21 Tsui, Pearl 9/17/2013 9/19/2018
22 Waldie, Donald J. 6/ 12/2012 7/ 9/2018
23 Warot, Albert Vincent 8/15/2017 2/22/2018
Terminated Committees
24 From Water to Parks, Yes on W 9/16/2016 8/14/2018
25 Rene Mejia for Bellflower Council—Candidate Controlled Committee 1/5/2017 2/1/2018 -41-

c',, "
LLI"''''''
AUTHORITY TO TRANSFER INACTIVE RECORDS 3

AND RECORDS INVENTORY LIST
Department:City Clerk Retention Period: 7 years
Destruction
12/31/2025
General Description Eligibility Date:
of Records: Fair Political Practices Commission (FPPC) Records - 2018 FOR CITY CLERK'S OFFICE USE Box No. CC546
SKU No.RF018923829

ITEM INCLUSIVE DATES
NO. DESCRIPTION OF SPECIFIC RECORDS OR FILES IN FILE

FROM TO

I AUTHORIZE THE RECORDS CONTAINED HEREIN TO BE TRANSFERRED TO THE OFFSITE STORAGE FACILITY AND CITY COUNCIL APPROVED RECORDS RETENTION APPLIED.

Approved: . t'?dZZ
Depa' -nt Head)
Date: sl
Approved: Gr Date: Slit/?dZ2.
7f,,,--/
y erk)
Approved: Date:50'.2—
City Manager)
-42-

c'
pY BCLLFL°'?

AUTHORITY TO TRANSFER INACTIVE RECORDS

AND RECORDS INVENTORY LIST
OR
N'+Nc
ooejKes
Department:City Clerk Retention Period: Various
Destruction
12/31/2022
General Description Eligibility Date:
of Records:

Fair Political Practices Commission (FPPC) General Office Files FOR CITY CLERK'S OFFICE USE Box No. CC561
SKU No.RF127618611

ITEM INCLUSIVE DATES
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES IN FILE

FROM TO
1 Copies of Form 700s ( John Paul Drayer, Robert Wilson, Rene Mejia) 11/16/2016 12/9/2016 2 Copies of Form 700s from 2018 Vacancy (John Paul Drayer, Anita McInnis) 11/15/2018 11/20/2018 3 Certified Voter Registration Application (John Paul Drayer) 11/13/2018 11/13/2018 4 FPPC Annual File 1/ 1/2014 12/31/2014
5 FPPC Annual File 1/ 1/2015 12/31/2015

I AUTHORIZE THE RECORDS CONTAINED HEREIN TO BE TRANSFERRED TO THE OFFSITE STORAGE FACILITY AND CITY COUNCIL APPROVED RECORDS RETENTION APPLIED.

Approved: cr Date: 11/21/7-ez-3
Depa ent Head)
Approved: _ . ii . /
i///
Date: 17//2-/b--d33
Approved: Date: A`>
ity Manager)
-43-

a'ka+W,Nal aar.a aa0,

AUTHORITY TO TRANSFER INACTIVE RECORDS

AND RECORDS INVENTORY LIST - MULTIPLE BOXES IN SINGLE RECORD SERIES 1 Department:City Clerk Retention Period:2 years
General Description
of Records:
2023 Public Records Act Requests and 2023 Subpoenas
Destruction Eligibility
Date:
12/31/2025
ITEM
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES

INCLUSIVE DATES

IN FILE
Box No.Barcode No.

FROM TO
1 PRA Nos. 23-01 to 23-149 1/3/2023 3/28/2023 CC590 62050492 2 PRA Nos. 23-150 to 23-270 3/29/2023 7/6/2023 CC591 62050491 3 PRA Nos. 23-271 to 23-402 7/6/2023 9/7/2023 CC592 62050490 4 PRA Nos. 23-403 to 23-574 and Subpoenas No. 23-01 to 23-08 9/7/2023 12/28/2023 CC593 62050489

I AUTHORIZE THE RECORDS CONTAINED HEREIN TO BE TRANSFERRED TO THE OFFSITE STORAGE FACILITY AND CITY COUNCIL APPROVED RECORDS RETENTION APPLIED.

Approved:

Date: i'7ps--
Date: a S
-44-

AUTHORITY TO TRANSFER INACTIVE RECORDS

AND RECORDS INVENTORY LIST - MULTIPLE BOXES IN SINGLE RECORD SERIES 1 Department:City Clerk Retention Period:Various
General Description
of Records:
2023 GENERAL OFFICE FILES, 2023 ANNOTATED
AGENDAS, 2023 COUNCIL MEETING AUDIO FILES, 2019

COUNCIL MEETING VIDEO FILES, CANDIDATE FILES FOR
THE MARCH 2017 ELECTION, AND STAFF TRAININGS
Destruction Eligibility
Date:
12/31/2025
ITEM
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES

INCLUSIVE DATES

IN FILE
Box No.Barcode No.

FROM TO
1 Appeals 01/01/2023 12/31/2023 CC612 62057578
2 Annotated Agendas 01/01/2023 12/31/2023 CC612 62057578 3 City Attorney Correspondence 01/01/2023 12/31/2023 CC612 62057578 4 Claims 01/01/2023 12/31/2023 CC612 62057578
5 City Council Meeting Materials (Mayor's Agenda, Potential Conflicts, Roll Call, Condolence/Memorial Letters)
01/01/2023 12/31/2023 CC612 62057578
6 General Correspondence — October — December 10/01/2023 12/31/2023 CC612 62057578 7 General Correspondence — July — September 07/01/2023 09/30/2023 CC612 62057578 8 General Correspondence — April — June 04/01/2023 06/30/2023 CC612 62057578 9 General Correspondence — January — March 01/01/2023 03/31/2023 CC612 62057578 10 City Council Correspondence 01/01/2023 12/31/2023 CC612 62057578 11 Maddy Act Notices 01/01/2023 12/31/2023 CC612 62057578 12 2023 Anti -Harassment Training Update 04/11/2023 04/13/2023 CC612 62057578 13 Posted Outside Agencies 01/01/2023 12/31/2023 CC613 62057587 14 Proof of Publication 01/01/2023 12/31/2023 CC613 62057587 15 Requisitions 01/01/2023 12/31/2023 CC613 62057587
-45-

AUTHORITY TO TRANSFER INACTIVE RECORDS

AND RECORDS INVENTORY LIST - MULTIPLE BOXES IN SINGLE RECORD SERIES 2 Department:City Clerk Retention Period:Various
General Description
of Records:
2023 GENERAL OFFICE FILES, 2023 ANNOTATED
AGENDAS, 2023 COUNCIL MEETING AUDIO FILES, 2019

COUNCIL MEETING VIDEO FILES, CANDIDATE FILES FOR
THE MARCH 2017 ELECTION, AND STAFF TRAININGS
Destruction Eligibility
Date:
12/31/2025
ITEM
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES

INCLUSIVE DATES

IN FILE
Box No.Barcode No.

FROM TO
16 Public Notices 01/01/2023 12/31/2023 CC613 62057587
17 Social Media Posts January — December 01/01/2023 12/31/2023 CC613 62057587 18 Summons 01/01/2023 12/31/2023 CC613 62057587
19 City Council Meeting Audio Files 01/01/2023 12/31/2023 CC613 62057587 20 2019 City Council Meeting Video Files 01/01/2019 12/31/2019 CC613 62057587 21 Nomination Packet : Dan Koops - March 07, 2017 General Municipal Election 01/01/2016 12/31/2016 CC613 62057587 22 Nomination Packet : Juan F. Garza - March 07, 2017 General Municipal Election 01/01/2016 12/31/2016 CC613 62057587
23 Nomination Packet : Robert Franklin Wilson - March 07, 2017 General Municipal Election 01/01/2016 12/31/2016 CC613 62057587 24 Nomination Packet : John Paul Drayer - March 07, 2017 General Municipal Election 01/01/2016 12/31/2016 CC613 62057587
25 Nomination Packet : Rene E. Mejia - March 07, 2017 General Municipal Election 01/01/2016 12/31/2016 CC613 62057587
-46-

AUTHORITY TO TRANSFER INACTIVE RECORDS

AND RECORDS INVENTORY LIST - MULTIPLE BOXES IN SINGLE RECORD SERIES 3 Department:City Clerk Retention Period:Various
General Description
of Records:
2023 GENERAL OFFICE FILES, 2023 ANNOTATED
AGENDAS, 2023 COUNCIL MEETING AUDIO FILES, 2019

COUNCIL MEETING VIDEO FILES, CANDIDATE FILES FOR
THE MARCH 2017 ELECTION, AND STAFF TRAININGS
Destruction Eligibility
Date:
12/31/2025
ITEM
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES

INCLUSIVE DATES

IN FILE
Box No.Barcode No.

FROM TO

I AUTHORIZE THE RECORDS CONTAINED HEREIN TO BE TRANSFERRED TO THE OFFSITE STORAGE FACILITY AND CITY COUNCIL APPROVED RECORDS RETENTION APPLIED.

Approved:

Approved: zi(if///,GtiJ
City "erk)
Date: (-3/6/7 C•0
-47-

Docus
ign
En
velope ID: 358B3C86-005F-423F-9F2D-B039E4218787
A

UTHORITY TO TRANSFERINA CTIVE RECORDS
A
ND RECORDS INVENTORY LIST 1
De
partment:

Econo
mic
De
velopment
Departme
nt Retention Period:2 years
tio
n
Gene
ral
Descriptio
nof
Reco
rds:Copies of
Invo
icesDestructio nEligibilityDate:12/31/2025FORCITYCLERK'SOFFICE USEBoxNo .ED4BarcodeNo .62057928 ITEM
NO.

DESCRIPTION
OF

SPECIFIC RECORDS OR FILES

INCLUSIVE DATES

IN FILE

FROM TO
1 O'Neil Ventures 12/1/2015 6/30/2023
2 Visa
statemen
ts with backup 9/1/2013 6/30/2023
3 Ava
nt Garde 7/1/2016 6/30/2023
4 OPHS/
Kingdo
m
Cause
s
Be
llflower 1/1/2016 8/31/2017
5 Burke, Williams &
Sore
nsen, LLP 6/1/2019 3/31/2022
6 AmeriNat 11/1/2013 5/31/2023
7 Kingdom
Cause
s
Go
od Soils 6/1/2013 6/30/2023

I AUTHORIZE THE RECORDS CONTAINED HEREIN
TO

BE TRANSFERRED TO THEOFFSITE STORAGE FACILITYAND CITY COUNCIL APPROVED RECORDS RETENTION APPLIED.

Signed by:
4A
VittAtetAy.

Approved: D84B7D5FDDEA432..
1' (
Department Head)
Date:
9/15/2025 18:09 AM PDT
D ate: qfi 12 dzS
-48-

Certificate Of Completion
Envelope Id: 358B3C86-005F-423F-9F2D-B039E4218787
Subject: Sign with Docusign: Authority to Transfer Records - Copies of Invoices - ED4.pdf, Authority...

Source Envelope:

Document Pages: 7 Signatures: 5
Certificate Pages: 4 Initials: 0
AutoNav: Enabled
Envelopeld Stamping: Enabled
Time Zone: (UTC-08:00) Pacific Time (US & Canada)
Record Tracking
Status: Original
9/10/2025 1:11:37 PM
Signer Events
Jim DellaLonga
[email protected]
City of Bellflower
Security Level: Email, Account Authentication
None)
Electronic Record and Signature Disclosure:

Accepted: 9/15/2025 8:09:25 AM
ID:0549b9a4-8e56-4c4c-b7de-d7a4bf8a23d3
In Person Signer Events
Editor Delivery Events
Agent Delivery Events
Intermediary Delivery Events
Certified Delivery Events
Carbon Copy Events
Witness Events
Notary Events
Envelope Summary Events
Envelope Sent
Certified Delivered
Signing Complete
Completed
Payment Events
Holder: City Clerk
[email protected]
Signature
Signed by.

V .lYIs.--OBIB7D5FDOEM32..

Signature Adoption: Pre -selected Style
Using IP Address:

Signature
Status
Status
Status
Status
Status
Signature
Signature
Status
Hashed/Encrypted
Security Checked
Security Checked
Security Checked
Status
Electronic Record and Signature Disclosure
Status: Completed
Envelope Originator:

City Clerk
16600 Civic Center Drive
16600 Civic Center Drive
Bellflower, CA 90706
[email protected]
IP Address:

Location: DocuSign
Timestamp
Sent: 9/10/2025 1:13:10 PM
Viewed: 9/15/2025 8:09:25 AM
Signed: 9/15/2025 8:09:55 AM
Timestamp
Timestamp
Timestamp
Timestamp
Timestamp
Timestamp
Timestamp
Timestamp
Timestamps
9/10/2025 1:13:10 PM
9/15/2025 8:09:25 AM
9/15/2025 8:09:55 AM
9/15/2025 8:09:55 AM
Timestamps
L'1 docusign
-49-

Electronic Record and Signature Disclosure created on: 6/8/2020 10:47:26 AM Parties agreed to: Jim DellaLonga

ELECTRONIC RECORD AND SIGNATURE DISCLOSURE
From time to time, City of Bellflower (we, us or Company) may be required by law to provide to you certain written notices or disclosures. Described below are the terms and conditions for providing to you such notices and disclosures electronically through the DocuSign system.

Please read the information below carefully and thoroughly, and if you can access this information electronically to your satisfaction and agree to this Electronic Record and Signature Disclosure (ERSD), please confirm your agreement by selecting the check -box next to 'I agree to use electronic records and signatures' before clicking `CONTINUE' within the DocuSign system.

Getting paper copies
At any time, you may request from us a paper copy of any record provided or made available electronically to you by us. You will have the ability to download and print documents we send to you through the DocuSign system during and immediately after the signing session and, if you elect to create a DocuSign account, you may access the documents for a limited period of time usually 30 days) after such documents are first sent to you. After such time, if you wish for us to send you paper copies of any such documents from our office to you, you will be charged a

0.00 per -page fee. You may request delivery of such paper copies from us by following the procedure described below.

Withdrawing your consent
If you decide to receive notices and disclosures from us electronically, you may at any time change your mind and tell us that thereafter you want to receive required notices and disclosures only in paper format. How you must inform us of your decision to receive future notices and disclosure in paper format and withdraw your consent to receive notices and disclosures electronically is described below.

Consequences of changing your mind
If you elect to receive required notices and disclosures only in paper format, it will slow the speed at which we can complete certain steps in transactions with you and delivering services to you because we will need first to send the required notices or disclosures to you in paper format, and then wait until we receive back from you your acknowledgment of your receipt of such paper notices or disclosures. Further, you will no longer be able to use the DocuSign system to receive required notices and consents electronically from us or to sign electronically documents from us.

All notices and disclosures will be sent to you electronically -50-

Unless you tell us otherwise in accordance with the procedures described herein, we will provideelectronicallytoyouthroughtheDocuSignsystemallrequirednotices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to you during the course of our relationship with you. To reduce the chance of youinadvertentlynotreceivinganynoticeordisclosure, we prefer to provide all of the requirednoticesanddisclosurestoyoubythesamemethodandtothesameaddressthatyouhavegiven us. Thus, you can receive all the disclosures and notices electronically or in paper format throughthepapermaildeliverysystem. If you do not agree with this process, please let us know as described below. Please also see the paragraph immediately above that describes the consequences of your electing not to receive delivery of the notices and disclosures electronically from us.

How to contact City of Bellflower:

You may contact us to let us know of your changes as to how we may contact you electronically,to request paper copies of certain information from us, and to withdraw your prior consent to receive notices and disclosures electronically as follows:

To contact us by email send messages to: [email protected] To advise City of Bellflower of your new email address
To let us know of a change in your email address where we should send notices and disclosures electronically to you, you must send an email message to us at [email protected] and in the body of such request you must state: your previous email address, your new email address. We do not require any other information from you to change your email address.

If you created a DocuSign account, you may update it with your new email address through youraccountpreferences.

To request paper copies from City of Bellflower
To request delivery from us of paper copies of the notices and disclosures previously providedbyustoyouelectronically, you must send us an email to [email protected] and in the bodyofsuchrequestyoumuststateyouremailaddress, full name, mailing address, and telephonenumber. We will bill you for any fees at that time, if any.

To withdraw your consent with City of Bellflower
To inform us that you no longer wish to receive future notices and disclosures in electronic format you may:
-51-

i. decline to sign a document from within your signing session, and on the subsequent page, select the check -box indicating you wish to withdraw your consent, or you may; ii. send us an email to [email protected] and in the body of such request you must state your email, full name, mailing address, and telephone number. We do not need any other information from you to withdraw consent.. The consequences of your withdrawing consent for online documents will be that transactions may take a longer time to process..

Required hardware and software
The minimum system requirements for using the DocuSign system may change over time. The current system requirements are found here: https://support.docusign.com/guides/signer-guide- signing-system-requirements.

Acknowledging your access and consent to receive and sign documents electronically To confirm to us that you can access this information electronically, which will be similar to other electronic notices and disclosures that we will provide to you, please confirm that you have read this ERSD, and (i) that you are able to print on paper or electronically save this ERSD for your future reference and access; or (ii) that you are able to email this ERSD to an email address where you will be able to print on paper or save it for your future reference and access. Further, if you consent to receiving notices and disclosures exclusively in electronic format as described herein, then select the check -box next to 'I agree to use electronic records and signatures' before clicking `CONTINUE' within the DocuSign system.

By selecting the check -box next to 'I agree to use electronic records and signatures', you confirm that:

You can access and read this Electronic Record and Signature Disclosure; and You can print on paper this Electronic Record and Signature Disclosure, or save or send this Electronic Record and Disclosure to a location where you can print it, for future reference and access; and
Until or unless you notify City of Bellflower as described above, you consent to receive exclusively through electronic means all notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to you by City of Bellflower during the course of your relationship with City of Bellflower.
-52-

Docusign
Envelope
ID: 358B3C86-005F-423F-9F2D-B039E4218787AUTHORITYTOTRA NSFER INACTIVE RECORDS A
ND
RECOR
DSINVENTO RY LIST 1
Departme
nt:Economic Development
De
partmentRetentio n Period:2 years
Gene
ral Descriptionof
Reco
rds:

Co
pies of Invoices DestructionEligibilityDa te:12/31/2025FORCITYCLERK'SOFFICE USEFORBoxNo.ED5BarcodeNo.62057927 ITEM
NO .DESCRIPTIO

N OF SPECIFIC
RECO
RDS
OR
FILES

INCLUSIVE DATES

IN FILE

FROM TO
1 Kingdom Causes
Bellflowe
r 9/1/2021 6/30/2022
2 Fair Housing
Foundatio
n 1/1/2015 6/30/2022
3 RSG 3/1/2018 3/31/2020
4 Staple
s 8/1/2013 1/31/2023
5 DuaneMo
rita 6/1/2013 9/30/2019
6 Clear
Channe
l 8/1/2013 6/30/2023
7 Graphic
Solutions 8/1/2019 3/31/2023
8 20434
S.

Santa Fe
Ave. ,
LLC 1/1/2020 6/30/2023

I AUTHORIZE THE RECORDS
CO

NTAINED HEREIN TO BE TRANSFERRED TO THE OFFSITE STORAGE FACILITY AND CITY COUNCIL APPROVED RECORDS RETENTION APPLIED.

Signe
d by:

VatottotAla
Approved:—
DS48705FDDEA432.. .Approve
d:Departme
nt Head
V/‘ --
City Clerk)
Date:
9/15/2025 18:09 AM PDT
Dat e: q/(WAOZ
-53-

Certificate Of Completion
Envelope Id: 358B3C86-005F-423F-9F2D-B039E4218787
Subject: Sign with Docusign: Authority to Transfer Records - Copies of Invoices - ED4.pdf, Authority...

Source Envelope:

V .lYIs.--OBIB7D5FDOEM32..

Signature Adoption: Pre -selected Style
Using IP Address:

City Clerk
16600 Civic Center Drive
16600 Civic Center Drive
Bellflower, CA 90706
[email protected]
IP Address:

Electronic Record and Signature Disclosure created on: 6/8/2020 10:47:26 AM Parties agreed to: Jim DellaLonga

0.00 per -page fee. You may request delivery of such paper copies from us by following the procedure described below.

All notices and disclosures will be sent to you electronically -55-

How to contact City of Bellflower:

If you created a DocuSign account, you may update it with your new email address through youraccountpreferences.

To withdraw your consent with City of Bellflower
To inform us that you no longer wish to receive future notices and disclosures in electronic format you may:
-56-

By selecting the check -box next to 'I agree to use electronic records and signatures', you confirm that:

Do
cusign
Envelo
pe ID: 358B3C86-005F-423F-9F2D-B039E4218787AUTHORITYTOTRANSFER INACTIVE RECORDSAND RECO
RDS INVENTORY LIST 1
De
partment:

Econo
mic Development Retention Period:Various
Genera
l Descriptionof
Reco
rds:Miscellaneous VHS and Cassette Tapes DestructionEligibilityDate:12/31/2012FORCITYCLERK'S OFFICE USEBoxNo.ED6BarcodeNo .62057926 ITEMNO.

DESCRIPTION
OF

SPECIFIC RECORDS
OR
FILES

INCLUSIVE DATES

IN FILE

FROM TO
1 Sto
rm
Runo
ff" VHS
ta
pe 2002 2002
2 Bellflowe
r/
Lo
s
Mochis"
VHS tape 2004 2004
3 9/11 Remembrance" VHS tape 2003 2003
4 Bravo Awards" VHS
ta
pe 2003 2003
5 Illegal Fireworks" VHS tape 2003 2003
6 9/11 memorial" VHS tape 2006 2006
7 Bellflower Car Show" VHS tape 2004 2004
8 Bellflower Fire" VHS tape 2002 2002
9 Firewo
rks Safety" VHS
tape
2003 2003
10 G
ift Basket" VHS tape 2001 2001
11 Teen Pilot" VHS tape 2004 2004
12 M
ake
a wish
Fo
undation" VHS tape 2005 2005
13 Inner City Games" VHS tape 2002 2002
14 Liberty Parade Day"
V
HS tape 2004 2004
15 Bellflowe
r
Fire
work
Sho
w" VHS
tape
2004 2004
16 Arno
ld in
Bellflower"
VHS tape 2003 2003
-58-

Do
cusign
Envelope
ID: 358B3C86-005F-423F-9F2D-B039E4218787
A
UTHORITY TO TRANSFER INACTIVERECO RDSANDRECORDSINVENTORYLIST 2Department:

Econo
mic
Developme
ntRetentio nPe riod:VariousGeneralDescriptionofRecords:

Miscellaneo
us VHS and
CassetteTape
sDestruc tionEligibilityDate:12/31/2012FORCITYCLERK'SOFFICE USEBoxNo.ED6BarcodeNo.62057926 ITEM
NO.

DESCRIPTIO

N OF SPECIFIC RECORDS OR FILES

INCLUSIVE DATES

IN FILE

FROM TO
17 John Pratt" VHS tape 2006 2006
18 Liberty Day
Parade"
VHS
tape
2003 2003
19 Ron Yary" VHS
tape
2001 2001
20 City
ofBe
llflower VHS tape 2003 2003
21 Bra
vo
Awards"
VHS tape 2002 2002
22 Hollywood
Spo
rts
Park"
VHS tape 2002 2002
23 Budget Cuts" VHS
tape
2002 2002
24 Henry
Lo
pez" VHS tape 2003 2003
25 Bellflowe
r
Firewo
rk
Show"
2003 2003
26 City of Bellflower (Starbucks)" Cassette 2004 2004
27 Utility
Ta
x"
Cassette
2001 2001
28 Bravo
A
wards" Cassette 2003 2003
29 Bellflo
wer/Los
M
ochis" Ca
ssette 2004 2004
30 State Water Quality Board" Cassette 2003 2003
31 Ron Yary"
Cassette
2001 2001
-59-

Docusign
Envelo
pe
ID :
358B3C86-005F-423F-9F2D-B039E4218787
AUTHO

RITY TOTRA NSFERINA CTIVE RECORDSAND
RECO
RDS INVENTORY LIST 3Department:

Econo
mic
Develo
pment RetentionPerio d:VariousGeneralDescriptionofRecords:

Miscellane
ous VHS and Cassette Tapes DestructionElicibilityDate:12/31/2012FORCITYCLERK'S OFFICE USEBoxNo. J E D6BarcodeNo .62057926 ITEM
NO.

DESCRIPTION OF SPECIFIC RECORDS
OR
FILES

INCLUSIVE DATES

IN FILE
FR
OM
TO
I
AUTHO

RIZE THE
RECO
RDS
CO

NTAINED HEREIN
TO
BE TRANSFERRED TO THE OFFSITE STORAGE FACILITY AND CITY COUNCILAPPROVEDRECORDSRETENTIONAPPLIED.

Appro
ved:

Signed by:

V
v
D84B7D5FDDFA432
Department Head)
Date:

Date:
9/15/2025 I 8:09
AM
PDT
q//IQ/zOZS-
-60-

-61-

-62-

-63-

-64-

DocusignEnvelope
ID: 358B3C86-005F-423F-9F2D-B039E4218787AUTHORITY
TO

TRANSFERINA CTIVERECO RDS
A
ND RECORDS INVENTORY LIST 40446„,1
Depa
rtment:

Eco
nomic
Develo
pment DepartmentRetentio nPerio d:2years
Ge
ne
ral Descriptionof
Reco
rds:

Co
pies of
Invo
ices and Progress
Payme
nts DestructionEligibilityDate:12/31/2025FORCITYCLERK'SOFFICE USEBoxNo.ED7BarcodeNo.62057925 ITEM
NO.

DESCRIPTION OF SPECIFIC
RECO
RDS
OR
FILES

INCLUSIVE DATES

IN FILE

FROM TO
1 Progre
ss Payments 7/1/2012 6/30/2023
2 Invoice
s 7/1/2012 6/30/2023
I
AUTHO

RIZE THE RECORDS CONTAINED HEREIN TO BE TRANSFERRED
TO

THE OFFSITE STORAGE FACILITY AND CITY COUNCIL

APPROVED
RECO
RDS

RETENTIO
N APPLIED.

Signed by:
vAppro
ved: \--
D
a&
B7D5FDD
Ewa2
Appro
ved:

Departme
nt
He
ad)
6// t/i-f"-y
Cle
rk)
Date :
9/15/2025 I 8:09AM PDT
Date: 4// Y77a
Z
-65-

Certificate Of Completion
Envelope Id: 358B3C86-005F-423F-9F2D-B039E4218787
Subject: Sign with Docusign: Authority to Transfer Records - Copies of Invoices - ED4.pdf, Authority...

Source Envelope:

V .lYIs.--OBIB7D5FDOEM32..

Signature Adoption: Pre -selected Style
Using IP Address:

City Clerk
16600 Civic Center Drive
16600 Civic Center Drive
Bellflower, CA 90706
[email protected]
IP Address:

Electronic Record and Signature Disclosure created on: 6/8/2020 10:47:26 AM Parties agreed to: Jim DellaLonga

0.00 per -page fee. You may request delivery of such paper copies from us by following the procedure described below.

All notices and disclosures will be sent to you electronically -67-

How to contact City of Bellflower:

If you created a DocuSign account, you may update it with your new email address through youraccountpreferences.

To withdraw your consent with City of Bellflower
To inform us that you no longer wish to receive future notices and disclosures in electronic format you may:
-68-

By selecting the check -box next to 'I agree to use electronic records and signatures', you confirm that:

r
CITY OF BELLFLOWE +, .

Page 1 of 3 ends

REQUEST FOR

AUTHORITY TO TRANSFER INACTIVE RECORDS
RECORDS OF: Finance
Denartment)
No Dates Available
Document No. 36414

FILE TOTAL -

TYPE INACTIVE
ITEM FILE NAME AND C -Copies RETENTION INCLUSIVE DATES DESTROY BOX NO. FUNCTION/CATEGORY O -Originals TIME IN FILE AFTER NO.

NUMBER

FROM TO
1 73/74 Ledger Entries, Rev. & Exp. Statements 74/75; G/L 73/ 74; C/O 3 yrs. 1973 1975 P 58 Excavation Permits #1438-5099; Construction Permits #1-2299 2 Cash Receipts; Master Payroll Register C/O 3 yrs. 5/1/95 6/30/96 6/30/00 801 3 POs 83/84, 84/85; Goldenrods; Pink Rev. Check Copies 83/84, C/O 3 yrs. 7/1/83 6/30/85 6/30/00 388 84/85; White Rev. 84/ 85
4 PERS Reports -All C/O 3 yrs. P 429*
5 Finance Bonds BCWD C/O 1 yr. P 297
6 ID Bonds #656-1977; Parade Expenses; Canceled checks; Petty C/O 1 yr. P 148 Cash Acct.; Rev. Acct.; Street Improvement Bond Acct. Prior to 1978
7 Master Payroll Register 7/3/96-10/11/96 C/O 3 yrs. 7/3/96 10/11/96 10/11/00 807 8 Financial Water Bonds C/O 1 yr. P 353*
9 A/P Invoice; Audit Trail; Cash Disb. 1/97-4/97 C/O 3 yrs. 1/97 4/97 4/01 803 10 A/P Check Listing/Update 7/1/96-6/97; A/P G/L Interface 7/1/96- C/O 3 yrs. 7/1/96 6/97 6/01 804 6/97
11 Bus. License Late Charge Notices 8/93-5/97; New Ceased Bus. C/O 3 yrs. 8/93 6/97 6/01 800 Monthly Report 1/96-6/96; Open Balance Bus. Reprt 5/97; Bus.

License Billing Audit Trail 7/96-6/97; 7/95-6/96
12 A/P Month -End Reports 7/95-5/97 C/O 3 yrs. 7/95 5/97 5/01 805 No Dates Available
Document No. 36414
-70-

S ,

CITY OF BELLFLOWER

Page 2 of 3 ends

REQUEST FOR

AUTHORITY TO TRANSFER INACTIVE RECORDS
RECORDS OF: Finance
tnP_nartmPnt)
ITEM
NO.

FILE NAME AND

FUNCTION/CATEGORY
NUMBER
FILE
TYPE
C -Copies
O -Originals
TOTAL

INACTIVE

RETENTION
TIME

INCLUSIVE DATES

IN FILE

DESTROY
AFTER
BOX
NO.

FROM TO
13 BCWD Finance Bonds C/O 1 yr. P 298*
14 Master Payroll Register 11/10/95 to 2/23/96 C/O 3 yrs. 11/10/95 2/23/96 2/23/00 790 15 Taxpayer Guides and RDA Records C/O 1 yr. 1971 1979 P 350 16 Miscellaneous Audits 1976- 1983 C/O 1 yr. 1976 1983 P 349 17 A/P T -Z 95/96 C/O 3 yrs. 7/95 6/96 6/00 773
18 Full Time Time Cards A -Z 95/96 C/O 3 yrs. 7/95 6/96 6/00 777 19 A/P L -M 95/96 C/O 3 yrs. 7/95 6/96 6/00 770
20 P/R Acct. Dist. Report 4/4/96-6/27/96; Cash Disb. Report 4/96- 6/96; Reports for Revenue Exp. & Balance Sheet 6/95; Master Aged Balance Sheet Report 4/97-6/97; A/R Invoice Update 7/95- 6/96
C/O 3 yrs. 4/96 6/97 6/01 799
21 A/P H -K 95/96 C/O 3 yrs. 7/95 6/96 6/00 769
22 Business License Month -End 7/95-6/96; 7/96-6/97 C/O 3 yrs. 7/95 6/97 6/01 795 23 Cash Receipts 7/95-6/96 C/O 3 yrs. 7/95 6/96 6/00 797 24 A/P Q -S 95/96 C/O 3 yrs. 7/95 6/96 6/00 772
25 Payroll Acct. Dist. 11 /94-1/20/95, 1/96-3/96; Tax Benefit and Deduction 12/95-6/96
C/O 3 yrs. 11/94 6/96 6/00 747
26 Miscellaneous Audits and 1981 Budget State C/O 1 yr. 1981 1981 1 P 351 No Dates Available
Document No. 36414
-71-

CITY OF BELLFLOWER
RECORDS OF: Finance
tnPnartmPnt)

REQUEST FOR

AUTHORITY TO TRANSFER INACTIVE RECORDS

Page 3 of 3 ends

ITEM
NO.

FILE NAME AND

FUNCTION/CATEGORY
NUMBER
FILE
TYPE
C -Copies
O -Originals
TOTAL.

INACTIVE

RETENTION
TIME

INCLUSIVE DATES

IN FILE

DESTROY
AFTER
BOX
NO.

FROM TO
27 A/P C -D 95/96 C/O 3 yrs. 7/95 6/96 6/00 767
28 Part Time Time Cards A -Z 95/ 96 C/O 3 yrs. 7/95 6/96 6/00 778 29 Finance Bonds C/O 1 yr. P 1 Y*
30 A/P N -P 95/96 C/O 3 yrs. 7/95 6/96 6/00 771
31 A/P E -G 95/96 C/o 3 yrs. 7/95 6/96 6/00 768
32 Quarterly Tax Federal Withholdings; FICA Reports; A/P 5/97- 6/97; Master W2 Listing 1995; Quarter -end Repot 1/ 1/95; Year - End Report 1995.

C/O 3 yrs. 1/95 6/97 6/01 811
33 BCWD Auditor Files C/O 1 yr. P 137*
34 A/P Invoice / Prepaid Check Audit Trail 7/96-10/96 C/O 3 yrs. 7/96 10/96 10/00 802 35 Numerical Warrants 2537=3548 C/O 3 yrs. 7/63 11/63 12/00 115 No Dates Available
Approved: Date:

Department Head)
Approved:

City C r
Approved:

City/Administrator)
Date:

S'-3-00 .

Date:

Document No. 36414
-72-

CITY OF BELLFLOWER

AUTHORITY TO PROCESS INACTIVE RECORDS
RECORDS OF: Finance Department (dept 1300)
Department)
GENERAL DESCRIPTION OF RECORDS: FY15/16 Accounting Records ITEM
NO.

FILE NAME AND

FUNCTION/CATEGORY
NUMBER
FILE
TYPE
C -Copies
O -Ori inals
TOTAL

RETENTION
TIME

INCLUSIVE DATES IN
FILE

DESTROY
AFTER
BOX
NO.

FROM TO PR
1 ACCOUNTS PAYABLE — A - BELL O 5 yrs. 07/01/15 06/30/16 06/30/21 F2613 2 ACCOUNTS PAYABLE — BELL -CLE O 5 yrs. 07/01/15 06/30/16 06/30/21 F2614 3 ACCOUNTS PAYABLE — CLE - E O 5 yrs. 07/01/15 06/30/16 06/30/21 F2615 4 ACCOUNTS PAYABLE — F -HEN O 5 yrs. 07/01/15 06/30/16 06/30/21 F2616 5 ACCOUNTS PAYABLE — HOM - LOS O 5 yrs. 07/01/15 06/ 30/16 06/30/21 F2617 6 ACCOUNTS PAYABLE — LOS - N O 5 yrs. 07/01/15 06/30/16 06/30/21 F2618 7 ACCOUNTS PAYABLE — O - R O 5 yrs. 07/01/15 06/30/16 06/30/21 F2619 8 ACCOUNTS PAYABLE — S — SO.CA.EDISON O 5 yrs. 07/01/15 06/30/16 06/30/21 F2620 9 ACCOUNTS PAYABLE — SO.CA. GAS - T O 5 yrs. 07/01/15 06/30/16 06/30/21 F2621 10 ACCOUNTS PAYABLE — U - V O 5 yrs. 07/01/15 06/30/16 06/30/21 F2622 11 ACCOUNTS PAYABLE — W - Z O 5 yrs. 07/01/15 06/30/16 06/30/21 F2623 12 PAYROLL TIMECARDS — A — I (NOT D) O 5 yrs. 07/01/15 06/30/16 06/30/21 F2624 13 PAYROLL TIMECARDS — J - Y (NOT L, M, R) O 5 yrs. 07/01/15 06/30/16 06/30/21 F2625 14 PAYROLL TIMECARDS — D, L, M, R O 5 yrs. 07/01/15 06/30/16 06/30/21 F2626 15 PAYROLL VENDORS — A -1 O 5 yrs. 07/01/15 06/30/16 06/30/21 F2627 16 PAYROLL VENDORS — J - W O 5 yrs. 07/01/15 06/30/16 06/30/21 F2628

Page 1 of 2 ends

-73-

CITY OF BELLFLOWER

AUTHORITY TO PROCESS INACTIVE RECORDS
RECORDS OF: Finance Department (dept 1300)
Department)
GENERAL DESCRIPTION OF RECORDS: FY15/16 Accounting Records Approved
Approved
Approved
Authority to Transfer
Date: 44
If
Date: !
Date: d 1/u
I

Page 2 of 2 ends

Authority to Destroy
Approved:

Department Head)
FILE
TOTAL
City Clerk)
Approved:

FILE NAME AND TYPE

RETENTION
City Attorney)
ITEM FUNCTION/CATEGORY C -Copies INCLUSIVE DATES IN DESTROY BOX NO. NUMBER O -Ori inals
TIME
FILE AFTER NO.

FROM TO PR
17 MASTER PAYROLL O 5 yrs 07/01/15 11/30/15 06/30/21 F2629 18 MASTER PAYROLL O 5 yrs 12/31/15 03/31/16 06/30/21 F2630 19 MASTER PAYROLL O 5 yrs 04/01/16 06/30/16 06/30/21 F2631 20 PAYROLL MO.END PERIODIC REPORTS; GENERAL
O 5 yrs 07/01/15 06/30/16 06/30/21 F2632

LEDGER INTERFACE REPORTS
21 END OF PAYROLL REPORTS; PERSONNEL CHANGES O 5 yrs 07/01/15 06/30/16 06/30/21 F2633 22 INVOICE/PREPAID CHECK AUDIT TRAIL REPORTS O 5 yrs 07/01/15 06/30/16 06/30/21 F2634 Approved
Approved
Approved
Authority to Transfer
Date: 44
If
Date: !
Date: d 1/u
I

Page 2 of 2 ends

Authority to Destroy
Approved: Date:

Date:

Department Head)
Approved:

City Clerk)
Approved:

City Manager)
Approved:

City Attorney)
Date:

Date:

Date:
-74-

CITY OF BELLFLOWER

AUTHORITY TO PROCESS INACTIVE RECORDS
RECORDS OF: Finance Department (dept 1300)
Department)
GENERAL DESCRIPTION OF RECORDS: FY16/17 Accounting Records ITEM
NO.

FILE NAME AND

FUNCTION/CATEGORY
NUMBER
FILE
TYPE
C -Copies
O -Ori inals
TOTAL

RETENTION
TIME

INCLUSIVE DATES IN
FILE

DESTROY
AFTER
BOX
NO.

FROM TO PR
1 ACCOUNTS PAYABLE — A - BELL O 5 yrs. 07/01/16 06/30/17 06/ 30/22 F2635 2 ACCOUNTS PAYABLE — BELL -CAL O 5 yrs. 07/01/16 06/30/17 06/ 30/22 F2636 3 ACCOUNTS PAYABLE — CAL — C MISC. O 5 yrs. 07/01/16 06/30/17 06/30/22 F2637 4 ACCOUNTS PAYABLE — D - GRA O 5 yrs. 07/01/16 06/ 30/17 06/ 30/22 F2638 5 ACCOUNTS PAYABLE — G MISC. - 1 O 5 yrs. 07/01/16 06/30/17 06/30/22 F2639 6 ACCOUNTS PAYABLE — J - L O 5 yrs. 07/01/16 06/30/17 06/30/22 F2640 7 ACCOUNTS PAYABLE — M - PAR O 5 yrs. 07/01/16 06/30/17 06/ 30/22 F2641 8 ACCOUNTS PAYABLE — PLA — SOU (PARTIAL) O 5 yrs. 07/01/16 06/30/17 06/30/22 F2642 9 ACCOUNTS PAYABLE — SOU (PARTIAL) — S MISC. O 5 yrs. 07/01/16 06/30/17 06/ 30/22 F2643 10 ACCOUNTS PAYABLE — T - V O 5 yrs. 07/01/16 06/30/17 06/30/22 F2644 11 ACCOUNTS PAYABLE — W - Z O 5 yrs. 07/01/16 06/ 30/17 06/30/22 F2645 12 PAYROLL TIMECARDS — A — I (NOT D) O 5 yrs. 07/01/16 06/30/17 06/30/22 F2646 13 PAYROLL TIMECARDS — J - Y (NOT L, M, R) O 5 yrs. 07/01/16 06/30/17 06/30/22 F2647 14 PAYROLL TIMECARDS — D, L, M, R O 5 yrs. 07/01/16 06/30/17 06/30/ 22 F2648 15 PAYROLL VENDORS — A - H O 5 yrs. 07/01/16 06/30/17 06/30/22 F2649 16 PAYROLL VENDORS — I - W O 5 yrs. 07/01/16 06/30/17 06/30/22 F2650

Page 1 of 3 ends

-75-

CITY OF BELLFLOWER

AUTHORITY TO PROCESS INACTIVE RECORDS
RECORDS OF: Finance Department (dept 1300)
Department)
GENERAL DESCRIPTION OF RECORDS: FY16/17 Accounting Records

Page 2 ends

FILE

FILE NAME AND TYPE
TOTAL
ITEM FUNCTION/CATEGORY C -Copies

RETENTION

INCLUSIVE DATES IN DESTROY BOX
NO. NUMBER O -Ori finals
TIME
FILE AFTER NO.

FROM TO PR
17 PAYROLL REGISTER O 5 yrs 07/01/16 12/31/17 06/30/22 F2651 18 PAYROLL REGISTER O 5 yrs 01/ 01/17 05/31/17 06/30/22 F2652 19 JOURNAL ENTRIES 0 5 yrs 07/01/16 06/ 30/17 06/30/22 F2653 20 END OF PAYROLL REPORTS; GENERAL LEDGER
O 5 yrs 07/01/16 06/ 30/17 06/30/22 F2654
INTERFACE REPORTS; PERSONNEL CHANGES
21 MASTER PAYROLL REPORTS; MONTH END PERIODIC
O 5 yrs 07/01/16 06/30/17 06/30/22 F2655
REPORT; 06/17 PAYROLL REGISTER
ACCOUNTS PAYABLE GENERAL LEDGER INTERFACE;
CHECK LISTING UPDATES; APPROVED PURCHASE
22 ORDERS; PURCHASE ORDER AUDIT TRAIL; CHECK O 5 yrs 07/01/16 06/ 30/17 06/30/22 F2656 REVERSALS; ACCOUNTS PAYABLE MONTH END
REPORTS; PURCHASE ORDER MONTH END REPORTS
23 ACCOUNTS RECEIVEABLE AUDIT TRAIL REPORTS;
O 5 yrs 07/01/16 06/30/17 06/30/22 F2657INVOICE/PREPAID CHECK AUDIT TRAIL REPORTS 24 BANK RECEIPT FOLDERS (BOW, BNY, LAIF, CALTRUST,
O 5 yrs 07/01/16 06/30/17 06/30/22 F2658LACPIF & UNION BANK 25 CASH REGISTER AUDIT TRAIL O 5 yrs 07/01/16 12/31/17 06/ 30/22 F2659 26 CASH REGISTER AUDIT TRAIL O 5 yrs 01/01/17 05/31/17 06/ 30/22 F2660 27 CASH REGISTER AUDIT TRAIL 6/17; CASH RECEIPT
O 5 yrs 07/01/16 06/30/17 06/30/22 F2661AUDITTRAIL — HDL WEB PAYMENTS 28 CASH RECEIPTS — 010-12000 TO 010-31320 5 yrs 07/01/16 06/30/17 06/30/22 F2662

Page 2 ends

-76-

CITY OF BELLFLOWER

AUTHORITY TO PROCESS INACTIVE RECORDS
RECORDS OF: Finance Department (dept 1300)
Department)
GENERAL DESCRIPTION OF RECORDS: FY16/17 Accountina Records Authority to Transfer
Approved: Date: i
artment Head)
App
S
Date: (/ Z
Date: y

Page 3 of 3 ends

Approved:

Authority to Destroy
Department Head)
Approved:

City Clerk)
Approved:

City Manager)
Approved:

Attorney)
Date:

Date:

FILE

FILE NAME AND TYPE
TOTAL
ITEM FUNCTION/CATEGORY C -Copies

RETENTION

INCLUSIVE DATES IN DESTROY BOX
NO. NUMBER O -Ori inals
TIME
FILE AFTER NO.

FROM TO PR
Aq CASH RECEIPTS — 010-31320 TO 010-32020 5 yrs 07/01/16 06/30/17 06/30/22 F2663 L3 CASH RECEIPTS — 010—,39LO,-EG O 5 yrs 07/01/16 06/30/17 06/30/ 22 F2664 31 CASH RECEIPTS —01C 3UgoTO 010-36542 O 5 yrs 07/01/16 06/30/17 06/30/22 F2665 0 CASH RECEIPTS — 010-36000 TO 010-36540 O 5 yrs 07/01/16 06/30/17 06/30/ 22 F2666 33 CASH RECEIPTS — 010-36570 TO 010-36650-010-36672 O 5 yrs 07/01/16 06/30/17 06/30/22 F2667 J 5OF8
CASH RECEIPTS — 010-36650-010-36672 (6 OF 8) TO 090- O 5 yrs 07/01/16 06/30/17 06/30/22 F2668 20500
CASH -RECEIPTS — 090-20506 TO DEPT 8000 O 5 yrs 07/01/16 06/30/17 06/30/ 22 F2669 Authority to Transfer
Approved: Date: i
artment Head)
App
S
Date: (/ Z
Date: y

Page 3 of 3 ends

Approved:

Authority to Destroy
Department Head)
Approved:

City Clerk)
Approved:

City Manager)
Approved:

Attorney)
Date:

Date:

Date:
-77-

CITY OF BELLFLOWER

AUTHORITY TO PROCESS INACTIVE RECORDS
RECORDS OF: Finance Department (dept 1300)
Department)
GENERAL DESCRIPTION OF RECORDS: FY17/18 Accounting Records ITEM
NO.

FILE NAME AND

FUNCTION/CATEGORY
NUMBER
FILE
TYPE
C -Copies
O -Ori inals
TOTAL

RETENTION
TIME

INCLUSIVE DATES IN
FILE

DESTROY
AFTER
BOX
NO.

FROM TO PR
1 ACCOUNTS PAYABLE — A - BELL O 5 yrs. 07/01/17 06/30/18 06/30/ 23 F2670 = 2 ACCOUNTS PAYABLE — BELL -CIT O 5 yrs. 07/01/17 06/30/18 06/30/ 23 F2671 3 ACCOUNTS PAYABLE — CIV - DUA O 5 yrs. 07/01/17 06/30/18 06/30/ 23 F2672 4 ACCOUNTS PAYABLE — D MISC. — G MISC. O 5 yrs. 07/01/17 06/30/18 06/30/23 F2673 5 ACCOUNTS PAYABLE — H&H - JHM O 5 yrs. 07/01/17 06/30/18 06/30/ 23 F2674 6 ACCOUNTS PAYABLE — JOE - LOS O 5 yrs. 07/01/17 06/30/ 18 06/30/23 F2675 7 ACCOUNTS PAYABLE — L MISC. - ORI O 5 yrs. 07/01/17 06/30/18 06/30/23 F2676 8 ACCOUNTS PAYABLE — OUR - SNO O 5 yrs. 07/01/17 06/30/18 06/30/23 F2677 9 ACCOUNTS PAYABLE — SOU - STA O 5 yrs. 07/01/17 06/30/18 06/30/23 F2678 10 ACCOUNTS PAYABLE — STO — T MISC. O 5 yrs. 07/01/17 06/30/18 06/30/23 F2679 11 ACCOUNTS PAYABLE — UND — V MISC O 5 yrs 07/01/17 06/30/18 06/30/23 F2680 12 ACCOUNTS PAYABLE — W - Z O 5 yrs. 07/01/17 06/30/18 06/30/23 F2681 13 PAYROLL TIMECARDS — A — I (NOT D) O 5 yrs. 07/01/17 06/30/18 06/30/23 F2682 14 PAYROLL TIMECARDS — J - Y (NOT L, M, R) O 5 yrs. 07/01/17 06/30/18 06/30/23 F2683 15 PAYROLL TIMECARDS — D, L, M, R O 5 yrs. 07/01/17 06/30/18 06/30/23 F2684 16 PAYROLL VENDORS — A - 1 O 5 yrs. 07/01/17 06/30/18 06/ 30/23 F2685

Page 1 of 4 ends

-78-

CITY OF BELLFLOWER

AUTHORITY TO PROCESS INACTIVE RECORDS
RECORDS OF: Finance Department (dept 1300)
Department)
GENERAL DESCRIPTION OF RECORDS: FY17/18 Accounting Records

Page 2 of 4 ends

FILE
TOTAL

FILE NAME AND TYPE

RETENTION
ITEM FUNCTION/CATEGORY C -Copies INCLUSIVE DATES IN DESTROY BOX NO. NUMBER O -Ori inals
TIME
FILE AFTER NO.

FROM TO PR
17 PAYROLL VENDORS — J - W O 5 yrs. 07/01/17 06/30/18 06/30/23 F2686 18 MASTER PAYROLL 12/17; PERSONNEL CHANGES O 5 yrs 07/01/17 06/30/18 06/30/23 F2687 19 MASTER PAYROLL O 5 yrs 01/01/18 05/31/18 06/23 F2688 20 JOURNAL ENTRIES 0 5 yrs 07/01/17 06/30/18 06/30/ 23 F2689 21 PAYROLL GENERAL LEDGER INTERFACE; YEAR END
O 5 yrs 07/01/17 06/30/18 06/ 30/ 23 F2690
REPORTS; YEAR END SALARY CHANGES
22 PAYROLL VENDOR CHECK REGISTER; VENDOR CHECK
O 5 yrs 07/01/17 06/30/18 06/30/ 23 F2691REGISTER; 06/18 MASTER PAYROLL 23 PAYROLL FLSA RETRO CALCULATIONS; END OF
O 5 yrs 07/01/17 06/30/18 06/30/23 F2692

PAYROLL REPORTS
INVOICE/PREPAID CHECK AUDIT TRAIL; CHECK
24 REVERSALS; APPROVED PURCHASE ORDERS; O 5 yrs 07/01/17 06/30/18 06/ 30/23 F2693

PURCHASE ORDER AUDIT TRAIL
CASH REISTER AUDIT TRAIL; GENERAL LEDGER
INTERFACE; CHECK LISTING UPDATE; ACCOUNTS
25 PAYABLE MONTH END REPORTS; PURCHASE ORDER O 5 yrs 07/01/17 06/30/18 06/30/23 F2694 MONTH END REPORTS; ACCOUNTS RECEIVEABLE

AUDIT TRAIL AND MONTH END REPORTS
26 CASH REGISTER AUDIT TRAIL — HDL WEB PAYMENTS O 5 yrs 07/01/17 06/30/18 06/ 30/23 F2695 27 CASH REGISTER AUDIT TRAIL O 5 yrs 07/01/17 12/31/17 06/ 30/23 F2696 28 CASH REGISTER AUDIT TRAIL O 5 yrs 01/01/17 05/31/18 06/ 30/23 F2697

Page 2 of 4 ends

-79-

CITY OF BELLFLOWER

AUTHORITY TO PROCESS INACTIVE RECORDS
RECORDS OF: Finance Department (dept 1300)
Department)
GENERAL DESCRIPTION OF RECORDS: FY17/18 Accountina Records, ITEM
NO.

FILE NAME AND

FUNCTION/CATEGORY
NUMBER
FILE
TYPE
C -Copies
O -Ori inals
TOTAL

RETENTION
TIME

INCLUSIVE DATES IN
FILE

DESTROY
AFTER
BOX
NO.

FROM TO PR
29 CASH RECEIPTS — 010-11000 TO 010-30130 0 5 yrs 07/01/17 06/30/18 06/30/23 F2698 30 CASH RECEIPTS — 010=30140 TO 010-31202 O 5 yrs 07/01/17 06/30/18 06/ 30/ 23 F2699 31 CASH RECEIPTS — 010-31204 TO 010-31320 (2 OF 3) 0 5 yrs 07/01/17 06/30/18 06/ 30/23 F2700 32 CASH RECEIPTS — 010-31320 (3 OF 3) TO 010-32020
2OF8
O 5 yrs 07/01/17 06/30/18 06/ 30/23 F2701
33 CASH RECEIPTS — 010-32020 (3 THRU 7 OF 8) 0 5 yrs 07/01/17 06/30/18 06/30/23 F2702 34 CASH RECEIPTS — 010-32020 (8 OF 8) TO 010-36030
1 OF 4
O 5 yrs 07/01/17 06/30/18 06/30/23 F2703
35 CASH RECEIPTS — 010-36030 (2 OF 4) TO 010-36650-010- 36672 1 OF 6
0 5 yrs 07/01/17 06/30/18 06/ 30/23 F2704
36 CASH RECEIPTS — 010-36650-010-36672 (2 THRU 6 OF 6) 0 5 yrs 07/01/17 06/30/18 06/30/ 23 F2705 37 CASH RECEIPTS — 010-36800-010-36900 TO 530-37100 0 5 yrs 07/01/17 06/30/18 06/30/23 F2706 38 CASH RECEIPTS — FUND 600 TO FRUND 9000 0 5 yrs 07/01/17 06/ 30/18 06/30/23 F2707

Page 3 of 4 ends

-80-

CITY OF BELLFLOWER

AUTHORITY TO PROCESS INACTIVE RECORDS
RECORDS OF: Finance Department (dept 1300)
Department)
GENERAL DESCRIPTION OF RECORDS: FY17/18 Accounting Records Authority to Transfer
Date: ?i
Date: ll 2
Date: S 3 21
Approved: 7r5g—,
ue-a%

Page 4 of 4 ends

Authority to Destroy
Approved:

Department Head)
Approved:

City Clerk)
Approved:

City Manager)
Approved:

City Attorney)
Date:

Date:

FILE
TOTAL

FILE NAME AND TYPE

RETENTION
ITEM FUNCTION/CATEGORY C -Copies
TIME

INCLUSIVE DATES IN DESTROY BOX
NO. NUMBER O -Ori inals FILE AFTER NO.

FROM TO PR
F2670
TO
F2707
Authority to Transfer
Date: ?i
Date: ll 2
Date: S 3 21
Approved: 7r5g—,
ue-a%

Page 4 of 4 ends

Authority to Destroy
Approved:

Department Head)
Approved:

City Clerk)
Approved:

City Manager)
Approved:

City Attorney)
Date:

Date:

Date:
-81-

Docusign Envelope ID: C3942A4D-DE10-4599-B80B-6855A7A70261

AUTHORITY TO TRANSFER INACTIVE RECORDS

AND RECORDS INVENTORY LIST
5 Years
1 Department:

General Description
of Records:

Finance
FY 19/20 — Journal Entries
Retention Period:

Destruction
Eligibility Date:
12/31/2025

FOR CITY CLERK'S OFFICE USE
Box No.

Barcode No.

F2755
61937821
ITEM
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES

INCLUSIVE DATES

IN FILE

FROM TO
1 FY 19/20 — Journal Entries 7/1/2019 6/30/2020

I AUTHORIZE THE RECORDS CONTAINED HEREIN TO BE TRANSFERRED TO THE OFFSITE STORAGE FACILITY AND CITY COUNCIL APPROVED RECORDS RETENTION APPLIED.

Approved:
l Signed by:

Q IMaA. GaYGUA,
3FA0C745F140482
Department Head)
Date:
10/14/2024 1 2:16 PM PDT
-82-

DocuSign
Certificate Of Completion
Envelope Id:C3942A4DDE104599B80BB855A7A70261
Subject: Sign with Docusign: Authority to Transfer Records Inventory List - 2018-2019 Accounts Rece..

Source Envelope:

Document Pages: 6 Signatures: 6
Certificate Pages: 4 Initials: 0
AutoNav: Enabled
Envelopeld Stamping: Enabled
Time Zone: (UTC-08:00) Pacific Time (US & Canada)
Status: Completed
Envelope Originator:

City Clerk
16600 Civic Center Drive
16600 Civic Center Drive
Bellflower, CA 90706
[email protected]
IP Address:

Record Tracking
Status: Original
10/14/2024 1:49:08 PM
Holder: City Clerk
[email protected]
Location: DocuSign
Signer Events Signature Timestamp
Anna Garan
[email protected]
Security Level: Email, Account Authentication
None)
Electronic Record and Signature Disclosure:

Accepted: 10/14/2024 2:16:23 PM
ID: 33eb6eee-8c1d-45a0-8ac5-732176e36f1c
Signed by
11411 a Gad au
3FAoon5F un4S2
Signature Adoption: Pre -selected Style
Using IP Address:

Sent: 10/14/2024 1:51:11 PM
Viewed: 10/14/2024 2:16:23 PM
Signed: 10/14/2024 2:16:39 PM
In Person Signer Events Signature Timestamp
Editor Delivery Events Status Timestamp
Agent Delivery Events Status Timestamp
Intermediary Delivery Events Status Timestamp
Certified Delivery Events Status Timestamp
Carbon Copy Events Status Timestamp
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent
Certified Delivered
Signing Complete
Completed
Payment Events
Hashed/Encrypted
Security Checked
Security Checked
Security Checked
Status
Electronic Record and Signature Disclosure
10/14/2024 1:51:11 PM
10/14/2024 2:16:23 PM
10/14/2024 2:16:39 PM
10/14/2024 2:16:39 PM
Timestamps
-83-

Electronic Record and Signature Disclosure created on: 6/8/2020 10:47:26 AM Parties agreed to: Anna Garan

Please read the information below carefully and thoroughly, and if you can access this information electronically to your satisfaction and agree to this Electronic Record and Signature Disclosure (ERSD), please confirm your agreement by selecting the check -box next to `I agree to use electronic records and signatures' before clicking `CONTINUE' within the DocuSign system.

0.00 per -page fee. You may request delivery of such paper copies from us by following the procedure described below.

All notices and disclosures will be sent to you electronically -84-

Unless you tell us otherwise in accordance with the procedures described herein, we will provide electronically to you through the DocuSign system all required notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to you during the course of our relationship with you. To reduce the chance of you inadvertently not receiving any notice or disclosure, we prefer to provide all of the required notices and disclosures to you by the same method and to the same address that you have given us. Thus, you can receive all the disclosures and notices electronically or in paper format through the paper mail delivery system. If you do not agree with this process, please let us know as described below. Please also see the paragraph immediately above that describes the consequences of your electing not to receive delivery of the notices and disclosures electronically from us.

How to contact City of Bellflower:

You may contact us to let us know of your changes as to how we may contact you electronically, to request paper copies of certain information from us, and to withdraw your prior consent to receive notices and disclosures electronically as follows:

If you created a DocuSign account, you may update it with your new email address through your account preferences.

To request paper copies from City of Bellflower
To request delivery from us of paper copies of the notices and disclosures previously provided by us to you electronically, you must send us an email to [email protected] and in the body of such request you must state your email address, full name, mailing address, and telephone number. We will bill you for any fees at that time, if any.

To withdraw your consent with City of Bellflower
To inform us that you no longer wish to receive future notices and disclosures in electronic format you may:
-85-

Acknowledging your access and consent to receive and sign documents electronically To confirm to us that you can access this information electronically, which will be similar to other electronic notices and disclosures that we will provide to you, please confirm that you have read this ERSD, and (i) that you are able to print on paper or electronically save this ERSD for your future reference and access; or (ii) that you are able to email this ERSD to an email address where you will be able to print on paper or save it for your future reference and access. Further, if you consent to receiving notices and disclosures exclusively in electronic format as described herein, then select the check -box next to `I agree to use electronic records and signatures' before clicking `CONTINUE' within the DocuSign system.

By selecting the check -box next to `I agree to use electronic records and signatures', you confirm that:

Department: Finance Retention Period: 5 years
General Description
of Records: Accounts Receivable - Revenue Files Destruction Eligibility Date: 12/31/2025
ITEM
NO. DESCRIPTION OF SPECIFIC RECORDS OR FILES

INCLUSIVE DATES
IN FILE Box No. BARCODE
NUMBER

FROM TO
1AUTHORITYTOTRANSFERINACTIVERECORDS
AND RECORDS INVENTORY LIST – MULTIPLE BOXES IN SINGLE RECORD SERIES 1 REVENUE FILES: FTB COLLECTION THRU 010-30130 7/1/2019 6/30/2020 F2775 62058011 2 REVENUE FILES: 010-30140 THRU 010-31320 7/1/2019 6/30/2020 F2776 62058010 3 REVENUE FILES: 010-31320 THRU 010-32020 (2 OF 10)* 7/1/2019 6/30/2020 F2777 62058009 4 REVENUE FILES: 010-32020 (3 OF 10)* THRU 010-32050 7/1/2019 6/30/2020 F2778 62058008 5 REVENUE FILES: 010-32500 THRU 010-36520 7/1/2019 6/30/2020 F2779 62058007 6 REVENUE FILES: 010-36530 THRU 010-37100 7/1/2019 6/30/2020 F2780 62058006 7 REVENUE FILES: 010-3750 THRU 999-10299 7/1/2019 6/30/2020 F2781 62058005 8 CASH REGISTER AUDIT TRAIL: JULY 2019 – NOV 2019 7/1/2019 6/30/2020 F2782 62058004 9 CASH REGISTER AUDIT TRAIL: DEC 2019 – MARCH 2020 7/1/2019 6/30/2020 F2783 62058003 10 CASH REGISTER AUDIT TRAIL (4/20-06/20); HDL WEB PAYMENTS REPORTS; AR AUDIT TRAIL REPORTS; P&R RECONCILIATION FORMS 7/1/2019 6/30/2020 F2784 62058002 2 of 10)” and “(3 of 10)” are internal notations for the Finance Department. These are not for records management purposes.

I AUTHORIZE THE RECORDS CONTAINED HEREIN TO BE TRANSFERRED TO THE OFFSITE STORAGE FACILITY AND CITY COUNCIL APPROVED RECORDS RETENTION APPLIED.

Approved: Date:

Department Head)
Approved: Date:

City Clerk)
Docusign Envelope ID: E0CB4C54-B4C9-4230-B3EC-7274DDFEB704 3/20/2025 | 9:15 AM PDT
3/20/2025 | 9:22 AM PDT
-87-

Certificate Of Completion
Envelope Id: E0CB4C54-B4C9-4230-B3EC-7274DDFEB704 Status: Completed Subject: Sign with Docusign: Authority to Transfer Records Inventory List - 2019-2020 Acct Pay. - F2...

Source Envelope:

Document Pages: 4 Signatures: 6 Envelope Originator:

Certificate Pages: 5 Initials: 0 City Clerk
AutoNav: Enabled
EnvelopeId Stamping: Enabled
Time Zone: (UTC-08:00) Pacific Time (US & Canada)
16600 Civic Center Drive
16600 Civic Center Drive
Bellflower, CA 90706
[email protected]
IP Address:

Record Tracking
Status: Original
3/20/2025 9:00:33 AM
Holder: City Clerk
[email protected]
Location: DocuSign
Signer Events Signature Timestamp
Tae Rhee
[email protected]
Security Level: Email, Account Authentication
None)
Signature Adoption: Pre-selected Style
Using IP Address:

Sent: 3/20/2025 9:02:34 AM
Viewed: 3/20/2025 9:13:29 AM
Signed: 3/20/2025 9:15:00 AM
Electronic Record and Signature Disclosure:

Not Offered via Docusign
Mayra Ochiqui
[email protected]
City of Bellflower
Security Level: Email, Account Authentication
None)Signature Adoption: Pre-selected Style
Using IP Address:

Sent: 3/20/2025 9:15:02 AM
Viewed: 3/20/2025 9:21:37 AM
Signed: 3/20/2025 9:22:17 AM
Electronic Record and Signature Disclosure:

Accepted: 6/25/2020 3:30:32 PM
ID: de941368-19f5-405c-a721-8f946c2d8362
In Person Signer Events Signature Timestamp
Editor Delivery Events Status Timestamp
Agent Delivery Events Status Timestamp
Intermediary Delivery Events Status Timestamp
Certified Delivery Events Status Timestamp
Carbon Copy Events Status Timestamp
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 3/20/2025 9:02:34 AM
Certified Delivered Security Checked 3/20/2025 9:21:37 AM -88-

Envelope Summary Events Status Timestamps
Signing Complete Security Checked 3/20/2025 9:22:17 AM
Completed Security Checked 3/20/2025 9:22:17 AM
Payment Events Status Timestamps
Electronic Record and Signature Disclosure
-89-

Please read the information below carefully and thoroughly, and if you can access this information electronically to your satisfaction and agree to this Electronic Record and Signature Disclosure (ERSD), please confirm your agreement by selecting the check-box next to ‘I agree to use electronic records and signatures’ before clicking ‘CONTINUE’ within the DocuSign system.

0.00 per-page fee. You may request delivery of such paper copies from us by following the procedure described below.

All notices and disclosures will be sent to you electronically Electronic Record and Signature Disclosure created on: 6/8/2020 10:47:26 AM Parties agreed to: Mayra Ochiqui
-90-

Unless you tell us otherwise in accordance with the procedures described herein, we will provide electronically to you through the DocuSign system all required notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to you during the course of our relationship with you. To reduce the chance of you inadvertently not receiving any notice or disclosure, we prefer to provide all of the required notices and disclosures to you by the same method and to the same address that you have given us. Thus, you can receive all the disclosures and notices electronically or in paper format through the paper mail delivery system. If you do not agree with this process, please let us know as described below. Please also see the paragraph immediately above that describes the consequences of your electing not to receive delivery of the notices and disclosures electronically from us.

How to contact City of Bellflower:

You may contact us to let us know of your changes as to how we may contact you electronically, to request paper copies of certain information from us, and to withdraw your prior consent to receive notices and disclosures electronically as follows:

If you created a DocuSign account, you may update it with your new email address through your account preferences.

To request paper copies from City of Bellflower
To request delivery from us of paper copies of the notices and disclosures previously provided by us to you electronically, you must send us an email to [email protected] and in the body of such request you must state your email address, full name, mailing address, and telephone number. We will bill you for any fees at that time, if any.

To withdraw your consent with City of Bellflower
To inform us that you no longer wish to receive future notices and disclosures in electronic format you may:
-91-

i. decline to sign a document from within your signing session, and on the subsequent page, select the check-box indicating you wish to withdraw your consent, or you may; ii. send us an email to [email protected] and in the body of such request you must state your email, full name, mailing address, and telephone number. We do not need any other information from you to withdraw consent.. The consequences of your withdrawing consent for online documents will be that transactions may take a longer time to process..

Acknowledging your access and consent to receive and sign documents electronically To confirm to us that you can access this information electronically, which will be similar to other electronic notices and disclosures that we will provide to you, please confirm that you have read this ERSD, and (i) that you are able to print on paper or electronically save this ERSD for your future reference and access; or (ii) that you are able to email this ERSD to an email address where you will be able to print on paper or save it for your future reference and access. Further, if you consent to receiving notices and disclosures exclusively in electronic format as described herein, then select the check-box next to ‘I agree to use electronic records and signatures’ before clicking ‘CONTINUE’ within the DocuSign system.

By selecting the check-box next to ‘I agree to use electronic records and signatures’, you confirm that:

Docusign Envelope ID: 5786A67E-86BB-4086-B7CE-1 BOB47A1 3461

AUTHORITY TO TRANSFER INACTIVE RECORDS

AND RECORDS INVENTORY LIST
Various
1 Department:

General Description
of Records:

Parks and Recreation
General Office Files
Retention Period:

Destruction
Eligibility Date:

FOR CITY CLERK'S OFFICE USE
12/31/2025
Box No.

Barcode No.

PR201
61937810
ITEM
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES

INCLUSIVE DATES

IN FILE

FROM TO
1 Facility Use Permits — Thompson Park (File 1-4)1/1/2022 12/31/2022 2 Returned Cleaning Deposits (File 1-6)1/1/2022 12/31/2022 3 Employment Applications (Remainder of 2021)1/1/2021 12/31/2021

I AUTHORIZE THE RECORDS CONTAINED HEREIN TO BE TRANSFERRED TO THE OFFSITE STORAGE FACILITY AND CITY COUNCIL APPROVED RECORDS RETENTION APPLIED.

DocuSigned by:

Approved:

F1fi1r 1RGWRAfi2
Department Head)
Date:
11/15/2024 1 2:09 PM PST
Date: 1(
-93-

0 docusign
Certificate Of Completion
Envelope Id: 57B6A67E86BB4DB6B7CE1B0B47A134B1
Subject: Sign with Docusign: Authority to Transfer Records Inventory List - General Office Files - P...

Source Envelope:

Document Pages: 7 Signatures: 7
Certificate Pages: 4 Initials: 0
AutoNav: Enabled
Envelopeld Stamping: Enabled
Time Zone: (UTC-08:00) Pacific Time (US & Canada)
Status: Completed
Envelope Originator:

City Clerk
16600 Civic Center Drive
16600 Civic Center Drive
Bellflower, CA 90706
[email protected]
IP Address:

Record Tracking
Status: Original Holder: City Clerk
11/15/2024 1:58:38 PM [email protected]
Location: DocuSign
Signer Events Signature Timestamp
PJ Mellana
[email protected]
Security Level: Email, Account Authentication
None)
Electronic Record and Signature Disclosure:

Accepted: 4/16/2024 9:30:04 AM
ID: 013dce47-89c0-4cd5-alb8-27bbd90d629e
r—0000S.9n d by
F161C1B67<26,62
Signature Adoption: Uploaded Signature Image
Using IP Address:

Sent: 11/15/2024 2:00:54 PM
Viewed: 11/15/2024 2:09:30 PM
Signed: 11/15/2024 2:09:48 PM
In Person Signer Events Signature Timestamp
Editor Delivery Events Status Timestamp
Agent Delivery Events Status Timestamp
Intermediary Delivery Events Status Timestamp
Certified Delivery Events Status Timestamp
Carbon Copy Events Status Timestamp
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent
Certified Delivered
Signing Complete
Completed
Payment Events
Hashed/Encrypted
Security Checked
Security Checked
Security Checked
Status
Electronic Record and Signature Disclosure
11/15/2024 2:00:54 PM
11/15/2024 2:09:30 PM
11/15/2024 2:09:48 PM
11/15/2024 2:09:48 PM
Timestamps
-94-

Electronic Record and Signature Disclosure created on: 6/8/2020 10:47:26 AM Parties agreed to: PJ Mellana

Please read the information below carefully and thoroughly, and if you can access this information electronically to your satisfaction and agree to this Electronic Record and Signature Disclosure (ERSD), please confirm your agreement by selecting the check -box next to `I agree to use electronic records and signatures' before clicking `CONTINUE' within the DocuSign system.

0.00 per -page fee. You may request delivery of such paper copies from us by following the procedure described below.

Consequences of changing your mind
If you elect to receive required notices and disclosures only in paper format, it will slow the speed at which we can complete certain steps in transactions with you and delivering services to you because we will need fu-st to send the required notices or disclosures to you in paper format, and then wait until we receive back from you your acknowledgment of your receipt of such paper notices or disclosures. Further, you will no longer be able to use the DocuSign system to receive required notices and consents electronically from us or to sign electronically documents from us.

All notices and disclosures will be sent to you electronically -95-

Unless you tell us otherwise in accordance with the procedures described herein, we will provide electronically to you through the DocuSign system all required notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to you during the course of our relationship with you. To reduce the chance of you inadvertently not receiving any notice or disclosure, we prefer to provide all of the required notices and disclosures to you by the same method and to the same address that you have given us. Thus, you can receive all the disclosures and notices electronically or in paper format through the paper mail delivery system. If you do not agree with this process, please let us know as described below. Please also see the paragraph immediately above that describes the consequences of your electing not to receive delivery of the notices and disclosures electronically from us.

How to contact City of Bellflower:

You may contact us to let us know of your changes as to how we may contact you electronically, to request paper copies of certain information from us, and to withdraw your prior consent to receive notices and disclosures electronically as follows:

If you created a DocuSign account, you may update it with your new email address through your account preferences.

To request paper copies from City of Bellflower
To request delivery from us of paper copies of the notices and disclosures previously provided by us to you electronically, you must send us an email to [email protected] and in the body of such request you must state your email address, full name, mailing address, and telephone number. We will bill you for any fees at that time, if any.

To withdraw your consent with City of Bellflower
To inform us that you no longer wish to receive future notices and disclosures in electronic format you may:
-96-

Acknowledging your access and consent to receive and sign documents electronically To confirm to us that you can access this information electronically, which will be similar to other electronic notices and disclosures that we will provide to you, please confirm that you have read this ERSD, and (i) that you are able to print on paper or electronically save this ERSD for your future reference and access; or (ii) that you are able to email this ERSD to an email address where you will be able to print on paper or save it for your future reference and access. Further, if you consent to receiving notices and disclosures exclusively in electronic format as described herein, then select the check -box next to `I agree to use electronic records and signatures' before clicking `CONTINUE' within the DocuSign system.

By selecting the check -box next to `I agree to use electronic records and signatures', you confirm that:

Docusign Envelope ID: D8B570DC-0EF1-43F6-9191-2E303D05D9A7

AUTHORITY TO TRANSFER INACTIVE RECORDS

AND RECORDS INVENTORY LIST
1 Department:Parks and Recreation Retention Period:2 years General Description
of Records:

General Office Files
Destruction
Eligibility Date:
12/31/2025

FOR CITY CLERK'S OFFICE USE
Box No.PR202
Barcode No.62057962
ITEM
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES

INCLUSIVE DATES

IN FILE

FROM TO
1 Returned Cleaning Deposits (Files 1-5)1/1/2023 12/31/2023 2 WorkNacation Schedules 1/1/2023 12/31/2023
3 Weekend Reports (Simms Park, Thompson Park, Caruthers Park)1/1/2016 12/31/2020 4 Cash Reconciliation Forms (Copies) (File 1)1/1/2023 12/31/2023

I AUTHORIZE THE RECORDS CONTAINED HEREIN TO BE TRANSFERRED TO THE OFFSITE STORAGE FACILITY AND CITY COUNCIL APPROVED RECORDS RETENTION APPLIED.

Signed by
Approved: F161C1867426462 Date:

Department Head)
Approved:
4/4/2025 1 1:09 PM PDT
-98-

Docusign Envelope ID D8B570DC-0EF1-43F6-9191-2E303D05D9A7

AUTHORITY TO TRANSFER INACTIVE RECORDS

AND RECORDS INVENTORY LIST
1 Department:Parks and Recreation Retention Period:2 years General Description
of Records:

General Office Files
Destruction
Elicibility Date:
12/31/2024

FOR CITY CLERK'S OFFICE USE
Box No.PR204
Barcode No.62057960
ITEM
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES

INCLUSIVE DATES

IN FILE

FROM TO
1 Cash Reconciliation Forms (Copies) (File 1)1/1/2016 12/31/2020 2 Incident Reports (BAC, Caruthers Park, Simms Park, Thompson Park, Misc.) (Copies)1/1/2019 12/31/2021 3 Invoices (Copies)1/1/2017 12/31/2021
4 Incoming Correspondence 1/1/2021 12/31/2021
5 Bellflower Farmers Market/Summer Streetfest Quarterly Reporting 1/1/2009 12/31/2022 6 Bellflower Farmers Market/Summer Streetfest Health Department/Registration 1/1/2008 12/31/2019 7 Los Angeles County Tax Collector (Farmers Market Public Health License/Permit Billing)1/1/2008 12/31/2021 8 Bellflower Farmers Market EBT Card Reconciliation Forms (Copies)1/1/2016 12/31/2022 9 Park Patrol Memos and Summary Reports 1/1/2020 12/31/2022 10 Accident Reports (Copies)1/1/2022 12/31/2022

I AUTHORIZE THE RECORDS CONTAINED HEREIN TO BE TRANSFERRED TO THE OFFSITE STORAGE FACILITY AND CITY COUNCIL APPROVED MIMEOS RETENTION APPLIED.
4/4/2025 I 1:09 PM PDT
Approved: F161C1B67426462 Date:

Department Head)
Approved:
erk)
Date:
-99-

Docusign Envelope ID D8B570DC-0EF1-43F6-9191-2E303D05D9A7

AUTHORITY TO TRANSFER INACTIVE RECORDS

AND RECORDS INVENTORY LIST
1 Department:Parks and Recreation Retention Period:2 years General Description
of Records:

General Office Files
Destruction
Elicibility Date:
12/31/2025

FOR CITY CLERK'S OFFICE USE
Box No.PR205
Barcode No.62057959
ITEM
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES

INCLUSIVE DATES

IN FILE

FROM TO
1 Weekend Reports (Caruthers Park, Simms Park, Thompson Park)1/1/2022 12/31/2022 2 Work/Vacation Schedules 1/1/2022 12/31/2022
3 Weekly Updates 1/1/2022 12/31/2022
4 Vacation/Time-Off Requests 1/1/2022 12/31/2022
5 Incident Reports (BAC, Caruthers Park, Simms Park, Thompson Park) (Copies)1/1/2022 12/31/2022 6 Facility Use Permits (BAC, Caruthers Park, Simms Park, Thompson Park (Files 1-4), Cancelled)1/1/2023 12/31/2023 7 Facility Use Agreements 1/1/2023 12/31/2023

I AUTHORIZE THE RECORDS CONTAINED HEREIN TO BE TRANSFERRED TO THE OFFSITE STORAGE FACILITY AND CITY COUNCIL APPROVE LC 3DS RETENTION APPLIED.

Approved: F161C1B67426462
Department Head
Date:
4/4/2025 1 1:09 PM PDT
Date: 1/(17/7A Z5
-100-

Docusign Envelope ID D8B570DC-0EF1-43F6-9191-2E303D05D9A7

AUTHORITY TO TRANSFER INACTIVE RECORDS

AND RECORDS INVENTORY LIST
1 Department:Parks and Recreation Retention Period:2 years General Description
of Records:

General Office Files
Destruction
Eligibility Date:
12/31/2024

FOR CITY CLERK'S OFFICE USE
Box No.PR206
Barcode No.62057958
ITEM
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES

INCLUSIVE DATES

IN FILE

FROM TO
1 Invoices (A -Z) (Copies)1/1/2022 12/31/2022
2 Invoices (A -P) (Copies)1/1/2015 12/31/2015

I AUTHORIZE THE RECORDS CONTAINED HEREIN TO BE TRANSFERRED TO THE OFFSITE STORAGE FACILITY AND CITY COUNCIL APPROVED RECORDS RETENTION APPLIED.

Approved: —F161C1B67426462
Department Head)
Approved:

Date:

Date:
4/4/2025 1 1:09 PM PDT
-101-

Docusign Envelope ID D88570DC-OEF1-43F6-9191-2E303D05D9A7

AUTHORITY TO TRANSFER INACTIVE RECORDS

AND RECORDS INVENTORY LIST
1 Department:Parks and Recreation Retention Period:2 years General Description
of Records:

General Office Files
Destruction
Eligibility Date:
12/31/2018

FOR CITY CLERK'S OFFICE USE
Box No.PR207
Barcode No.62057957
ITEM
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES

INCLUSIVE DATES

IN FILE

FROM TO
1 Invoices (A -Z) (Copies)1/1/2016 12/31/2016
2 Invoices (Q -Z) (Copies)1/1/2015 12/31/2015

I AUTHORIZE THE RECORDS CONTAINED HEREIN TO BE TRANSFERRED TO THE OFFSITE STORAGE FACILITY AND CITY COUNCIL APPROVED`REC RDS RETENTION APPLIED.
ff
F161C1B67426462Approved:

Approved:

Department Head)
Date:
4/4/2025 I 1:09 PM PDT
Date: I/7-7/ 2 O ZS
-102-

Docusign Envelope ID: D8B570DC-0EF1-43F6-9191-2E303D05D9A7

AUTHORITY TO TRANSFER INACTIVE RECORDS

AND RECORDS INVENTORY LIST
1 Department:Parks and Recreation Retention Period:3 years General Description
of Records:Employment Applications
Destruction
Elicibility Date:
12/31/2025

FOR CITY CLERK'S OFFICE USE
Box No.PR208
Barcode No.62057956
ITEM
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES

INCLUSIVE DATES

IN FILE

FROM TO
1 P&R Recruitment Applications (Successful and Unsuccessful)1/1/2021 12/31/2022

I AUTHORIZE THE RECORDS CONTAINED HEREIN TO BE TRANSFERRED TO THE OFFSITE STORAGE FACILITY AND CITY COUNCIL APPROVE EtdrIDS RETENTION APPLIED.
4/4/2025 I 1:09 PM PDT
Approved: F161C1867426462. Date:

Department Head)
Approved:Date: Y(112.O2----
-103-

docusign
Certificate Of Completion
Envelope Id: D8B570DC-OEF1-43F6-9191-2E303D05D9A7
Subject: Sign with Docusign: Authority to Transfer Records Inventory List - General Office Files - P...

Source Envelope:

Document Pages: 7 Signatures: 7
Certificate Pages: 4 Initials: 0
AutoNav: Enabled
Envelopeld Stamping: Enabled
Time Zone: (UTC-08:00) Pacific Time (US & Canada)
Status: Completed
Envelope Originator:

City Clerk
16600 Civic Center Drive
16600 Civic Center Drive
Bellflower, CA 90706
[email protected]
IP Address:

Record Tracking
Status: Original Holder City Clerk
4/1/2025 3:49:17 PM [email protected]
Location: DocuSign
Signer Events Signature Timestamp
P.J. Mellana
[email protected]
Security Level: Email, Account Authentication
None)
Electronic Record and Signature Disclosure:

Accepted: 4/16/2024 9:30:04 AM
ID. 013dce47-89c0-4cd5-al b8-27bbd90d629e
Signed Dy
F161G1867E26t62
Signature Adoption: Uploaded Signature Image
Using IP Address:

Sent: 4/1/2025 3:50:48 PM
Viewed: 4/4/2025 1:08:53 PM
Signed: 4/4/2025 1:09:07 PM
In Person Signer Events Signature Timestamp
Editor Delivery Events Status Timestamp
Agent Delivery Events Status Timestamp
Intermediary Delivery Events Status Timestamp
Certified Delivery Events Status Timestamp
Carbon Copy Events Status Timestamp
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent
Certified Delivered
Signing Complete
Completed
Hashed/Encrypted
Security Checked
Security Checked
Security Checked
4/1/2025 3:50:48 PM
4/4/2025 1:08:53 PM
4/4/2025 1:09:07 PM
4/4/2025 1:09:07 PM
Payment Events Status
Electronic Record and Signature Disclosure
Timestamps
-104-

Electronic Record and Signature Disclosure created on: 6/8/2020 10:47:26 AM Parties agreed to: P.J. Mellana

0.00 per -page fee. You may request delivery of such paper copies from us by following the procedure described below.

A11 notices and disclosures will be sent to you electronically -105-

Unless you tell us otherwise in accordance with the procedures described herein, we will provide electronically to you through the DocuSign system all required notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to you during the course of our relationship with you. To reduce the chance of you inadvertently not receiving any notice or disclosure, we prefer to provide all of the required notices and disclosures to you by the same method and to the same address that you have given us. Thus, you can receive all the disclosures and notices electronically or in paper format through the paper mail delivery system. If you do not agree with this process, please let us know as described below. Please also see the paragraph immediately above that describes the consequences of your electing not to receive delivery of the notices and disclosures electronically from us.

How to contact City of Bellflower:

You may contact us to let us know of your changes as to how we may contact you electronically, to request paper copies of certain information from us, and to withdraw your prior consent to receive notices and disclosures electronically as follows:

If you created a DocuSign account, you may update it with your new email address through your account preferences.

To request paper copies from City of Bellflower
To request delivery from us of paper copies of the notices and disclosures previously provided by us to you electronically, you must send us an email to [email protected] and in the body of such request you must state your email address, full name, mailing address, and telephone number. We will bill you for any fees at that time, if any.

To withdraw your consent with City of Bellflower
To inform us that you no longer wish to receive future notices and disclosures in electronic format you may:
-106-

By selecting the check -box next to 'I agree to use electronic records and signatures', you confirm that:

AUTHORITY TO TRANSFER INACTIVE RECORDS

AND RECORDS INVENTORY LIST
Department:Planning Department— Business License Division Retention Period: Close + 5
years
Destruction
12/31/2025
General Description Eligibility Date:
of Records:

Closed Out Business Licenses FOR CITY CLERK'S OFFICE USE Box No. PL140
SKU No.RF127619574
ITEM

INCLUSIVE DATES
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES IN FILE

FROM TO
1 9009 Alondra Blvd. — RYS Group DBA Taqueria Mexico— Business License#17448 12/28/2009 2/22/2020 2 9102 Alondra Blvd. — Freshwater& Laundrymate— Business License#14040 7/8/2010 9/23/2020 3 9123 Alondra Blvd. — Lola's Beauty Bar— Business License#20374 1/3/2019 3/15/2020 4 9312 Alondra Blvd. — Maciel's Party Rental— Business License#18857 10/31/2016 6/1/2020 5 9312 Alondra Blvd. —Free Methodist Camino De Garcia— Business License#17913 5/28/2015 6/1/2020 6 9357 Alondra Blvd. —S & J Cleaners— Business License#16193 5/23/2013 1/21/2020 7 9823 Alondra Blvd. —Abby West Transportation, LLC— Business License#20566 4/8/2019 4/23/2020 8 9873 Alondra Blvd. —Welcome Beauty— Business License#20699 6/ 5/2019 6/ 4/2020 9 9881 Alondra Blvd. —Alondra Nail-Spa— Business License#21096 12/ 19/2019 10/ 28/2020 10 10054 Alondra Blvd. — US Metro Group, Inc. — Business License#19974 5/20/2018 1/31/2020 11 10145 Alondra Blvd. — Bellflower Coin Laundry— Business License#11716 7/24/2007 1/31/2020 12 10220 Alondra Blvd. — Pizza USA— Business License#20586 4/15/2019 1/31/2020 13 10224 Alondra Blvd. —Woodruff Plaza Dry Cleaners— Business License#18144 10/7/2015 3/1/2020 14 10355 Alondra Blvd. —Indoor Comfort Equipment, Inc. —Business License#21203 3/1/2020 2/25/2020 15 17112 Ardmore Ave. —Casa De QTZL— Business License#21308 5/11/2020 6/18/2020 16 17117 Ardmore Ave. — 1 Unit—Norberto Garcia— Business License#13212 3/28/2006 1/7/2020 17 17636 Ardmore Ave. — 1 Unit— Paul Kim Chan— Business License#20108 8/15/2018 8/5/2020 -108-

i LI t"4''''
AUTHORITY TO TRANSFER INACTIVE RECORDS 2

AND RECORDS INVENTORY LIST
cR
wNc.,ez.+ee
Department:Planning Department— Business License Division Retention Period: Close + 5
years
Destruction
12/31/2025
General Description Eligibility Date:
of Records:

Closed Out Business Licenses FOR CITY CLERK'S OFFICE USE Box No. PL140
SKU No.RF127619574
ITEM

INCLUSIVE DATES
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES IN FILE

FROM TO
18 8522 Artesia Blvd. Apt.#23— Don Memo Candies— Business License#21421 7/11/2020 9/1/2020 19 8522 Artesia Blvd. #23— Don Memo Candies— Business License#19528 10/27/2017 5/22/2020 20 8559 Artesia Blvd. —Apollo Motorhome Holidays, LLC—Business License#21137 3/1/2020 10/1/2020 21 8625 Artesia Blvd. —STG Auto Group— Business License#21359 6/18/2020 6/22/2020 22 8702 Artesia Blvd. —Coin-Op Laundry— Business License#01029 8/6/1986 1/30/2020 23 9032 Artesia Blvd. —West Coast Supply NN — Business License#15266 1/31/2012 1/30/2020 24 9042 Artesia Blvd. —All Pro Wheels— Business License#20102 8/13/2018 3/14/2020 25 9214 Artesia Blvd. — Elmar Commercial Properties, LLP— Business License#16869 1/1/2014 11/19/2020 26 9214 Artesia Blvd. — Elliot Auto Supply Co., Inc. DBA Factory Motor Sports Parts, Co. — Business License#14984 9/6/2011 6/30/2020 27 9236 Artesia Blvd. — Designer Plumbing &Air, Inc. — Business License#21367 7/1/2020 7/6/2020 28 9405 Artesia Blvd. — LJB Registration Services— Business License#21567 1/1/2021 9/22/2020 29 9551 Artesia Blvd. —55 Property Services, Inc. — Business License#21062 11/1/2019 10/31/2020 30 9608 Artesia Blvd. —TXAMTL— Business License#20730 6/19/2019 6/19/2020 31 10027 Artesia Blvd. — Bellflower Lakewood Pipe & Steel— Business License#12126 3/10/2008 1/31/2020 32 10230 Artesia Blvd. — Preferred Diagnostic Imaging, LLC— Business License#12957 5/4/2009 9/30/2020 33 10230 Artesia Blvd. #207— Innovi Healthcare, Inc. DBA Innovi Medical Group— Business License#21356 7/6/2020 9/14/2020 34 10276 Artesia Blvd. — Free N Easy Holidays, LLC— Business License#20786 7/29/2019 3/27/2020 -109-

AUTHORITY TO TRANSFER INACTIVE RECORDS 3

AND RECORDS INVENTORY LIST
Of S.0.
k'fryCl 106E
Department:Planning Department— Business License Division Retention Period: Close + 5
years
Destruction
12/31/2025
General Description Eligibility Date:
of Records:

Closed Out Business Licenses FOR CITY CLERK'S OFFICE USE Box No. PL140
SKU No.RF127619574
ITEM

INCLUSIVE DATES
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES IN FILE

FROM TO
35 10301 Artesia Blvd. —The Management CA, Inc. — Business License#16739 1/1/2014 1/28/2020 36 10301 Artesia Blvd. — R.S. Elle, LLC DBA R.S. Elle Management— Business License#21178 1/28/2020 10/3/2020 37 10301 Artesia Blvd. Unit 102— Light'em Up— Business License#14535 3/10/2011 12/ 9/2020 38 10301 Artesia Blvd. #104-105— Paradise Crawfish— Business License#2049 2/ 6/2019 10/1/2020 39 10453 Artesia Blvd. Apt.#89B—3KG Photobooth— Business License#18741 9/6/2016 9/ 5/2020 40 9955 Artesia PI. —Golden Massage— Business License#20121 8/22/2018 5/1/2020 41 10146 Artesia PI. — MPB Equipment— Business License#19526 10/27/2017 1/13/2020 42 17932 Balfern Ave. — DYLIS, LLC— Business License#20167 9/12/2018 5/27/2020 43 14118 Bellflower Blvd. — Harbinder Singm—Business License#05759 12/3/1999 11/2/2020 44 14213 Bellflower Blvd. — Rewa Threading and Beauty Salon — Business License#19986 6/11/2018 3/20/2020 45 14224 Bellflower Blvd. —YoYo Massage SPA— Business License#16419 9/18/2013 8/ 31/2020 46 14234 Bellflower Blvd. — Red Hair Designers— Business License#20249 10/23/2018 7/ 13/2020 47 14316 Bellflower Blvd. —Safeguard Equities, Inc. — Business License#00207 7/1/1982 7/1/2020 48 14768 Bellflower Blvd. —Q Cleaners— Business License#03603 6/ 16/1998 6/27/2020 49 15108 Bellflower Blvd. — Somerset Scoops and Water— Business License#18254 12/1/2015 11/30/2020 50 16102 Bellflower Blvd. — Mark W. Alpert— Business License#00877 7/ 6/1984 3/12/2020 51 16500 Bellflower Blvd. Unit#25— Pholanthropy, LLC— Business License#20383 2/17/2019 6/30/2020 -110-

01.B«LF1_
04k AUTHORITY TO TRANSFER INACTIVE RECORDS 4

AND RECORDS INVENTORY LIST
OgUWr.VCI iWF.iNFa
Department:Planning Department— Business License Division Retention Period: Close + 5
years
Destruction
12/31/2025
General Description Eligibility Date:
of Records:

Closed Out Business Licenses FOR CITY CLERK'S OFFICE USE Box No. PL140
SKU No.RF127619574

ITEM INCLUSIVE DATES
NO. DESCRIPTION OF SPECIFIC RECORDS OR FILES IN FILE

FROM TO
52 16503 Bellflower Blvd. — Risk Fitness Center— Business License#19769 3/5/2018 8/18/2020 53 16536 Bellflower Blvd. Suite 102— New American Funding Broker Solutions, Inc. — Business License#20098 7/1/2018 2/11/2020 54 16536 Bellflower Blvd. —Citywide Home Loans, LLC DBA Citywide Home Loans— Business License#20597 3/22/2019 1/1/2020 55 16633 Bellflower Blvd. — Healthway Foods— Business License#15119 11/4/2011 1/31/2020 56 16700 Bellflower Blvd. #B— BSA Pharmacy— Business License#19922 5/14/2018 10/5/2020 57 16700 Bellflower Blvd. #C— BSA Wholesale— Business License#19921 5/14/2018 10/5/2020 58 16704 Bellflower Blvd. —Montealegre Colombian Coffee Company— Business License#20392 1/14/2019 2/15/2020 59 16739 Bellflower Blvd. — Beaver Menkes & Hass An Acc— Business License#00028 7/1/1982 8/11/2020 60 16809 Bellflower Blvd. —Dilly/Dally Cleaning Service— Business License#21418 8/3/2020 8/12/2020 61 16911 Bellflower Blvd. 2nd Floor—Golden Empire Mortgage— Business License#15132 11/9/2011 12/30/2020 62 16911 Bellflower Blvd. #200—Creative Capital Solutions, LLC — Business License#18207 11/10/2015 11/2/2020 63 17020 Bellflower Blvd. — Relax Massage— Business License#16146 5/2/2013 6/24/2020 64 17034 Bellflower Blvd. —Sword of the Spirit International—Business License#19255 6/13/2017 6/1/2020 65 17057 Bellflower Blvd. Suite 213— Reliable Motors— Business License#14539 3/15/2011 3/15/2020 66 17152 Bellflower Blvd. —Halcyon Powersports, Inc. DBA Moto United Beach Cities— Business License#19908 5/ 3/2018 9/1/2020 67 17157 Bellflower Blvd. —Cartell Used Auto Sales— Business License#19632 12/27/2017 3/ 31/2020 68 17413 Bellflower Blvd. — Buckeye Title Loans— Business License#19797 4/1/2018 1/8/2020 -111-

c%-"'°"
1"1"'''''
k
a"i -ie"
nw`
k AUTHORITY TO TRANSFER INACTIVE RECORDS 5
C

AND RECORDS INVENTORY LIST
OR k'1NO iW:t_*
Department:Planning Department— Business License Division Retention Period: Close + 5
years
Destruction
12/31/2025
General Description Eligibility Date:
of Records: Closed Out Business Licenses FOR CITY CLERK'S OFFICE USE Box No. PL140
SKU No.RF127619574

ITEM INCLUSIVE DATES
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES IN FILE

FROM TO
69 17413 Bellflower Blvd. —Cash1 — Business License#19798 4/1/2018 1/8/2020 70 17610 Bellflower Blvd. #212—JC Health Center— Business License#17646 2/5/2015 5/20/ 2020 71 17838 Bellflower Blvd. — Pams Hair Co. — Business License#01286 8/ 9/1989 2/1/2020 72 17840 Bellflower Blvd. —S1 Health Center— Business License#17950 6/ 18/2015 9/1/2020 73 15709 Blaine Ave. —7 Units— Raymond Martin— Business License#13712 3/3/2007 8/1/2020 74 15920 Carpintero Ave. Apt.# 10—Savii Essentials— Business License#21374 8/1/2020 8/20/2020 75 9022 Cedar St. —John Dibsy— Business License#01089 6/ 18/1987 7/13/2020 76 13762 Clark Ave. — Uncle Reds Pizzeria— Business License#20453 2/ 15/2019 1/31/2020 77 14343 Clark Ave. —Green Hanger Cleaners— Business License#20740 6/24/2019 2/1/2020 78 14369 Clark Ave. — Bellflower Dental Center— Business License#02992 2/5/1998 2/4/2020 79 15524 Clark Ave. —Sarah Ocampo's Home Garden— Business License#21671 3/2/2020 12/14/2020 80 16203 Clark Ave. Suite D— Metro Body Paint Studio— Business License#18593 6/22/2016 3/3/2020 81 16216 Clark Ave. —Annette's Lice Scan Fingerprinting — Business License#11363 2/7/2007 3/15/2020 82 16317 Clark Ave. —St. Luke Pharmacy, Inc. — Business License#17436 10/ 15/2014 11/30/2020 83 16320 Clark Ave. —Western Paining— Business License#18757 9/12/2016 12/31/2020 84 16324 Clark Ave. —Ji Lee's— Business License#17842 1/1/2015 2/20/2020 85 17024 Clark Ave. — Edward W. Lew D.M.D. — Business License#18806 10/4/2016 7/1/2020 -112-

AUTHORITY TO TRANSFER INACTIVE RECORDS 6
Rcw.+.c roceci`ee.

AND RECORDS INVENTORY LIST
Department:Planning Department— Business License Division Retention Period: Close + 5
years
Destruction
12/31/2025
General Description Eligibility Date:

Of Records:

Closed Out Business Licenses FOR CITY CLERK'S OFFICE USE Box No. PL140
SKU No.RF127619574
ITEM

INCLUSIVE DATES
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES IN FILE

FROM TO
86 17024 Clark Ave. #A—Cathay Massage Therapy—Contract Massage Tech: Mengchen Liu— Business License#19912 5/8/2018 9/27/2020 87 17024 Clark Ave. #A—Cathay Massage Therapy—Contract Massage Tech: Yan Zhao— Business License#20920 9/18/2019 9/28/2020 88 17024 Clark Ave. #A—Cathay Massage Therapy—Contract Massage Tech: Limel Xiao— Business License#20682 5/30/2019 9/27/2020 89 17102 Clark Ave. —G & S Burgers— Business License#17415 10/8/2014 4/14/2020 90 17207 Clark Ave. — Duran Auto Repair— Business License#20903 9/10/2019 2/10/2020 91 17403 Clark Ave. —Clayton Commercial Center— Business License#16937 1/1/2014 2/26/2020 92 17405 Clark Ave. —Mashuat Restaurant— Business License#19744 2/19/2018 7/28/2020 93 17619 1/
2 Clark Ave. —Juice City Ent. —Business License#20718 6/17/2019 11/13/2020 94 17655 Clark Ave. — Bellflower Tire &Auto Repair— Business License#18509 5/ 5/2016 2/29/2020 95 17814 Clark Ave. — 1 Unit— Peters Rental— Business License#12511 10/3/2008 8/15/2020 96 14015 Cornuta Ave. —Glammin' It Up With Mel— Business License#19614 12/14/2017 12/31/2020 97 15720— 15724 Cornuta Ave. —3 Units—Ostrom Rentals— Business License#16124 4/18/2013 3/ 9/2020 98 16126 Cornuta Ave. #111 — Monday— Friday Sauce— Business License#21456 8/21/2020 7/10/2020 99 16220 Cornuta Ave., Apt.#6— Father& Son Pool Service— Business License#21625 8/10/2020 12/15/2020 100 16337 Cornuta Ave. #7—Chaka Motorsports— Business License#20878 9/1/2019 8/24/2020 101 17034 Downey Ave. #B— Born to Roam— Business License#20808 7/24/2019 4/24/2020 102 15541 Eucalyptus Ave. —James C. Michaud— Business License#00121 7/1/1982 3/ 8/2020 -113-

AUTHORITY TO TRANSFER INACTIVE RECORDS 7

AND RECORDS INVENTORY LIST
OkOWINa T00E ”
Department:Planning Department— Business License Division Retention Period: Close + 5
years
Destruction
12/31/2025
General Description Eligibility Date:

RecoS:

Closed Out Business Licenses FOR CITY CLERK'S OFFICE USE Box No. PL140
SKU No.RF127619574

ITEM INCLUSIVE DATES
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES IN FILE

FROM TO
103 15735— 15743 Eucalyptus Ave. —22 Units— Hawaiian Apartments, LLC 6/21/2016 7/22/2020 104 16138 Eucalyptus Ave. Apt. #22 —2nd Business License—Cyber Ride, LLC—Business License#21241 3/4/2020 12/1/2020 105 10124 Faywood St. —Cook-E Enterprises— Business License#17702 2/25/2015 3/1/2020 106 14003 Fidler Ave. — Ronald D. Howard — Business License#01367 7/1/1990 12/30/2020 107 9047 Flower St. — Lawrence Hutchens— Business License#06350 11/15/2000 7/1/2020 108 9113 Flower St. —Chido's Naija Delights— Business License#21528 10/1/2020 10/25/2020 109 9344 Flower St. — Bellflower Hair Designs— Business License#18443 4/1/2016 3/1/2020 110 9511 Flower St. —The Glam Collective—Contract Stylist: Giselle Mata— Business License#19998 7/1/2018 10/29/2020 111 9511 Flower St. —The Glam Collective— Business License#19773 4/1/2018 4/1/2020 112 9556 Flower St. —4 Da Low Auto Sales, LLC— Business License#21055 11/25/2019 12/31/2020 113 9720 Flower St. Apt. #327—BAQS USA, LLC— Business License#19983 8/1/2018 5/20/2020 114 9733 Flower St. Suite B—S. Health Center—Business License#17949 6/ 15/2015 9/1/2020 115 9329 Gardendale St. —Saragosa Rentals*- Business License#04981 4/12/1999 9/ 14/2020 116 16274 Grand Ave. —C.A.S. Computer Sales— Business License#12675 1/13/2009 3/13/2020 117 17504 Grand Ave. Apt..#3—TM Electric— Business License#21626 11/12/2020 12/15/2020 118 9510 Harvard St. — M G Brassard Living Trust— Business License#00145 7/1/1982 7/30/2020 119 10423 Hayford St. H-65— 1 Unit—VandenBerg Family Trust— Business License#15477 5/14/2012 6/10/2020 -114-

c"'`'*,,,,
1" '''''
AUTHORITY TO TRANSFER INACTIVE RECORDS 8

AND RECORDS INVENTORY LIST
o4pWO+a i'oo
Department:Planning Department- Business License Division Retention Period: Close + 5
years
Destruction
12/31/2025
eneral Description Eligibility Date:GG neral D
Closed Out Business Licenses FOR CITY CLERK'S OFFICE USE ofBox No. PL140_
SKU No.RF127619574

ITEM INCLUSIVE DATES
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES IN FILE

FROM TO
120 9510 Ives St. -Reliable Steel, Co- Business License#21036 11/13/2019 1/1/2020

I AUTHORIZE THE RECORDS CONTAINED HEREIN TO BE TRANSFERRED TO THE OFFSITE STORAGE FACILITY AND CITY COUNCIL APPROVED RECORDS RETENTION APPLIED.

Approved: Date: 10j (q1-2_
Department Head)
4, 4 Date: /0Approved: Cj/202 3
Approved: Date: (/
City Manager)
-115-

G<
C
pF BELLFLO N,
Fk AUTHORITY TO TRANSFER INACTIVE RECORDS

AND RECORDS INVENTORY LIST
Department:Planning Department — Business License Division Retention Period: Close + 5
years
Destruction
12/31/2025
General Description Eligibility Date:

R@Cords:

Closed Out Business Licenses FOR CITY CLERK'S OFFICE USE Box No. PL141
SKU No.RF127619573

ITEM INCLUSIVE DATES
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES IN FILE

FROM TO
1 13512 Lakewood Blvd. #F—California Body— Business License#10333 8/15/2005 2/ 5/2020 2 13536 Lakewood Blvd. #524— King Western Wear— Business License#21504 9/17/2020 9/11/2020 3 15000 Lakewood Blvd. — Laser Precision Tooling & Eng., Inc. — Business License#02711 4/16/1997 12/31/2020 4 15320 Lakewood Blvd. —The Two Diamonds Tax Services, Inc. — Business License#20333 12/5/2018 12/1/2020 5 15628 Lakewood Blvd. —Mission Fleet Services, LLC DBA Mission Fleet Services— Business License#21613 11/6/2020 11/9/2020 6 16227 Lakewood Blvd. — Bio Design Development, LLC— Business License#16783 1/1/2014 2/18/2020 7 16238 Lakewood Blvd. —L And D Plumbing — Business License#00926 7/1/1985 10/20/2020 8 16506 Lakewood Blvd. —Greater Long Beach Vascular Access Center— Business License#13624 1/25/2010 5/31/2020 9 17013 Lakewood Blvd. —Gardena Group Investment Inc. DBA Gardena Oil — Business License#09856 1/4/2005 1/31/2020 10 17220 Lakewood Blvd. —Spirit Halloween Superstore, LLC— Business License#20032 8/1/2018 10/31/2020 11 17222 Lakewood Blvd. —Sunrise Beauty International, Inc. DBA Sunrise Beauty Supply— Business License#12478 9/16/2008 6/30/2020 12 17608 Lakewood Blvd. —Gallery Motorsport— Business License#20310 11/26/2018 7/6/2020 13 17616 Lakewood Blvd. — Laktel Enterprises, Inc. — Business License#21318 5/14/2020 5/20/2020 14 10006 Lindale St. —Gerald Steven Huck— Business License#18248 11/24/2015 5/21/2020 15 9431 Los Angeles St. —2 Units—Carlos A. Salazar— Business License#17044 4/8/2014 10/17/2020 16 9439 Los Angeles St. —Rey Carillo—9439 Los Angeles—Business License#00193 7/1/1982 1/7/2020 17 10123 Maple St. — Leyva's Family Child Care— Business License#19050 2/28/2017 1/27/2020 -116-

pF BELLFIp keR AUTHORITY TO TRANSFER INACTIVE RECORDS 2

AND RECORDS INVENTORY LIST
ROwuo l'(%l¢SyEP
Department:Planning Department— Business License Division Retention Period: Close + 5
years
Destruction
12/31/2025
eneral Description Eligibility Date:GG neral D
Closed Out Business Licenses FOR CITY CLERK'S OFFICE USE Box No. PL141
SKU No.RF127619573

ITEM INCLUSIVE DATES
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES IN FILE

FROM TO
18 9103 Mapleside St. —First Nation— Business License#20555 5/1/2019 5/11/2020 19 8829 Mayne St. —Surjit K. Jalota— Business License#00941 8/18/1985 4/15/2020 20 9139 Mayne St. —Cutter Rental*- Business License#04474 1/8/1999 1/13/2020 21 10349 Monterey St. —Appleseed Preschool/Phillips Family Child Care— Business License#19865 4/17/2018 3/24/2020 22 9469 Muroc St. — Leads Goods— Business License#21286 4/1/2020 4/30/2020 23 9258 Nichols St. — D & F Forklift—Business License#21535 10/1/2020 11/9/2020 24 9133 Oak St. —Caroll, LLC— Business License#21293 4/21/2020 5/22/2020 25 9709 Oak St. — 1 Unit— McGreal Family Trust— Business License#14587 4/5/2008 4/28/2020 26 16310 Orchard Ave. —Clark (Orchard) Rental— Business License#04345 12/23/1998 1/29/2020 27 9234 Palm St. #C— Luxury Paint— Business License#18511 5/ 9/2016 3/18/2020 28 9254 Palm St. — 16 Units— BhuPinder Jalota— Business License#12745 2/3/2009 4/15/2020 29 9260 Palm St. — 16 Units— BhuPinder Jalota— Business License#12746 2/3/2009 4/15/2020 30 9444 -9446 Park St. —5 Units— Rober Saunders— Business License#17425 10/14/2014 2/28/2020 31 10531 Plunkett St. —Canned Heat, LLC— Business License#19203 5/22/2017 7/1/2020 32 9326 Prichard St. — 1 Unit—McClellan Siblings BLF Estate, LLC— Business License#20482 10/ 10/2018 6/24/2020 33 9608 Prichard St. —Cantu Electric— Business License#19118 4/3/2017 12/3/2020 34 9936 Ramona St. Unit 2 — Maven —Business License#21186 1/1/2020 9/21/2020 -117-

F Itl:1LFj
c``' r AUTHORITY TO TRANSFER INACTIVE RECORDS 3
gyp

AND RECORDS INVENTORY LIST
R WRVa roo0^'
Department:Planning Department— Business License Division Retention Period: Close + 5
years
Destruction
12/31/2025
General Description Eligibility Date:

RecoS:

Closed Out Business Licenses FOR CITY CLERK'S OFFICE USE ofBox No. PL141
SKU No.RF127619573
ITEM

INCLUSIVE DATES
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES IN FILE

FROM TO
35 9936 Ramona St. #16—Want It More— Business License#21371 6/23/2020 8/11/2020 36 9020 Rose St. —Patten Company — Business License#06538 2/23/2001 1/ 1/2020 37 9349 Rose St. — Roseville LLC DBA Bellflower Christian Ret Ctr— Business License#16560 11/15/2013 9/14/2020 38 9130 Rosecrans Ave. —Star Express Car Wash — Business License#21068 12/16/2019 1/2/2020 39 9509 Rosecrans Ave. — Eurobilt Clothing — Business License#19036 3/1/2017 11/5/2020 40 9530 Rosecrans Ave. — 1 Unit—GHO Lmien— Business License#15464 5/ 8/2012 12/1/2020 41 9900 Ramona St. Apt. #12—CCSILHOUETTE— Business License#21640 11/20/2020 12/18/2020 42 10244 Rosecrans Ave. — B & B Pharmacy— Business License#18449 4/6/2016 10/4/2020 43 10340 Rosecrans Ave. —Apex Smog — Business License#18151 10/12/2015 10/29/2020 44 15345 Ryon Ave. —2 Units—Gerald F. &Joann Higginbotham— Business License#13812 4/8/2007 9/24/2020 45 9443 Somerset Blvd. — Fordstarr Janitorial— Business License#20855 8/2/2019 8/11/2020 46 9612 Somerset Blvd. —S & S Solutions— Business License#21133 1/14/2020 6/1/2020 47 9732 Somerset Blvd. — IDC Embroidery—Business License#16273 7/ 8/2013 11/1/2020 48 9765 Somerset Blvd. — Mini Culichi— Business License#20387 1/10/2019 1/9/2020 49 13514 Tangier Ave. — NE Plus Ultra— Business License#20625 5/1/2019 2/1/2020 50 10259 Van Ruiten St. —Goodfellas Fleetwash, LLC DBA Goodfellas Fleetwash— Business License#21538 10/1/2020 10/20/2020 51 15929 Virginia Ave. —Tidalwave Enterprises, Inc. Gc— Business License#16978 3/19/2014 2/20/2020 -118-

E.t_,L"w`
k AUTHORITY TO TRANSFER INACTIVE RECORDS 4

AND RECORDS INVENTORY LIST
Department:Planning Department— Business License Division Retention Period: Close + 5
years
Destruction
12/31/2025
General Description Eligibility Date:
of Records:

Closed Out Business Licenses FOR CITY CLERK'S OFFICE USE _ Box No. PL141
SKU No.RF127619573

ITEM INCLUSIVE DATES
NO. DESCRIPTION OF SPECIFIC RECORDS OR FILES IN FILE

FROM TO
52 15919 Virginia Ave. —Tri County Development& Construction, Inc. — Business License#20915 9/16/2019 8/4/2020 53 10030 Washington St. — 1 Unit— David & Betty Valadao— Business License#14053 7/14/2010 2/21/2020 54 17624 Windward Ter. —Moss Haus— Business License#18154 10/13/2015 9/30/2020 55 13414 Woodruff Ave. — Precision Instrument Repair Co. — Business License#00183 7/1/1982 6/1/2020 56 14325 Woodruff Ave. — Rosewood Barber Shop— Business License#10527 10/28/2005 10/26/2020 57 15522— 15524 Woodruff Ave. — 17 Units—David Belinowiz— Business License#18900 11/30/2016 11/4/2020 58 16433 Woodruff Ave. Apt. #35—Kevin's Physical Therapy and Wellness— Business License#21581 10/25/2020 12/18/2020 59 17409 Woodruff Ave. —Stonebridge Funeral and Cremation— Business License#18404 3/ 8/2016 7/31/2020 60 15153 1/4—%Woodruff Ave. —Tanner Rental— Business License#05113 4/19/1999 3/5/2020 61 925 Azalea Dr., Costa Mesa, CA 92626—Shuttle Choice Transit— Business License#20216 10/9/2018 5/21/2020 62 3 MacArthur PI. Suite 1100, Newport Beach, CA 92707— Placeworks— Business License#18263 12/1/2015 9/10/2020 63 5454 Broadway. Oakland, CA 94618—The Lew Edwards Group— Business License#21381 6/22/2020 10/31/2020 64 868 Folson St. San Francisco, CA 94107—Crown Building Maintenance— Business License#14476 2/9/2011 6/25/2020 65 101 N. Cherry St. Suite 501., Winston Salem, NC 27101 — Primo Water Operations, Inc. — Business License#21010 11/1/2019 11/30/2020 Signatures on Next Page]
-119-

G,
OFBELL"
4""''
AUTHORITY TO TRANSFER INACTIVE RECORDS 5

AND RECORDS INVENTORY LIST
QkO_NG TOOE-F0.

Department:Planning Department— Business License Division Retention Period: Close + 5
years
Destruction
12/31/2025
General Description Eligibility Date:

Records: Closed Out Business Licenses FOR CITY CLERK'S OFFICE USE ofBox No. PL141
SKU No.RF127619573

ITEM INCLUSIVE DATES
NO. DESCRIPTION OF SPECIFIC RECORDS OR FILES IN FILE

FROM TO

I AUTHORIZE THE RECORDS CONTAINED HEREIN TO BE TRANSFERRED TO THE OFFSITE STORAGE FACILITY AND CITY COUNCIL APPROVED RECORDS RETENTION APPLIED.

Approved: s ' tvik, Date:1°1 tCt1 23
Dyoartment Head)
Approved: Date: 7.51( 02-3
Approved: Date: /y `L`f ,3
CI y Manager)
-120-

AUTHORITY TO TRANSFER INACTIVE RECORDS

AND RECORDS INVENTORY LIST
4OWINQ IWEn{00.

Department:Planning Department— Business License Division Retention Period: Close + 5
years
Destruction
12/31/2025
General Description Eligibility Date:

Records:

Closed Out Business Licenses FOR CITY CLERK'S OFFICE USE Box No. PL142
SKU No.RF127619572
ITEM

INCLUSIVE DATES
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES IN FILE

FROM TO
1 Contractors: Out of City (Single)—January 2020 1/1/2020 12/31/2020 2 Contractors: Out of City (Single)— February 2020 2/1/2020 12/31/2020 3 Contractors: Out of City (Single)— March 2020 3/1/2020 12/31/2020 4 Contractors: Out of City (Single)—April 2020 4/1/2020 12/31/2020 5 Contractors: Out of City (Single)— May 2020 5/1/2020 12/31/2020 6 Contractors: Out of City (Single)—June 2020 6/1/2020 12/31/2020 7 Contractors: Out of City (Single)—July 2020 7/1/2020 12/31/2020 8 Contractors: Out of City (Single)—August 2020 8/1/2020 12/31/2020 9 Contractors: Out of City (Single)—September 2020 9/1/2020 12/31/2020 10 Contractors: Out of City (Single)—October 2020 10/1/2020 12/31/2020 11 Contractors: Out of City (Single)—November 2020 11/1/2020 12/31/2020 12 Contractors: Out of City (Single)— December 2020 12/1/2020 12/31/2020 13 Contractors: Out of City (Yearly)—January 2020 1/1/2020 12/31/2020 14 Contractors: Out of City (Yearly)—February 2020 2/1/2020 12/31/2020 15 Contractors: Out of City (Yearly)—March 2020 3/1/2020 12/31/2020 16 Contractors: Out of City (Yealy)—April 2020 4/1/2020 12/31/2020 17 Contractors: Out of City (Yearly)— May 2020 5/1/2020 12/31/2020 -121-

V
Y pF BELLFLp
wFk AUTHORITY TO TRANSFER INACTIVE RECORDS 2

AND RECORDS INVENTORY LIST
ROWING TOOET"Q*
Department:Planning Department— Business License Division Retention Period: Close + 5
years
Destruction
12/31/2025
General Description Eligibility Date:
of Records:

Closed Out Business Licenses FOR CITY CLERK'S OFFICE USE Box No. PL142
SKU No.RF127619572
ITEM

INCLUSIVE DATES
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES IN FILE

FROM TO
18 Contractors: Out of City (Yearly)—June 2020 6/1/2020 12/31/2020 20 Contractors: Out of City (Yearly)—July 2020 7/1/2020 12/31/2020 20 Contractors: Out of City (Yearly)—August 2020 8/1/2020 12/31/2020 21 Contractors: Out of City (Yearly)—September 2020 9/1/2020 12/31/2020 22 Contractors: Out of City (Yearly)—October 2020 10/1/2020 12/31/2020 23 Contractors: Out of City (Yearly)— November 2020 11/1/2020 12/31/2020 24 Contractors: Out of City (Yearly)— December 2020 12/1/2020 12/31/2020 25 2020 Fireworks Stands Refundable Deposits 7/ 14/2020 12/31/2020 26 2020 Approved Fireworks Stands Letters 5/4/2020 12/31/2020 27 2020 Approved Fireworks Stands Waiting List Groups 5/4/2020 12/31/2020 28 2020 Fireworks Stands Misc. Permits 3/23/2020 12/31/2020 29 2020 Fireworks Stands Application Packets 3/23/2020 12/31/2020 30 2020 Fireworks Stand Financial Reports 3/23/2020 12/31/2020 31 2020 Fireworks Stands Representatives Social Distancing Protocols Letters 5/13/2020 12/31/2020 32 2020 Fireworks Stands Application Packets Letters 2/10/2020 12/31/2020 33 2020 Fireworks Stands Letters of Intent 12/23/2019 12/31/2020 34 13640 Bellflower Blvd. — Filming Date: October 27, 2020— NFL Network Services, LLC—02-04-PD 10/27/2020 10/27/2020 -122-

C ppBELLFLOwek AUTHORITY TO TRANSFER INACTIVE RECORDS 3

AND RECORDS INVENTORY LIST
OR N•Ma loot/"EP
Department:Planning Department — Business License Division Retention Period: Close + 5
years
Destruction
12/31/2025
eneral Description Eligibility Date:GG
Cords:

Closed Out Business Licenses FOR CITY CLERK'S OFFICE USE ofBox No. PL142
SKU No.RF127619572

ITEM INCLUSIVE DATES
NO. DESCRIPTION OF SPECIFIC RECORDS OR FILES IN FILE

FROM TO
35 9030 Somerset Blvd. (HSP)—Filming Date: August 25, 2020— Filming Date: August 25, 2020—Fatking Films, LLC—02- 8/25/2020 8/25/202003-PD
36 13640 Bellflower Blvd. —Filming Date: August 07, 2020— BAM Production—02-02-PD 8/7/2020 8/7/2020 37 9030 Somerset Blvd. —(Hollywood Sports Park) - Filming Date: January 08, 2020—Tilta, Inc. —02-01-PD 1/8/2020 1/8/2020 38 2020 Bingo Renewals 2/28/2020 2/28/2020
39 2020 Block Party Permits 1/1/2020 12/31/2020
40 2020 D & E Permit Renewals 1/20/2020 12/31/2020

I AUTHORIZE THE RECORDS CONTAINED HEREIN TO BE TRANSFERRED TO THE OFFSITE STORAGE FACILITY AND CITY COUNCIL APPROVED RECORDS RETENTION APPLIED.

G.A.0
Vl+ t ° IQ I)-5Approved: Date:OP (Department Head) Approved:
4 /: , _ _ _
I` - Date: /U 9 7-ei3
Cit
Approved: Date: k(74/1.A
fylanager)
-123-

DocuSign Envelope ID: 99D37667-651D-4F1B-8124-B218733BE159

AUTHORITY TO TRANSFER INACTIVE RECORDS

AND RECORDS INVENTORY LIST
Department:Planning Division Retention Period:2 years
General Description
of Records:

Various Planning Records
Destruction
Eligibility Date:
12/31/2025
FOR CITY CLERK':3 0FFICE USE
i Box No.:..' -o PL157.

LS__K_!INO. " ,,a,_,RF127619452
ITEM
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES

INCLUSIVE DATES

IN FILE

FROM TO
1 Planning Department Correspondence 1/1/2021 6/30/2021 2 Temporary Use Permit (TUPs) Applications 171/2022 10/31/2022 3 Business Recovery Program Applications 7/1/2020 4/30/2021 4 2021-2023 Temporary Sign Applications 6/1/2021 II /30/2023

I AUTHORIZE THE RECORDS CONTAINED HEREIN TO BE TRANSFERRED TO THE OFFSITE STORAGE FACILITY AND CITY COUNCIL APPROVED RECORDS RETENTION APPLIED.

Approvedo
Approved:
eThD"i5us4gnatAzdby (%i
Department
6/5/2024 I 9:55 AM PDT
Date:
o-t-= (-7'[]/2f
-124-

DocuSigtar
Elizabeth Oba
eoba@bellflower-org
Security Level: Email, Account Authentication
None)
I;'a"-y'hh
Signature Adoption: Pre-selected Style
Using IP Address:

Sent: 6/3/2024 2:07:14 PM
Resent: 6/5/2024 9:44:54 AM
Viewed: 6/5/2024 9:55:04 AM
Signed: 6/5/2024 9:55:12 AM
Electronic Record and ":i3n.aturb D;*Ju*uiv.

Aooepted: 6/5/2024 9:55:04 AM
ID: 279849bc-c399-40d-9780-d7b11c5fae23
-125-

Electronic Record and Signature Disclosure created on: 6/8/2020 10:47:26 AM Parties agreed to: Elizabeth Oba

Please read the information below carefully and thoroughly, and if you can access this information electronically to your satisfaction and agyee to this Electronic Record and Signature Disclosure (ERSD), please confirm your agreement by selecting the check-box next to 'I agyee to use electronic records and signatures' before clicking 'CONTINUE' within the DocuSign system.

Getting paper copies
At anytime, you may request from us a paper copy of any record provided or made available electronicallyto you byus. You will have the ability to download and pit documents we send to you tbrough the DocuSign system duig and immediately after the signing session and, if you electto create a DocuSign account, you may access the documents for a limited period of time usually 30 days) after such documents are first sent to you. After such time, if you wish forus to send you paper copies of any such documents from our office to you, you will be charged a

0.00 per-page fee. You may request delivery of such paper copies firom us by following the procedure described below.

Withdrawing your consent
If you decide to receivc notices and disclosures from us electronically, you may at anytime change your mind and tell us that thereafter you want to receive required notices and disclosures only in paper format. How you must inform us of your decision to receive fiuture notices and disclosure in paper format and withdraw your consent to receive notices and disclosures electronically is described below.

Consequences of changing your mind
Ifyou elect to receive required notices and disclosures only in paper format, it will slow the speed at which we can complete certain steps in transactions with you and deliveffig services to you because we will need first to send the required notices or disclosures to you in paper format, and then wait until we receive back from you your acknowledgment of your receipt of such paper notices or disclosures. Further, you will no longer be able to use the DocuSign system to receive required notices and consents electronically from us or to sign electronically documents from us.

All notices and disclosures wffl be sent to you electronically -126-

Unless you tell us otherwise in accordance with the procedures described herein, we will provide electronically to you tmough the DocuSign system all required riotices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to you duffig the course of our relationship with you. To reduce the chance of you inadvertently not receiving any notice or disclosure, we prefer to provide all of the required notices and disclosures to you by the same method and to the same address that you have given us. Thus, you can receive all the disclosures and notices electronically or in paper format through the paper mail delivery system. If you do not agyee with this process, please let us know as described below. Please also see the paragraph immediately above that describes the consequences of your electing not to receive delivery of the notices and disclosures electronically from us.

How to contact City of Bellflowera
You may contact us to let us know of your changes as to how we may contact you electronically, to request paper copies of certain information from us, and to withdraw your prior consent to receive notices and disclosures electronically as follows:

Ifyou created a DocuSign account, you may update it with your new email address through your account preferences.

To request paper copies from City of Benflower
To request delivery from us of paper copies ofthe notices and disclosures previously provided by us to you electronically, you must send us an email to [email protected] and in the body of such request you must state your email address, full name, mailinz ar1dreqs, and telephone number. We will bill you for any fees at that time, if any.

To withdraw your consent with City of Bellflower
To inform us that you no longer wish to receive future notices and disclosures in electronic fomnat you may:
-127-

i. decline to sign a document from within your signing session, and on the subsequent page, select the check-box indicating you wish to withdraw your consent, or you may; ii. send us an email to [email protected] and in the body of such request you must state your email, full name, mailing address, and telephone number. We do not need any other information from you to withdraw consent.. The consequences of your withdrawing consent for online documents will be that transactions may take a longer time to process..

Required hardware and software
The minimum system requirements forusing the DocuSign system may change over time. The current system requirements are found here: https://support.docusign.com/guides/signer-guide- signing-system-requirements.

Arknmvlcd4yxy 3uux aiieSS and consent to receive and sign documents electronically To confirm to us that you can access tbis information electronically, which will be similar to other electronic notices and disclosures that we will provide to you, please confirm that you have read this ERSD, and (i) that you are able to print on paper or electronically save this ERSD for your future reference and access; or (ii) that you are able to email this ERSD to an email address where you will be able to pit on paper or save it for your future reference and access. Further, if you consent to receiving notices and disclosures exclusively in eiectronic format as described herein, then select the check-box next to 'I agree to use electronic records and signatures' before clicking cCONTINUE' within the DocuSign system-
By selecting the check-box next to 'I agree to use electronic records and signatures', you confirm that:

You can access and read this Electronic Record and Signature Disclosure; and You can pit on paper this Electronic Record and Signature Disclosure, or save or send this Electronic Record and Disclosure to a location where you can pit it, for future reference and access; and
Until or unless you notify City of Bellflower as described above, you consent to receive exclusively through electronic means all notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to you by City of Bellflower duig the course of your relationship with City of Bellflower
-128-

D
D

D
00 00 0
0 0
c(
n
m
rn
CL
a.

D—

C
Os
m
N m
m Om
0 a 0 O
m mo
z 00 Zz
D z m
o
m m z O 0 m
o
O
p
CD
m
o'

c
7C
3 0
cn
cn
o
v
-

ri
a
3 "

o
CD
m
r
cl
s

(
Da
.
,

aM
o
v
-
mo
i
cn

-
v
=

O
0 n
C/
)

O
-

o rm
l
l
Z

D
rn
Z
Om
M<
rz
n m m 0 O v
cn
o
o
mo
o
C
x
-
n
cn

Z
0 o
FE
rn
m.

O
N
N
N
n
v'

m
N
c(
n
cn
N
m
cn
Zm
00 rn
31 .

A
w
N
O
c
n
c=

c
c
n
c
O
O
O
cD
O
O
cn
cn
o
m
cn
cn
0 3
3 3
3 3
CD
Q
cn
m
m
m rm
+
kr
m
t
f
t
o
r
M
i
f
t
o
o
o
0 0
C
v
m
m
m
m
D
D
D
D
D
G7
OD
G1
G)

o
r-
+

0 r
-
h
ry
-

o G)

o
MM
I v
O z
o
O
v
Ct
)
n m O 0
0 0
0 0
0 0
0 0
0 r
0 0
00 i
i
rn

r
n
C
z
m
N

N
N
N
N
N
N
N
m
o
A)

w
w
w
w
w
w
D
mx N
N
N

N
N
N
N
N
O
m
O N
O

O
o
O
o
0 0
Cl
)

N
O
O
00 I
O
O
Ui
o
O
p
CD
m
o'

c
7C
3 0
cn
cn
o
v
-

ri
a
3 "

o
CD
m
r
cl
s

(
Da
.
,

aM
o
v
-
mo
i
cn

-
v
=

O
0 n
C/
)

O
-

o rm
l
l
Z

D
rn
Z
Om
M<

rz
n m m 0 O v
cn
o
o
mo
o
C
x
-
n
cn

Z
0 o
FE
rn
m.

O
N
N
N
n
v'

m
N
c(
n
cn
N
m
cn
-129-

AUTHORITY TO TRANSFER INACTIVE RECORDS

AND RECORDS INVENTORY LIST
1 Department:Public Safety Retention Period:2 Years
General Description
of Records:
2022 General Office Files
Destruction
Eligibility Date:
12/31/2024

FOR CITY CLERK'S OFFICE USE
Box No.PS130
Barcode No.62057589
ITEM
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES

INCLUSIVE DATES

IN FILE

FROM TO
1 2022 — Weekly Field Activity Reports 1/1/2022 12/31/2022 2 2022 — Legal Advertising / Notices / Proofs of Publication / Hearing Notices 1/1/2022 12/31/2022 3 2022 — Administrative citation payment plans 1/1/2022 12/31/2022 4 2022 — Administrative citations 1/1/2022 12/31/2022
5 2022 — Administrative citation hearings 1/1/2022 12/31/2022 6 2022 — Permit parking applications 1/1/2022 12/31/2022 7 2022 — Incoming/outgoing correspondence 1/1/2022 12/31/2022 8 2022 — Administrative Citations and Parking Citations (Handwritten)1/1/2022 12/31/2022 9 2022 — Public Safety Commission and Public Safety Review Committee Annotated Agendas 1/1/2022 12/31/2022

I AUTHORIZE THE RECORDS CONTAINED HEREIN TO BE TRANSFERRED TO THE OFFSITE STORAGE FACILITY AND CITY COUNCIL APPROVED REORDS RETENTION APPLIED.

Approved:

Department Head)
Date: 3 ' 4 -4i7
Date: 31q/ a" 0
-130-

AUTHORITY TO TRANSFER INACTIVE RECORDS

AND RECORDS INVENTORY LIST
1 Department:Public Safety Retention Period:2 Years
General Description
of Records:

General Office Files for Various Years (2009, 2018, 2021, and 2022) Destruction
Eligibility Date:
12/31/2024

FOR CITY CLERK'S OFFICE USE
Box No.PS131
Barcode No.62057590
ITEM
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES

INCLUSIVE DATES

IN FILE

FROM TO
1 2009 — Emergency Operation Plan (Plan was superseded in 2018)6/1/2009 10/18/2018 2 2021 — False alarm warning letters and violation notices 1/1/2022 12/31/2022 3 2022 - Stypmann hearings 1/1/2022 12/31/2022
4 2021/2022 — Public Safety Commission and Public Safety Review Committee Meeting Recordings 1/1/2021 12/31/2022

I AUTHORIZE THE RECORDS CONTAINED HEREIN TO BE TRANSFERRED TO THE OFFSITE STORAGE FACILITY AND CITY COUNCIL APPROVED RECORDS RETENTION APPLIED.

Approved:

Department Head)
Approved:

City Clerk)City
C/g/Ifyy^:^-
Date: 3 &
Date: 3 (i i- -
-131-

AUTHORITY TO TRANSFER INACTIVE RECORDS

AND RECORDS INVENTORY LIST - MULTIPLE BOXES IN SINGLE RECORD SERIES 1 Department:Public Safety Retention Period:2 Years
General Description
of Records:
2022 Tow Releases
Destruction Eligibility
Date:
12/31/2024
ITEM
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES

INCLUSIVE DATES

IN FILE
Box No.Barcode No.

FROM TO
1 2022 — Tow release documents 1/1/2022 6/30/2022 PS132 62057592 2 2022 — Tow release documents 7/1/2022 12/31/2022 PS133 62057591

I AUTHORIZE THE RECORDS CONTAINED HEREIN TO BE TRANSFERRED TO THE OFFSITE STORAGE FACILITY AND CITY COUNCIL APPROVED RECORDS RETENTION APPLIED.

Approved: 44 --
Department Head)
Approved:

Date: t{.1!
Date:
-132-

AUTHORITY TO TRANSFER INACTIVE RECORDS
AND RECORDS INVENTORY LIST 4o DELLFLnw ER

44. Department:Public Safety Retention Period:2 Years
General Description
of Records:
2022 City Tows (CHP 180 Forms)
Destruction
Eligibility Date:
12/31/2024

FOR CITY CLERK'S OFFICE USE
Box No.PS134
Barcode No.62057593
ITEM
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES

INCLUSIVE DATES

IN FILE

FROM TO
1 2022 City Tows (CHP 180 Forms)1/1/2022 12/31/2022

I AUTHORIZE THE RECORDS CONTAINED HEREIN TO BE TRANSFERRED TO THE OFFSITE STORAGE FACILITY AND CITY COUNCIL APPROVED RECORDS RETENTION APPLIED.

Approved:Date:

Department Head)
Approved:
lerk)
-133-

AUTHORITY TO TRANSFER INACTIVE RECORDS

AND RECORDS INVENTORY LIST
1 Department:Public Safety Retention Period:Various
General Description
of Records:

Miscellaneous Grants —Various Years: Justice Assistance Grants 2009-2014, Dui Checkpoint Grants 2011-2014, Cops Grant 2012, UCB Sobriety Checkpoint Grant 2013, UCB Click It or Ticket Grant 2007-2011
Destruction
Eligibility Date:
12/31/2024

FOR CITY CLERK'S OFFICE USE
Box No.PS135
Barcode No.62057594
ITEM
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES

INCLUSIVE DATES

IN FILE

FROM TO
1 Justice Assistance Grants 2009-2014 1/1/2009 12/31/2014 2 COPS Grant 2012 1/1/2012 12/31/2012
3 DUI Checkpoints Grant 2011-2014 1/1/2011 12/31/2014
4 University of California Berkeley Sobriety Checkpoint Grant 2013 1/1/2013 12/31/2013 5 University of California Berkeley "Next Generation — Click It or Ticket" 2007-2011 1/1/2007 12/31/2011

I AUTHORIZE THE RECORDS CONTAINED HEREIN TO BE TRANSFERRED TO THE OFFSITE STORAGE FACILITY AND CITY COUNCIL APPROVED RECORDS RETENTION APPLIED.

Approved: Date:

Approved:

Department Head)
City Clerk)
Date: `-.3/(//262-(0
-134-

AUTHORITY TO TRANSFER INACTIVE RECORDS

AND RECORDS INVENTORY LIST
1 Department:Public Safety Retention Period:2 Years
General Description
of Records:
2023 City Tows (CHP 180 Forms)
Destruction
Eligibility Date:
12/31/2025

FOR CITY CLERK'S OFFICE USE
Box No.PS136
Barcode No.62057595
ITEM
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES

INCLUSIVE DATES

IN FILE

FROM TO
1 City Tows (CHP 180 Forms) 2023 1/1/2023 12/31/2023

I AUTHORIZE THE RECORDS CONTAINED HEREIN TO BE TRANSFERRED TO THE OFFSITE STORAGE FACILITY AND CITY COUNCIL APPROVED RECORDS RETENTION APPLIED.

Approved:

Department Head)
Date: ? b
Date: 5/ y
-135-

AUTHORITY TO TRANSFER INACTIVE RECORDS

AND RECORDS INVENTORY LIST - MULTIPLE BOXES IN SINGLE RECORD SERIES 1 Department:Public Safety Retention Period:2 Years
General Description
of Records:

Tow Release Documents 2023
Destruction Eligibility
Date:
12/31/2025
ITEM
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES

INCLUSIVE DATES

IN FILE
Box No.Barcode No.

FROM TO
1 Tow release documents — January -April 2023 1/1/2023 4/30/2023 PS137 62057585 2 Tow release documents — May -September 2023 5/1/2023 9/30/2023 PS138 62057586 3 Tow release documents — October -December 2023 10/1/2023 12/31/2023 PS139 62057598

I AUTHORIZE THE RECORDS CONTAINED HEREIN TO BE TRANSFERRED TO THE OFFSITE STORAGE FACILITY AND CITY COUNCIL APPROVED RECORDS RETENTION APPLIED.

Approved:

Department Head)
Approved:1
Ierk)
Date:

Date: 31V12-6
-136-

AUTHORITY TO TRANSFER INACTIVE RECORDS

AND RECORDS INVENTORY LIST
1 Department:Public Safety Retention Period:2 Years
General Description
of Records:

Miscellaneous Department Files: 2023 Handwritten Citations, Administrative Citation Payment Plans 2023, Tow Releases 2020, Stypmann Hearings 2023, Public Notices 2023, Bravo 2023
Destruction
Eligibility Date:
12/31!2025

FOR CITY CLERK'S OFFICE USEE
Box No.PS140
Barcode No.62057597
ITEM
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES

INCLUSIVE DATES

IN FILE

FROM TO
1 Handwritten Citations — 2023 01/01/2023 12/31/2023
2 Administrative Citation Payment Plans — 2023 01/01/2023 12/31/2023 3 Administrative Citation Hearings — 2023 01/01/2023 12/31/2023 4 False Alarm Warning Letters and Violation Notices - 2023 01/01/2023 12/31/2023 5 Incoming/Outgoing Correspondence - 2023 01/01/2023 12/31/2023 6 BRAVO 2023 11/22/2023 12/31/2023
7 Tow Releases -2020 01/01/2020 03/31/2020
8 Public Safety Commission/Public Safety Review Committee Annotated Agendas 01/01/2023 12/31/2023 9 Stypmann Hearings — 2023 01/01/2023 12/31/2023
10 Public Notices - 2023 01/01/2023 12/31/2023
-137-

AUTHORITY TO TRANSFER INACTIVE RECORDS

AND RECORDS INVENTORY LIST
2 Department:Public Safety Retention Period:2 Years
General Description
of Records:

FOR CITY CLERK'S OFFICE USE
Box No.PS140
Barcode No.62057597
ITEM
NO.DESCRIPTION OF SPECIFIC RECORDS OR FILES

INCLUSIVE DATES

IN FILE

FROM TO

I AUTHORIZE THE RECORDS CONTAINED HEREIN TO BE TRANSFERRED TO THE OFFSITE STORAGE FACILITY AND CITY COUNCIL APPROVED RECORDS RETENTION APPLIED.

Approved:Date: 3 _ / — ,Vo
-138-

AUTHORITY TO TRANSFER INACTIVE RECORDS

AND RECORDS INVENTORY LIST
1 Department:Public Safety Retention Period:2 Years
General Description
of Records:

Miscellaneous Department Files: 2023 Parking Permit Applications, 26 Week Summary of Crimes Reports, Weekly Field Activity Reports, Administrative Citations, Public Safety Commissions Meeting Recordings
Destruction
Eligibility Date:
12/31/2025

FOR CITY CLERK'S OFFICE USE
Box No.PS141
Barcode No.62057596
ITEM
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES

INCLUSIVE DATES

IN FILE

FROM TO
1 Parking Permit Applications - 2023 01/01/2023 12/31/2023 2 26 Week Summary of Crimes Reports — 2023 01/01/2023 12/31/2023 3 Weekly Field Activity Reports - 2023 01/01/2023 12/31/2023 4 Administrative Citations — 2023 01/01/2023 12/31/2023 5 Public Safety Commission Meeting Recordings - 2023 01/01/2023 12/31/2023

I AUTHORIZE THE RECORDS CONTAINED HEREIN TO BE TRANSFERRED TO THE OFFSITE STORAGE FACILITY AND CITY COUNCIL APPROVED RECORDS RETENTION APPLIED.

Approved: '
Department Head)
Date:
-139-

0 0
0 cD
0 0_
RL
r 0
D 0_
U) C: U) m
o D -
n
c Z
Cm
C
O
O
OD m
CDm
G)
z
00 I ;
u
W
w.
o
O
0 a.

Z 700Z
N
C7
o
r-
0 C
N
C/)
n
C
F=
m mo D
N —
I
C
m
CD
Cl)
rn _
Z
70 m O Cn O 7
t O co m O m
C 2 O
mDpZ
C nm
i
z0n m X O 7
Cl)
0 N
n
Cf)
0 m7 700
c NIN_
w. 05
z pON) -140-

0 0
cn
cD
CL
Q-
R 0 Q-
ZmOE:

C U) m v D -
n c Z
m
c0D
o
ni: mem Mz o
0 o
X
m
m0
Cb
may
wS
o
O
cD a.

Z
cn
Z
N
C7
o 0
r- c
N
n
n
r=
m m0
T
N o o
m C/)
0-)
rt
O
Z
cn
c
Tm
0 0 N
OC)
ZOO
01 w
X
00 u
0 m O
O
cn
m
O
r r n r O m
T
a
rt
O cn
c O
mDpZCC:

U) rn
n
D C7 m m O iCJ D cn
-141-

0 0 m

0. Q-
0 c w CL
cD
C: U) m v
C Z
m
C
OZ
O
0 i:
m 70
D
m
C
G)
z
O
I
E-)
7 m
SCD
m0
o
mZ-
j
D
w_
o
O
m
Z
0- IQ
N
7 O O
r C
N
C/)
n <
m
m
o D
N
I
O O
m C/)
0')_
Z DnCf)
Oiv
m :
u
O
XO
x m O O Cf) O 7 I
o Z0
O co71mr- O m
C 2
7 O
mDpz Cl)
m z0n m m O SCJ O Cf)
CD
0 I
0 00*
Z — p0x
Qc)
rrqr
-142-

AUTHORITY TO TRANSFER INACTIVE RECORDS

AND RECORDS INVENTORY LIST V OF
CLLFLOwFR
igIWINu nx\\l\r'
Department:Municipal Water System Retention Period: 7 years Destruction
12/31/2022
General Description Eligibility Date:
of Records:

MUNICIPAL WATER SYSTEM FINANCIAL RECORDS FOR CITY CLERK'S OFFICE USE Box No. MWS15
SKU No.RF127619524
ITEM

INCLUSIVE DATES
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES IN FILE

FROM TO
1 CHECK REGISTER WITH SUPPORTING BACK UP 9/1/2011 12/31/2012 2 MUNI FOLDER: PROPOSED & DRAFT BUDGETS, P&L PREVIOUS YEAR COMPARE, BALANCE SHEETS, ADP 7/1/2007 6/30/2015BILLINGS
Note: This box was found by Bellflower Somerset Municipal Water Company on February 12, 2024, and provided to the City of Bellflower for retention.

I AUTHORIZE THE RECORDS CONTAINED HEREIN TO BE TRANSFERRED TO THE OFFSITE STORAGE FACILITY AND CITY COUNCIL APPROVED RECORDS RETENTION APPLIED.

Approved: Date:

Department Head)
Approved: Date:

City Clerk)
Approved: Date:

City Manager)
DocuSign Envelope ID: 7D78BF14-96FB-48F4-A62A-A0CB2F57D508 3/12/2024 | 12:21 PM PDT
3/18/2024 | 9:42 AM PDT
DocuSign Envelope ID: 70C97F78-68BA-432F-93B6-B8178FA78269 Department Head)
Approved: _________________________________________________ Date: ____________ DocuSign Envelope ID: 25BD4776-CA3D-4456-AF4C-26C8FA9A7F43 3/18/2024 | 12:36 PM PDT
3/19/2024 | 12: 09 PM PDT
-143-

AUTHORITY TO TRANSFER INACTIVE RECORDS

AND RECORDS INVENTORY LIST
a,

DCLLFLOWFR
401146
Department:Municipal Water System Retention Period: 7 years Destruction
12/31/2020
General Description Eligibility Date:
of Records:

MUNICIPAL WATER SYSTEM FINANCIAL RECORDS FOR CITY CLERK'S OFFICE USE Box No. MWS17
SKU No.RF127619522
ITEM

INCLUSIVE DATES
NO.

DESCRIPTION OF SPECIFIC RECORDS OR FILES IN FILE

FROM TO
1 CHECK REGISTER WITH SUPPORTING BACK UP 7/1/2010 6/30/2013 Note: This box was found by Bellflower Somerset Municipal Water Company on February 12, 2024, and provided to the City of Bellflower for retention.

I AUTHORIZE THE RECORDS CONTAINED HEREIN TO BE TRANSFERRED TO THE OFFSITE STORAGE FACILITY AND CITY COUNCIL APPROVED RECORDS RETENTION APPLIED.

Approved: Date:

Department Head)
Approved: Date:

City Clerk)
Approved: Date:

City Manager)
DocuSign Envelope ID: 7D78BF14-96FB-48F4-A62A-A0CB2F57D508 3/12/2024 | 12:21 PM PDT
3/18/2024 | 9:42 AM PDT
DocuSign Envelope ID: 70C97F78-68BA-432F-93B6-B8178FA78269 Department Head)
Approved: __________________________________________________ Date: ____________ DocuSign Envelope ID: 25BD4776-CA3D-4456-AF4C-26C8FA9A7F43 3/18/2024 | 12:36 PM PDT
3/19/2024 | 12:09 PM PDT
-144-

Certificate Of Completion
Envelope Id: 7D78BF1496FB48F4A62AA0CB2F57D508 Status: Completed Subject: Complete with DocuSign: Authority to Transfer Inactive Records - MWS14 to MWS18.pdf Source Envelope:

Document Pages: 5 Signatures: 10 Envelope Originator:

Record Tracking
Status: Original
3/11/2024 10:32:26 AM
Holder: City Clerk
[email protected]
Location: DocuSign
Signer Events Signature Timestamp
Len Gorecki
[email protected]
Security Level: Email, Account Authentication
None)
Signature Adoption: Pre-selected Style
Using IP Address:

Sent: 3/11/2024 10:35:09 AM
Resent: 3/12/2024 11:44:08 AM
Viewed: 3/12/2024 12:17:05 PM
Signed: 3/12/2024 12:21:54 PM
Electronic Record and Signature Disclosure:

Accepted: 3/12/2024 12:17:05 PM
ID: 7225575a-cbf0-40d3-ba6e-d01896f9db71
Ryan Smoot
[email protected]
Security Level: Email, Account Authentication
None)
Signature Adoption: Drawn on Device
Using IP Address:

Signed using mobile
Sent: 3/12/2024 12:21:55 PM
Resent: 3/18/2024 9:25:22 AM
Viewed: 3/18/2024 9:42:27 AM
Signed: 3/18/2024 9:42:54 AM
Electronic Record and Signature Disclosure:

Accepted: 3/18/2024 9:42:27 AM
ID: 8803fa8d-f914-4ee8-b670-81a7f07aff5f
In Person Signer Events Signature Timestamp
Editor Delivery Events Status Timestamp
Agent Delivery Events Status Timestamp
Intermediary Delivery Events Status Timestamp
Certified Delivery Events Status Timestamp
Carbon Copy Events Status Timestamp
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 3/11/2024 10:35:09 AM
DocuSign Envelope ID: 70C97F78-68BA-432F-93B6-B8178FA78269DocuSignEnvelopeID: 25BD4776-CA3D-4456-AF4C-26C8FA9A7F43 -145-

Envelope Summary Events Status Timestamps
Certified Delivered Security Checked 3/18/2024 9:42:27 AM Signing Complete Security Checked 3/18/2024 9:42:54 AM
Completed Security Checked 3/18/2024 9:42:54 AM
Payment Events Status Timestamps
Electronic Record and Signature Disclosure
DocuSign Envelope ID: 70C97F78-68BA-432F-93B6-B8178FA78269DocuSignEnvelopeID: 25BD4776-CA3D-4456-AF4C-26C8FA9A7F43 -146-

Please read the information below carefully and thoroughly, and if you can access this information electronically to your satisfaction and agree to this Electronic Record and Signature Disclosure (ERSD), please confirm your agreement by selecting the check-box next to ‘I agree to use electronic records and signatures’ before clicking ‘CONTINUE’ within the DocuSign system.

0.00 per-page fee. You may request delivery of such paper copies from us by following the procedure described below.

All notices and disclosures will be sent to you electronically Electronic Record and Signature Disclosure created on: 6/8/2020 10:47:26 AM Parties agreed to: Len Gorecki, Ryan Smoot
DocuSign Envelope ID: 70C97F78-68BA-432F-93B6-B8178FA78269DocuSignEnvelopeID: 25BD4776-CA3D-4456-AF4C-26C8FA9A7F43 -147-

Unless you tell us otherwise in accordance with the procedures described herein, we will provide electronically to you through the DocuSign system all required notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to you during the course of our relationship with you. To reduce the chance of you inadvertently not receiving any notice or disclosure, we prefer to provide all of the required notices and disclosures to you by the same method and to the same address that you have given us. Thus, you can receive all the disclosures and notices electronically or in paper format through the paper mail delivery system. If you do not agree with this process, please let us know as described below. Please also see the paragraph immediately above that describes the consequences of your electing not to receive delivery of the notices and disclosures electronically from us.

How to contact City of Bellflower:

You may contact us to let us know of your changes as to how we may contact you electronically, to request paper copies of certain information from us, and to withdraw your prior consent to receive notices and disclosures electronically as follows:

If you created a DocuSign account, you may update it with your new email address through your account preferences.

To request paper copies from City of Bellflower
To request delivery from us of paper copies of the notices and disclosures previously provided by us to you electronically, you must send us an email to [email protected] and in the body of such request you must state your email address, full name, mailing address, and telephone number. We will bill you for any fees at that time, if any.

To withdraw your consent with City of Bellflower
To inform us that you no longer wish to receive future notices and disclosures in electronic format you may:

DocuSign Envelope ID: 70C97F78-68BA-432F-93B6-B8178FA78269DocuSignEnvelopeID: 25BD4776-CA3D-4456-AF4C-26C8FA9A7F43 -148-

i. decline to sign a document from within your signing session, and on the subsequent page, select the check-box indicating you wish to withdraw your consent, or you may; ii. send us an email to [email protected] and in the body of such request you must state your email, full name, mailing address, and telephone number. We do not need any other information from you to withdraw consent.. The consequences of your withdrawing consent for online documents will be that transactions may take a longer time to process..

Acknowledging your access and consent to receive and sign documents electronically To confirm to us that you can access this information electronically, which will be similar to other electronic notices and disclosures that we will provide to you, please confirm that you have read this ERSD, and (i) that you are able to print on paper or electronically save this ERSD for your future reference and access; or (ii) that you are able to email this ERSD to an email address where you will be able to print on paper or save it for your future reference and access. Further, if you consent to receiving notices and disclosures exclusively in electronic format as described herein, then select the check-box next to ‘I agree to use electronic records and signatures’ before clicking ‘CONTINUE’ within the DocuSign system.

By selecting the check-box next to ‘I agree to use electronic records and signatures’, you confirm that:

DocuSign Envelope ID: 70C97F78-68BA-432F-93B6-B8178FA78269DocuSignEnvelopeID: 25BD4776-CA3D-4456-AF4C-26C8FA9A7F43 -149-

Certificate Of Completion
Envelope Id: 70C97F7868BA432F93B6B8178FA78269 Status: Delivered Subject: Complete with DocuSign: Authority to Transfer Inactive Records - MWS14-MWS18.pdf Source Envelope:

Document Pages: 10 Signatures: 0 Envelope Originator:

Certificate Pages: 4 Initials: 0 City Clerk
AutoNav: Enabled
EnvelopeId Stamping: Enabled
Time Zone: (UTC-08:00) Pacific Time (US & Canada)
16600 Civic Center Drive
16600 Civic Center Drive
Bellflower, CA 90706
[email protected]
IP Address:

Record Tracking
Status: Original
3/18/2024 9:45:52 AM
Holder: City Clerk
[email protected]
Location: DocuSign
Signer Events Signature Timestamp
Mayra Ochiqui
[email protected]
City of Bellflower
Security Level: Email, Account Authentication
None)
Sent: 3/18/2024 9:47:06 AM
Viewed: 3/18/2024 9:56:16 AM
Electronic Record and Signature Disclosure:

Accepted: 6/25/2020 3:30:32 PM
ID: de941368-19f5-405c-a721-8f946c2d8362
In Person Signer Events Signature Timestamp
Editor Delivery Events Status Timestamp
Agent Delivery Events Status Timestamp
Intermediary Delivery Events Status Timestamp
Certified Delivery Events Status Timestamp
Carbon Copy Events Status Timestamp
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 3/18/2024 9:47:06 AM
Certified Delivered Security Checked 3/18/2024 9:56:16 AM Payment Events Status Timestamps
Electronic Record and Signature Disclosure
DocuSign Envelope ID: 25BD4776-CA3D-4456-AF4C-26C8FA9A7F43 -150-

Please read the information below carefully and thoroughly, and if you can access this information electronically to your satisfaction and agree to this Electronic Record and Signature Disclosure (ERSD), please confirm your agreement by selecting the check-box next to ‘I agree to use electronic records and signatures’ before clicking ‘CONTINUE’ within the DocuSign system.

0.00 per-page fee. You may request delivery of such paper copies from us by following the procedure described below.

All notices and disclosures will be sent to you electronically Electronic Record and Signature Disclosure created on: 6/8/2020 10:47:26 AM Parties agreed to: Mayra Ochiqui
DocuSign Envelope ID: 25BD4776-CA3D-4456-AF4C-26C8FA9A7F43 -151-

Unless you tell us otherwise in accordance with the procedures described herein, we will provide electronically to you through the DocuSign system all required notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to you during the course of our relationship with you. To reduce the chance of you inadvertently not receiving any notice or disclosure, we prefer to provide all of the required notices and disclosures to you by the same method and to the same address that you have given us. Thus, you can receive all the disclosures and notices electronically or in paper format through the paper mail delivery system. If you do not agree with this process, please let us know as described below. Please also see the paragraph immediately above that describes the consequences of your electing not to receive delivery of the notices and disclosures electronically from us.

How to contact City of Bellflower:

You may contact us to let us know of your changes as to how we may contact you electronically, to request paper copies of certain information from us, and to withdraw your prior consent to receive notices and disclosures electronically as follows:

If you created a DocuSign account, you may update it with your new email address through your account preferences.

To request paper copies from City of Bellflower
To request delivery from us of paper copies of the notices and disclosures previously provided by us to you electronically, you must send us an email to [email protected] and in the body of such request you must state your email address, full name, mailing address, and telephone number. We will bill you for any fees at that time, if any.

To withdraw your consent with City of Bellflower
To inform us that you no longer wish to receive future notices and disclosures in electronic format you may:

DocuSign Envelope ID: 25BD4776-CA3D-4456-AF4C-26C8FA9A7F43 -152-

i. decline to sign a document from within your signing session, and on the subsequent page, select the check-box indicating you wish to withdraw your consent, or you may; ii. send us an email to [email protected] and in the body of such request you must state your email, full name, mailing address, and telephone number. We do not need any other information from you to withdraw consent.. The consequences of your withdrawing consent for online documents will be that transactions may take a longer time to process..

Acknowledging your access and consent to receive and sign documents electronically To confirm to us that you can access this information electronically, which will be similar to other electronic notices and disclosures that we will provide to you, please confirm that you have read this ERSD, and (i) that you are able to print on paper or electronically save this ERSD for your future reference and access; or (ii) that you are able to email this ERSD to an email address where you will be able to print on paper or save it for your future reference and access. Further, if you consent to receiving notices and disclosures exclusively in electronic format as described herein, then select the check-box next to ‘I agree to use electronic records and signatures’ before clicking ‘CONTINUE’ within the DocuSign system.

By selecting the check-box next to ‘I agree to use electronic records and signatures’, you confirm that:

DocuSign Envelope ID: 25BD4776-CA3D-4456-AF4C-26C8FA9A7F43 -153-

Certificate Of Completion
Envelope Id: 25BD4776CA3D4456AF4C26C8FA9A7F43 Status: Completed Subject: Complete with DocuSign: Authority to Transfer Inactive Records - MWS14 to MWS18.pdf Source Envelope:

Document Pages: 14 Signatures: 10 Envelope Originator:

Record Tracking
Status: Original
3/18/2024 12:31:23 PM
Holder: City Clerk
[email protected]
Location: DocuSign
Signer Events Signature Timestamp
Tae Rhee
[email protected]
Finance Director
Security Level: Email, Account Authentication
None)Signature Adoption: Pre-selected Style
Using IP Address:

Sent: 3/18/2024 12:33:32 PM
Viewed: 3/18/2024 12:34:32 PM
Signed: 3/18/2024 12:36:10 PM
Electronic Record and Signature Disclosure:

Accepted: 3/18/2024 12:34:32 PM
ID: 771f8ae1-45ef-4276-803e-2cff7b739093
Mayra Ochiqui
[email protected]
City of Bellflower
Security Level: Email, Account Authentication
None)Signature Adoption: Pre-selected Style
Using IP Address:

Sent: 3/18/2024 12:36:11 PM
Resent: 3/19/2024 12:04:45 PM
Viewed: 3/19/2024 12:09:38 PM
Signed: 3/19/2024 12:09:57 PM
Electronic Record and Signature Disclosure:

Envelope Summary Events Status Timestamps
Certified Delivered Security Checked 3/19/2024 12:09:38 PM Signing Complete Security Checked 3/19/2024 12:09:57 PM Completed Security Checked 3/19/2024 12:09:57 PM
Payment Events Status Timestamps
Electronic Record and Signature Disclosure
-155-

Please read the information below carefully and thoroughly, and if you can access this information electronically to your satisfaction and agree to this Electronic Record and Signature Disclosure (ERSD), please confirm your agreement by selecting the check-box next to ‘I agree to use electronic records and signatures’ before clicking ‘CONTINUE’ within the DocuSign system.

0.00 per-page fee. You may request delivery of such paper copies from us by following the procedure described below.

All notices and disclosures will be sent to you electronically Electronic Record and Signature Disclosure created on: 6/8/2020 10:47:26 AM Parties agreed to: Tae Rhee, Mayra Ochiqui
-156-

Unless you tell us otherwise in accordance with the procedures described herein, we will provide electronically to you through the DocuSign system all required notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to you during the course of our relationship with you. To reduce the chance of you inadvertently not receiving any notice or disclosure, we prefer to provide all of the required notices and disclosures to you by the same method and to the same address that you have given us. Thus, you can receive all the disclosures and notices electronically or in paper format through the paper mail delivery system. If you do not agree with this process, please let us know as described below. Please also see the paragraph immediately above that describes the consequences of your electing not to receive delivery of the notices and disclosures electronically from us.

How to contact City of Bellflower:

You may contact us to let us know of your changes as to how we may contact you electronically, to request paper copies of certain information from us, and to withdraw your prior consent to receive notices and disclosures electronically as follows:

If you created a DocuSign account, you may update it with your new email address through your account preferences.

To request paper copies from City of Bellflower
To request delivery from us of paper copies of the notices and disclosures previously provided by us to you electronically, you must send us an email to [email protected] and in the body of such request you must state your email address, full name, mailing address, and telephone number. We will bill you for any fees at that time, if any.

To withdraw your consent with City of Bellflower
To inform us that you no longer wish to receive future notices and disclosures in electronic format you may:
-157-

i. decline to sign a document from within your signing session, and on the subsequent page, select the check-box indicating you wish to withdraw your consent, or you may; ii. send us an email to [email protected] and in the body of such request you must state your email, full name, mailing address, and telephone number. We do not need any other information from you to withdraw consent.. The consequences of your withdrawing consent for online documents will be that transactions may take a longer time to process..

Acknowledging your access and consent to receive and sign documents electronically To confirm to us that you can access this information electronically, which will be similar to other electronic notices and disclosures that we will provide to you, please confirm that you have read this ERSD, and (i) that you are able to print on paper or electronically save this ERSD for your future reference and access; or (ii) that you are able to email this ERSD to an email address where you will be able to print on paper or save it for your future reference and access. Further, if you consent to receiving notices and disclosures exclusively in electronic format as described herein, then select the check-box next to ‘I agree to use electronic records and signatures’ before clicking ‘CONTINUE’ within the DocuSign system.

By selecting the check-box next to ‘I agree to use electronic records and signatures’, you confirm that:

Bellflower City CouncilMarch 9, 2026

Bellflower City Council
March 9, 2026