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Case Record Storage and Retrieval Services RFP (Part I)

Case Record Storage and Retrieval Services RFP (Part I)

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APPENDIX C: SOW TECHNICAL EXHIBITS<br />

TECHNICAL EXHIBITS C-9<br />

DEPARTMENT PUBLIC SOCIAL SERVICES<br />

LOS ANGELES COUNTY<br />

REQUEST TO BORROW CASE RECORD SEGMENTS TRANSMITTAL<br />

Office / Facility Requesting:__________________________ Date: _______________<br />

Name of Requestor:<br />

______________________<br />

Open Closing Closing Date:__________________<br />

Check ( √)<br />

here for<br />

“Normal<br />

Request”<br />

(Last 3 years)<br />

Closing Dates of All<br />

Segments<br />

<strong>Case</strong><br />

Number<br />

<strong>Case</strong> Name<br />

(Last Name First)<br />

File No of<br />

Requestor<br />

Approved By____________________________________, Administrative Deputy<br />

Copies: Original <strong>and</strong> Copy<br />

Distribution: Original Contractor<br />

Copy: Primary Transfer Desk<br />

Retain: One Year<br />

PA 2241<br />

CASE RECORD STORAGE AND RETRIEVAL SERVICES (<strong>RFP</strong>) 2012<br />

185

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