REQUESTORS INFORMATION
Date: ______________
Print Full Name: _________________________________________________________________________
Address: ____________________________ City, State, Zip Code: ________________________________
Company Name (If Applicable): _____________________________________________________________
Telephone: ___________________ Fax: ___________________ Email: ____________________________
PLEASE LIST PUBLIC RECORDS REQUESTED
- INSPECTION - OBTAIN COPIES (See reverse side for costs)
Records Requested:
RECORDS DIVISION USE ONLY
Disposition of Request:
Received: ___________ 10-day Deadline: ___________ 14-day Extension? ___________ 14-day Letter Sent: ___________
Determination Letter Sent: _________ First Production Due: _________ Second Production Due: _________ Other? ________
Documents/Response Provided on: _______________
Completed
Mail Pick-up Phone Email Other _______________
Amount Due/Paid: $ ______________ Total # of Pages: ______________
Copy Format: ____________________
Comments:
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
Action Taken ____________________
Date Received ___________________
Due Date _______________________
Completed Date __________________
P
UBLIC
R
ECORDS
R
EQUEST
F
ORM
Office Hours 7:30 a.m. to 5:30 p.m. Monday Thursday and Friday 7:30 a.m. to 4:30 p.m.
30940 Hawthorne Blvd. Rancho Palos Verdes, CA 90275-5391
Phone (310) 544-5217 Fax (310) 544-5291 E-Mail: cityclerk@rpvca.gov
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City of Rancho Palos Verdes Public Records Request
1. The C
ity will respond to requests for public records in accordance with the provisions of the California Public Records
Act as the Act now exists or may hereafter be amended, and nothing in this Form is intended nor shall it be construed
to conflict with the terms of the Public Records Act.
2. Information is available in City offices during regular business hours - Monday through Thursday, 7:30 AM to 5:30 PM
and Friday from 7:30 AM to 4:30 PM. Many frequently requested documents are also available for viewing/printing via
the Internet at the City’s website (http://www.rpvca.gov), including City Council Agendas and staff reports, City Council
Minutes, Commission and Committee Agendas and Minutes, Municipal Code, the City Budget, and the City’s General
Plan, etc.
3. Requests must be focused and specific and must reasonably describe identifiable records. Requests not meeting this
criterion may be delayed for further clarification. Examples of information that may expedite the process:
a. The name or title of the document, i.e., EIR No. 100
b. An address or property location
c. A developer name
d. A date of Public Hearing or Council approval/denial, if applicable.
4. If your request is to inspect records rather than receive copies, an appointment will be arranged for you once the
records are gathered. Original City records must remain in the custody of the City in order to protect their integrity
and ensure accessibility.
5.
Government Code § 6250 et seq. provides that any person may receive a copy of an identifiable public record (with
some exceptions), unless impractical to do so. The City will determine, within 10 days of receipt of a request
, whether
it can comply with the request and will promptly notify you of the determination and the estimated cost for the records
requested. The City may extend the time in which to provide its determination by 14 days under certain
circumstances. The City will produce any existing documents responsive to your request that are not exempt from
disclosure. Once the information requested is available, you will be contacted at the phone number or address you
listed on this form. If you refuse to provide an address, you may go to the City Clerk’s office during office hours
any time after 10 days to receive the City’s determination or the 14-day ex
tension notice, whichever is applicable.
6. The following fees for copies are in accordance with the City of Rancho Palos Verdes Resolution No. 2010-77,
adopted September 7, 2010.
General Copying
TOTAL COPIES REQUESTED
(a) 8.5 inches x 11 inches
$0.23/sheet
(a)
$
(b) 8.5 inches x 14 inches
$0.24/sheet
(b)
$
(c) 11 inches x 17 inches
$0.24/sheet
(c)
$
(d) Oversize items
Cost charged by outside
vendor
(d)
$
Sheet Cost
$
Audio and Video Media
(e) Burned to CD/DVD
$5 per CD/DVD
(e)
$
Audio & Video Cost
$
Electronic Records
(f) Burned to CD/DVD
$5 per CD/DVD
(f)
$
(g) Special productions including data
compilation, extraction, programming
Cost to produce (See
Resolution No. 2010-77)
(g)
$
(h) Emailed
Cost of time to copy
(h)
$
Electronic Records
$
TOTAL COST
$
Other copy fees are as follows:
The City reserves the right to hire an appropriate outside vendor to copy the requested materials. Such outside
charges will be billed at actual cost. The City reserves the right to require a deposit prior to duplicating copies.
A copy of the California Public Records Act is available for review at City Hall.