HomeMy WebLinkAboutRISK MANAGEMENT - 02/09/2015 City of Bremerton Public Records Destruction Log
The purpose of this form is to document compliance and reasonable accountability by verifying that specific public records have met current, approved minimum retention
periods before being destroyed pursuant to RCW 40.14.070, WAC 434-610.070, and WAC 434.640.010, -020, and -030. Please fill out this form when destroying public records
whose minimum retention is other than "Retain until no longer needed for agency business then destroy" (such as records covered in the "Records with Minimal Retention
Value"section of the Local Government Records Retention Schedule(CORE)).
Legal Disposition Authority(taken from Records Retention Schedule) Agency Records
Records Series Records Retention Description Date Minimum Method of Destruction
Records Series Title Minimum Retention Period (Box/item numbers, Dates Covered
DAN Schedule Retention Met (See examples below")
volume,etc.)
1.8 Legal Affairs GS50-01-10 Local 6 YEARS AFTER CLAIM 2%2 BANKERS' 2007 Claims closed in 2008 12/31/2014 Secure Recycling
Rev. 1 Government CLOSED BOX 2008 Claims closed in 2008 (destroyed 2/9/15)
CORE
1.14 Risk GS50-06C-15 Local 4 YEARS 2 BANKERS' 2001-2007 Insurance 12/31/2011 Secure Recycling
Management/Insurance Rev.0 Government BOXES renewal information (destroyed
CORE 1/23/15)
1.14 Risk GS2010-0-81 Local 3 YEARS AFTER DATE OF 13inch Redwell 2011 Incidents 12/31/2014 Secure Recycling
Management/Insurance Rev.3 Government INCIDENT (destroyed 2/6/15)
CORE
*Examples of methods of destruction:electronic deletion,in-house OR outside contractor shredding,secure recycling,other(describe)
Statement: The public records listed above have met their minimum retention period(s), are not subject to ongoing or reasonably anticipated litigation or
public records requests, are not needed for audit or other agency business, and shall be destroyed.
The individual responsible for inventoryin:p listed records must sign below prior to the Record's Manager approval:
Employee Signature: i Printed Name: )�Jnppjyj a Ll i e k y-1 Division: 0 blu A #,j. ln�g cp_
n,(��ck_y K,(,j ot_,*
The Records Manager must sign the approval of this equest prior to the destruction of the listed records:
Records Manager Signatu � /Lt Printed Name:,-�L1,P�Q mi-e til Date Approved: //4n.
The person/people responsible
- for the destruction of records must sign upon destruction of the listed records:
Employee Signature:\N `� Printed Name: An. A bQ cz, Date Records Destroyed: SPP. alcove-,
Vendor Business Name(if used): Phone:
Vendor Signature: Printed Name: Date Records Destroyed:
The retention and disposition action for this Public Records Destruction Log is"Retain for the life of the agency"pursuant to CORE series GS50-09-06.
Form Revised 05/06/2014