HomeMy WebLinkAboutMUNI COURT - 04/26/2016 , 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) Agenty Records
Date Method of
Description Minimum
Records Series Title Records Series Records Retention Mlnimum Retention Period (Box/Item numbers, Dates Covered Destructlon(See
DAN Schedule Retention exam les below•)
volume,etc.) Met P
Check Register GS2011-184 CORE-2.2 3 years January—December 2009 01-01-16 Secure shred bin
for outside
Report contractor
shredding
Remittance GS2011-184 CORE 2.2 6 years lanuary—December 2009 01-01-16 Secure shred bin
Summary Report for outside
contractor
shredding
Trust Account G52011-184 CORE 2.2 6 years January—December 2009 O1-01-16 Secure shred bin
Summary Report for outside
contractor
shredding
Source Records— GS50-09-14 CORE 3.1 Verification of Successful DM52-066-01 Closed March 19, 2016—April 04-25-16 Secure shred bin
Images(Non- Rev. 1 Conversion 25, 2016 for outside
Archival) contractor
shredding
Uniform Notice of DM52-066- District& 3 years Closed March 1—31,2013 04-01-16 Electronic Copy
Infraction,Court 01 Municipal Courts Deleted
Docket,&Case File Retention
Schedule—V6
Uniform Citation, DM52-06A- District& 3 years Closed March 1—31,2013 04-01-16 Secure shred bin
Complaint,Court Ol Municipal Courts for outside
Docket&Case File Retention contractor
Schedule—V6 shredding
*Examples of inethods of destruction:electronic deletion,in-house OR outside contractor shredding,secure recyding,other(describe)
Statement: The public records listed above have met their minimum retention period(s), are not subject to ongoing or reasonab/y anticipated litigation or
- public records requests, are not needed for audit or other agency business,and shall be destroyed.
The individual responsible for inventorying the listed records must sign below prior to the Record's Manager approvaf:
,
Employee Signature: � - ! L�l Xl�YBrinted Name: �L�C..I,,,� .t-7Y'1 N e,)�ar� Division: 1 � �vI7 I C�.�L�,, �OZ���
Form Revised 05/06/2014
, City of Bremerton Public Records Destruction Log
,The Records Manager must sign the approval of this request prior to the destruction of the listed records:
) �, �j, /
Records Manager Signature:C� �� Printed Name: � •�1'1�L71/� �L�1�1� Date Approved: r �'
The person/people responsible for the destruction of records must sign upon destruction of the listed records:
Employee Signature: ��1���'�1 '/ L�(J J�� Printed Name: �Q 1 �"Y� �Q��ClY"1 Date Records Destroyed: �'� •��J � "'
vendor Business Name(if used): Phone: �
Vendor Signature: Printed Name: Date Records Destroyed:
The retention and disposition action for this Public Records Destrudion Log is'Retain for the life of the agency"pursuant to CORE series G550-09-06.
Form Revised 05/06/2014
, 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 untif 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) Agenty Records
Date Method of
Description ' Minimum
Records Series Title Records Series Records Retention Dates Covered Destruction(See
DAN Schedule Minimum Retention Perlod (Box/Item numbers, Retention
volume,etc.) Met examptes below•)
Uniform Citation, DM52-06J-01 District& 3 years Closed January 1—December, 01-01- Secure shred bin
Complaint,Court Municipal Courts 2011 j5 for outside
Docket&Case File Retention � contractor
(photo enforced) Schedule—V6 shredding
*Examples of inethods of destruction:electronic deletion,in-house OR outside contractor shredding,secure recycling,other(describeJ
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 inventorying the listed records must sign below prior to the Record's Manager approval:
Employee Signature: .�iYl Printed Name: �Q-l��Irl N�I�Y1 Division: Jr� l>/'1 / C l�,( C��l)1�'�
The Records Manager must si he approval of this request prior to the destruction of�ie listed records: _
<�'�,�•in�� �Y)� Date A roved: � ' ���v'
Records Manager Signature. Printed Name: PP
The person/people responsible for the destruction of records must sign upon destruction of the listed records:
Employee Signature: 'ZR--�-� 1-TY'1 Printed Name: .l 1 ��l s�?� Date Records Destroyed: `"7���` � w
Vendor Business Name(if used�: Phone:
Vendor Signature• Printed Name: Date Records Destroyed:
Form Revised 05/06/2014
' LC�i �C� MO�II G� CERTIFICATE OF DESTRUCTION
�' � • i y a F°A �ly�O °'
�j � �� 2910 Hogum Bay Rd ,��� �
' ��% ���'�%i����/���y���,,/�� Olympia Wa 98516 ���� �
%i'��i, ��i.� G�'�//i �//G,''//- �G,��//�.e �/�i, ��i� E-Mail: Ims@wcnx.org � � o
%O/%////O//�//%//%////,07///e0///////�/��//,��///%/'/�////�.%/� Phone: 1-877-898-0112 � ��
N a m e: C O O P M U N I C I P A L C O U R T-B R E M E R T O N F a x: 1-3 6 0-4 8 6-2 4 6 7 ��
Address: 550 PARK AVE ��'��v,� e���
City: BREMERTON , 98337 • -
Phone: 360-473-5242 Account : 2185-952778-705 Route Id: SN92
Request: RWAUTO Invoice Date: 4/26/2016 Invoice#: 1212082
On the date shown, Designated Confidential Data was Shredded and Destroyed as per Customers Instructions.
Notes: Acct: 952778-705
Service Description � Qty Rate Amount
65SC 2.00 65 GAL SHRED CART 2 89
Driver Signature: Date: Truck
Customer Signature: Date: Time