HomeMy WebLinkAboutRISK MANAGEMENT - 09/29/2016 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 Schedu/e(CORE)).
Legal Disposition Authority(taken from Records Retention Schedule) Agenty Records
Date Method of
Records Series Records Retention Description Minlmum
Records Series Title Minimum Retention Period (Box/Item numbers, Dates Covered Destruction(See
DAN Schedule volume,etc.) RetM tion examples below*)
Risk Management/ GS50-06C-15 CORE Ver. 3.2 4 years insurance 2009-2010 12/31/2014 Secure recycling
Insurance Rev.O renewal
information-all
lines
*Examples of inethods of descruction: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 desrroyed.
The individual responsible for inven rying the i ted records must sign below prior to the Record's Manager approval:
Employee Signature: �iL( Printed Name: Thelma Swem Division: Risk Mana�ement
The Records Manager must sign the approval of this r uest prior to the destruction of the listed records: ,
Records Manager Signature: �� Printed Name: Thelma Swem Date Approved: 9/29/16
The person/people responsible for the destructi of records must sign upon destruction of the listed records:
Employee Signature: l� �.-�'��rinted Name: Thelma Swem Date Records Destroyed: 9/29/16
Vendor Business Name(if used): Phone:
Form Revised OS/06/2014