HomeMy WebLinkAboutCLERK 05/11/2018City 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 Title
Records Series
Records Retention
Minimum Retention Period Description
(8oxmnumbers,
Dates Covered
Date
Minimum
Method Of
Destruction (See
DAN <
Schedule
olu
volume,
me, etc.)
Retention
examples below*)
Met
Contracts/Agreements-
GS50-01-11
CORE
Termination Plus 6 years 2 boxes
6/4/1969-12/31/2008
1/1/2016
Outside Shred
General
Company
Contracts/Agreements-
G550-01-11
CORE
Termination plus 6 years
2/1/1982-12/31/2007
1/1/2015
Outside Shred
General
Company
Contracts/Agreements-
GS50-01-11
CORE
Termination plus 6 years
1/1/2010-12/31/2010
1/1/2017
Outside Shred
General
Company
Financial Transactions
G52011-184
CORE
6 years after Fiscal Year
2010-2011
1/1/2018
Outside Shred
Company
Contracts/Agreements-
GS50-01-11
CORE
Termination plus 6 years 2 boxes
1/1/2011-12/31/2011
1/1/2018
Outside Shred
General
Company
Licenses, Permits, Fees
GS50-12D-04
Tax & License
3 years Combined Excise
Jan 2012 -Dec 2012
1/1/16
Outside Shred
& Taxes
Tax
Company
Licenses, Permits, Fees
GS50-12D-04
Tax & License
3 years Combined Excise
Jan 2013 -Dec 2013
1/1/17
Outside Shred
& Taxes
Tax
Company
Labor Distribution &
GS50-03E-04
CORE
4 years 4 boxes
0/15/2013-12/31/2013
1/1/2018
Outside Shred
Timesheet
GS50-03E-25
01/15/2011-12/2012
Company
01/15/2005-12/31/2007
01/01/2008-12/31/2010
Licenses, Permits, Fees
GS50-12D-04
Tax & License
5 years Combined Excise
3/7/12-4/19/2012
11/17/17
Outside Shred
& Taxes
Tax
4/20/12-5/29/12
Company
5/30/12-7/31/12
8/1/12-10/22/12
10/23/12-11/16/12
Form Revised 05/06/2014
City of Bremerton Public Records Destruction Log
Licenses, Permits, Fees
GS50-12D-04
Tax & License
5 years Combined Excise
1/11/13-1/25/13
1/26/18
Outside Shred
& Taxes
Tax
1/28/13-2/1/13
Company
12/13/12-1/10/13
2/4/13-3/14/13
Licenses, Permits, Fees
GS50-12D-06
Tax & License -
6 years Combined Excise
1/1/2011-12/31/2011
1/1/2018
Outside Shred
& Taxes
Closed Accounts
Tax
Company
*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 inventorying the listed records must sign below prior to the Record's Manager approval:
Employee Signature: D Printed Name: Shannon L. Corin Division: City Clerk
The Records Manager must sign the approval of this request prior to the destruction of the listed records:
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Records Manager Signature: _ Printed Name: Shannon L. Corin Date Approved: 5/11/18
The person/people responsible for the destruction of records must sign upon destruction of the listed records:
Employee Signature: Printed Name:
Vendor Business Name (if used): Pho
Vendor Signature:
Form Revised 05/06/2014
Date Records Destroyed:
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.
Name: COOP BREMERTON
Address: 1600 OYSTER BAY AVE S
City: BREMERTON 98312
CERTIFICATE OF DESTRUCTION
2910 Hogum Bay Rd
Olympia Wa 98516
E -Mail: Ims@wcnx.org
Phone: 1-877-898-0112
Fax: 1-360-486-2467
Phone: 360-473-5400 Account #: 2185-952778-698 Route Id: TSP5
Request: MR -MS -CHRIS Invoice Date: 4/20/2018 Invoice #: 1327884
On the date shown, Designated Confidential Data was Shredded and Destroyed as per Customers Instructions.
Notes: 4/20 PURGE 78 BOXES. $34.70 PER 95 GALLON. OK TO BILL. PLEASE ARRIVE AT 8AM
Service Description Qty Rate Amount
65SC 1.00 65 GAL SHRED CART 3.13
35SC 1.00 35 GAL SHRED CART 3.13
SHPURGE 1.00 SHRED ONE TIME PURGE 34.70
Driver Signature: Date Truck
Customer Signature:
Date: Time
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