HomeMy WebLinkAboutPWU 110123City 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)
Description
Records Series Title
Records Series
Records Retention
Minimum Retention Period
(Box/item
DAN
Schedule
numbers, volume,
etc.) _
Line Location
UT50-32-05
Utility Services
Retain for 1 year after
16 Boxes —
Requests
Rev. 1
Records Retention
request fulfilled then
Records relating
Schedule Version
Destroy.
1
to line location
1.5 (June 2021)
requests.
Agency Records
Date Minimum Method of
Dates Covered Retention Met Destruction (See
examples below*)
2001, 2002, 2003, 2004, 2005, 1/1/2021
2006, 2007, 2008, 2011, 2012,
2013, 2014, 2016, 2018, 2019
*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 isted records must sign below prior to the Record's Manager/ approval: �ic l
Employee Signature://ZPrinted Name: V/A � ' �%�% / ! o Division: C t i / L I•
11
The Records Manager must sign the a royal of this eques prior to the destruction of the+ listed records:
Records Manager Signature: �J Printed Name: 1 I� �t r 1� 1 �n Date Approved: I oz
\-) &�Ag
The person/people responsible for the destruction of records must sign upon destruction of the listed records:
Employee Signature: Printed Name: Date Records Destroyed:
Vendor Business Name (if used):
Vendor Signature:
Phone:
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
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)
Records Series Title Records Series Records Retention Minimum Retention Period
DAN Schedule
Billing Stubs
GS2012-046
Local Government
Retain for 4 years after
Rev. 0
Common Records
end of fiscal year or until
Retention
completion of State
Schedule (CORE)
Auditor's examination
Version 4.2
report, whichever is
(August 2021)
1 sooner then Destrov.
Agency Records
Description Method of
(Box/Item J Date Minimum
numbers, volume, Dates Covered Retention Met Destruction (See
etc.) examples below*)
47 Boxes — Billing 2007, 2008, 2010, 2011, 2012, 2013, 1/1/2023
stubs, remittance 2014, 2015, 2016, 2017, 2018
advices, payment
stubs.
*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���9'priior to the Record's Manager approval: /,
Employee Signature: Printed Name: "A �� IYII,/`eAl Division: (��/
OF
The Records Manager must sign the approval of this request prior to the destruction of the listed records: j+ Records Manager Signature: Printed Name: I I (A (A I +,;,o �y _ Date Approved: � � I � � 0
The person/people responsible for the destruction of records must sign upon destruction of the listed records:
Employee Signature:
Vendor Business Name (if used):_ _
Vendor Sign
Printed Name: —
Phone:
Printed Name:
Date Records Destroyed:
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 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 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)
Records Series Title Records Series Records Retention Minimum Retention Period
DAN Schedule
Banking - GS2011-185 Local Government Retain for 6 years after
Accounts and Rev. 0 Common Records end of fiscal year then
Transactions Retention Destroy.
Schedule (CORE)
Version 4.2
(August 2021)
Agency Records
Description Method of
(Box/Item Dates Covered Date Minimum Destruction (See
numbers, volume, Retention Met
examples below*)
etc.)
5 Boxes - 2009, 2011, 2012, 2014, 2015, 1/1/2023
Automated 2016
Clearing House
(ACH)
*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 t listed r cords must sign below prior to the Record's Manager approval:
Employee Signature: Printed Name: &' A-Y2V,e i ,a ! / ADivision: VC
The Records Manager must sign the approval of this equest prior to the destruction of the listed records:
Records r-
Records Manager Signature: Printed Name: �t(I �(A �� I_ I CArnJ I � Date Approved:
`T
The person/people responsible for the destruction of records must sign upon destruction of the listed records:
Employee Signature: Printed Na
Vendor Business Name (if used):
Vendor Signature:
Phone:
Printed Name:
Date Records Destroyed:
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
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 _
Description Method of
Records Series Title
Records Series
Records
Records Retention
Minimum Retention Period
(Box/Item Dates Covered Date Minimum
Destruction (See
Schedule
numbers, volume Retention Met
examples below")
etc.)
Financial
GS2011-184
Local Government
Retain for 6 years after
89 Boxes —
2005, 2006, 2007, 2008, 2009,
1/1/2023
Transactions —
Rev. 3
Common Records
end of fiscal year then
Receipts, billing
2010, 2011, 2012, 2013, 2014,
General
Retention
Destroy.
statemetns,
2015, 2016
Schedule (CORE)
billing
Version 4.2
summaries,
(August 2021)
adjustments,
cash receipts,
daily cash
summary,
journals
*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: L
Employee Signature: Printed Name:
611 /.�,11 VW."' 1-144� /T o� Division: � / i /� t ' f
The Records Manager must sign th ap royal of this request p for to the destruction of the listed records: ^�-�
Records Manager Signature: Printed Name: �( Gl in i I i `-'� Date Approved:
The person/people responsible for the destruction of records must sign upon destruction of the listed records:
Employee Signature:
Printed Name:
Date Records Destroyed:
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 OS/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 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
Description
Method of
Records Series Title
Records Series
Records Retention
Minimum Retention Period
(Box/Item
Dates Covered
Date Minimum
Destruction (See
DAN
Schedule
numbers, volume,
Retention Met
examples below*)
etc.)
Leave/Overtime -
GS50-04B-09
Local Government
Retain for 4 years after
21 Boxes —
1980, 1981, 1982, 1983, 1984,
1/1/2023
Routine
Rev. 2
Common Records
end of fiscal year or until
Leave/Overtime
1985, 1986, 1987, 1999, 2000,
Retention
completion of State
sheets,
2001, 2002, 2003, 2004, 2005,
Schedule (CORE)
Auditor's examination
2006, 2007, 2008, 2009, 2010,
Version 4.2
report, whichever is
2011, 2012, 2013, 2014, 2015,
(August 2021)
sooner then Destroy.
2016, 2017, 2018
*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 H ted records must sign below prior to the Record's Manager approval:
Employee Signature: Printed Name: (/CJ /1— � / � 7 d �/ ,Division:_
The Records Manager must sign the approval of thi request prior to the destruction of the listed records:
A
Records Manager Signature: Printed Name: (� I�f�C!►T +• 1 I )'� i�i Date Approved:
The person/people responsible for the destruction of records must sign upon destruction of the listed records:
Employee Signature:
Vendor Business Name (if used):
Printed Name: _ _ Date Records Destroyed:
Pho
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
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
Method of
Description
Records Series Title
Records Series Records Retention
Minimum Retention Period
(Box/item
Dates Covered Date Minimum
Destruction (see
DAN Schedule
numbers, volume,
Retention Met
examples below*)
etc.)
Employee Pay -
GS50-03E-15
Local Government
Retain for 4 years after
32 Boxes —Time
1980, 1981, 1982, 1983, 1984,
1/1/2023
'
History
Rev. 1
Common Records
end of fiscal year and no
Sheets
1985, 1986, 1987, 1988, 1999,
Retention
longer needed for agency
2001, 2002, 2003, 2004, 2005,
Schedule (CORE)
business (including
2006, 2007, 2008, 2009, 2010,
Version 4.2
retirement benefit
2011, 2017, 2013, 2014, 2015,
(August 2021)
verification) then Destroy.
2016, 2017, 2018
*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 is d recor s must sign below prior to the Record's Manager approval:
Employee Signature: Printed Name: "J2 / �A X ! G 11Division: CAL �i
The Records Manager must sign the approval of this equest prior to the destruction of the listed records:
Records Manager Signature:4A Printed Name: rl1 l i(,r� 1 I(A l f► t 1�� Date Approved: I I I 2U Z J
The person/people responsible for the destruction of records must sign upon destruction of the listed records:
Employee Signature: Printed Name: Date Records Destroyed:
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
Name: CO OP CITY OF BREMERTON
Address:
100 OYSTER BAY AVE S
City:
BREMERTON 98312
Phone:
360-473-2316
Request:
RR-MS-CHRIS
CERTIFICATE OF DESTRUCTION
Le May
Mobile FOR INFO
1Q
rl"Fl, 10/1 P/I
, r/- se, r Ode el4pl; 1/1"'Pe/f wili ou eiv,
Account: 2185-952778-1100 Service Date: 11/3/2023 Route Id: TSP5 Ticket #: 1672873
On the date shown, Designated Confidential Data was Shredded and Destroyed as per Customers Instructions.
CUSTOMER COPY
Service Description Qty Rate Amount
SHEXB 1.00 SHRED EXTRA BOX 4.38
SHPURGE 1.00 SHRED ONE TIME PURGE 43.80
Driver Signature: Date: l ruck
Customer Signature:
2910 Hogum Bay Rd
Olympia Wa 98516
E-Mail: Ims@wcnx.org
,�632,Q
Date: Time
Phone:1-877-898-0112 Fax:1-360-486-2467
CAJk
U.J- C-a V\. 5
ao-C,5.