9.17.2024 Records Destruction Certificate

City of El Mirage — Regular Meeting (2024-09-17)

View PDF Item 2 Meeting page

Extracted text (via ocr_local) 7944 characters 
ARIZONA STATE LIBRARY, ARCHIVES AND PUBLIC RECORDS govt ety,

AZ 8
A DIVISION OF THE ARIZONA SECRETARY OF STATE reve Teeny &
teen o
i P S
SECRETARY OF STATE CERTIFICATE OF RECORDS DESTRUCTION Arizona State Library,

Archives and Public Records

As authorized under ARS §41-151.19, "...A report of records destruction that includes a list of all records disposed of shall be filed at least annually with the state
library on a form prescribed by the state library." Failure to comply with these procedures is a violation of ARS §41-151.19.

INSTRUCTIONS

Use this form ONLY for records that were destroyed and were on a current approved Retention Schedule

1. In the top section enter the name of your Agency or Public Body, and include any subdivision breakdown for division, department or unit.
2. List the Record Series associated with the destruction using the exact record series number(s) and name(s) found in the Retention Schedule Database.

3. Enter the earliest date of records you are requesting to destroy under the Records Start Date column and the latest date for the records you are requesting to
destroy under the Records End Date column.

4. Enter the date the records were eligible for destruction.
5. Enter the format of the records to be destroyed under the Format: Paper, Digital, Microfilm column.
6. Enter the number of records being destroyed under the Number of Files, Boxes, Reels or Electronic File Size column.

7. Ifadditional pages are needed for reporting, please attach a file with the certificate when sending to the Arizona State Library, Archives, and Public
Records.

8. At the bottom of the form the Agency or Public Body Records Officer must sign and date the Certificate of Destruction to certify the records were properly
destroyed.

9. Send the completed form and any additional files to records@azlibrary.gov or records@azsos.libanswers.com.

ARCHIVES AND RECORDS MANAGEMENT
1901 West Madison Street * Phoenix, Arizona 85009
Revised 07/03/2024 (602) 926-3720 + records@azlibrary.gov  http://www.azlibrary.gov/arm

ARIZONA STATE LIBRARY, ARCHIVES AND PUBLIC RECORDS + ae Oly,
A DIVISION OF THE ARIZONA SECRETARY OF STATE Reserer “g

ca
°
GS

>

teQona

heieeteier ret cans CERTIFICATE OF RECORDS DESTRUCTION Arizona State Library, ©
SECRETARY OF STATE

Archives and Public Records

CERTIFICATE OF RECORDS DESTRUCTION

A.RS. §41-151.19. Those records determined to be of no legal, administrative, historical, or other value shall be disposed of by such a method as the state library may specify.
A report of records destruction that includes a list of all records disposed of shall be Siled at least annually with the state library on a form prescribed by the state library.

Public Body City of El Mirage Division City Clerk
City Clerk

Department Office/ Unit
Eligible to :
Record Series Number and Title operas Rs ven Destroy Format: — Amount File
Date Paper | Microfilm | Digital | Boxes | Files Size
ADOT Scope of Work 11.20.1990 11.20.2000 | 11.20.2005 ra] O Oo 1
Homeland Security After Action Report 8.242006 8.24.2006 8.24.2011 [x] O oO 1
Environmental Protection Agency Violation Notice 3.24.2004 3.24.2004 3.24.2014 ix) O oO 1
Az State Procurement Agreement 10.21.2002 6.30.2006 6.30.2011 4} O oO 1
US Office of Management & Budget Memo 8.24.2012 8.24.2012 8.24.2017 ra oO Oo 1
Az Dept of Health Services Equipment Use Agreement 4.10.2013 6.30.2014 6.30.2019 ix] oO Oo 1
Homeland Security Unit Training MOU 5.3.2013 5.3.2013 5.3.2018 ra Oo Oo 1
Az Attorney General Victims Rights Program 10.5.2013 6.30.2014 6.30.2019 i) oO O 1
US Dept of Justice Voters Rights 10.13.2015 10.13.2015 10.13.2020 Od O O 1
Form Filled Out By (print): Email: Phone:
Wendy Henson whenson@elmirageaz.gov 623.876.2931
Records Officer Name (print): Title (print): Date:
Wendy Henson Deputy City Clerk 9.17.2024
Records Officer Signature: Email: Phone:
7 ll whenson@elmirageaz.gov 623.876.2931

ARCHIVES AND RECORDS MANAGEMENT
1901 West Madison Street * Phoenix, Arizona 85009
Revised 07/03/2024 (602) 926-3720 + records@azlibrary.gov * http://www.azlibrary.gov/arm

SECRETARY OF STATE

CERTIFICATE OF RECORDS DESTRUCTION

ARIZONA STATE LIBRARY, ARCHIVES AND PUBLIC RECORDS
A DIVISION OF THE ARIZONA SECRETARY OF STATE

aD 8

reget erng

teyoua

ov loz
e Vy

x
°
°
m”
S

Arizona State Library, °
Archives and Public Records

CERTIFICATE OF RECORDS DESTRUCTION

A.RS. §41-151.19. Those records determined to be of no legal, administrative, historical, or other value shall be disposed of by such a method as the state library may specify.
A report of records destruction that includes a list of all records disposed of shall be filed at least annually with the state library on a form prescribed by the state library.

City of El Mirage

City Clerk

Public Body Division
Department City Clerk Office/ Unit
Eligible to :
Record Series Number and Title records RK coors Destroy Format: — Amount File
Date Paper | Microfilm | Digital | Boxes | Files Size
Emergency Management Funds Memo 11.6.2014 11.6.2014 11.6.2019 [x] O O 1
AZTEC Case Mgmt System IGA 6.14.2010 6.14.2015 6.14.2019 Xl O Oo 1
Office of Personal Management Position Classification Memo 7.10.2015 7.10.2015 7.10.2020 ix] oO oO 1
Area Agency on Aging Disposition 10.1.2010 10.1.2010 10.1.2015 x] O O 1
AZ Dept of Health Services Agreement 12.27.2005 12.27.2015 | 12.27.2020 & oO Oo 1
Federal Fund Commitment Letter 1.28.2016 1.28.2016 1.28.2021 ix] O O 1
Az DEQ PM-10 Ordinance 4.24.2013 4.24.2013 4.24.2018 Xl O Oo 1
Wizard Paramedic Training Agreement 9.10.2015 9.10.2016 9.10.2021 Kl O O 1
ADOT IGA El Mirage Road ITS 5.5.2016 6.30.2017 6.30.2022 x] O O 1
Form Filled Out By (print): Email: Phone:
Wendy Henson whenson@elmirageaz.gov 623.876.2931
Records Officer Name (print): Title (print): Date:
Wendy Henson Deputy City Clerk 9.17.2024
Records Signature: Email: Phone:
> a whenson@elmirageaz.gov 623.876.2931

7

Revised 07/03/2024

ARCHIVES AND RECORDS MANAGEMENT
1901 West Madison Street * Phoenix, Arizona 85009

(602) 926-3720 + records@azlibrary.gov * http://www.azlibrary.gov/arm

SECRETARY OF STATE

ARIZONA STATE LIBRARY, ARCHIVES AND PUBLIC RECORDS
A DIVISION OF THE ARIZONA SECRETARY OF STATE

CERTIFICATE OF RECORDS DESTRUCTION

I
e “e “Wg
Piece ace ep %
teyonn 2
ég
Arizona State Library, °
Archives and Public Records

CERTIFICATE OF RECORDS DESTRUCTION

A.RS. §41-151.19. Those records determined to be of no legal, administrative, historical, or other value shall be disposed of by such a method as the state library may specify.
A report of records destruction that includes a list of all records disposed of shall be filed at least annually with the state library on a form prescribed by the state library.

City of El Mirage

City Clerk

Public Body Division
Department City Clerk Office/ Unit
Eligible to :
Record Series Number and Title seconds Rs come Destroy Format: — Amount File
Date Paper | Microfilm | Digital | Boxes | Files Size
Az Dept Homeland Security Sub-recipient Agreement 8.26.2016 9.30.2017 9.30.2022 ix] O O 1
Az Dept Fire Safety Manufactured Housing IGA 10.12.2012 10.12.2017 10.12.2022 x] O oO 2
Az Dept Forestry Fire Rate Agreement 4.1.2013 5.15.2018 5.15.2023 xl O oO 1
US Dept of Justice Task Force Agreement 1.17.2018 9.30.2018 9.30.2023 Xx] O O 1
Az Attorney General Victims Rights Program 9.11.2018 6.30.2019 6.30.2024 Fa O oO 1
ADOT IGA Frontage Road 1.29.2018 6.30.2019 6.30.2024 Xl O O 1
Motorola Solutions Radio Purchase 9.5.2019 9.5.2019 9.6.2024 Xl O O 1
oO O oO
Oo O oO
Form Filled Out By (print): Email: Phone:
Wendy Henson whenson@elmirageaz.gov 623.876.2931
Records Officer Name (print): Title (print): Date:
Wendy Henson Deputy City Clerk 9.17.2024
Records f Signature: Email: Phone:
Wim whenson@elmirageaz.gov 623.876.2931

Revised 07/03/2024

ARCHIVES AND RECORDS MANAGEMENT
1901 West Madison Street * Phoenix, Arizona 85009

(602) 926-3720 * records@azlibrary.gov » http://www.azlibrary.gov/arm