Request 498 - Risk Management DEPARTMENT OF STATE
DrvisionofLibraryar3~l-E .,~'~ RECQRDS DISPOSITION REQUEST No.
Informatior~ Services / / ~! (~, /
PAGE I OF / PAGES
i
1. AGENCY ./ / . /~. DIVISION 3. BUREAU
City of M~ami Beach / Risk Management
4, ADDRESS {Street, City, and Z~e) 5. CONTACT {Name & Telephone Number)
1700 Conve~enter Dr.
Judith Adelman - (305)673-7014
Miami Beach, F1 33319
Ted Baldassarre - (305)673-7014
6. SUBMITTED BY: I hereby certify that the records to be disposed of
SUBMIT TO: are correctly represented below, tha~an~]~lit requirements for the
-~., ~: ~"':: records ha,ye been_fulJ~ justified./~/fd/~t fu/ther retention is not
,::~ :',,!....,.Florfda Department of State required-~'cir any I~i~g~j,~on pendi~ ~/immipimt.
:::>:~'ur@~u of Archives and Records Management ~~~~/~--/~'
:!i!:~;iilMai'r Station 9A
~.,..,,~:::::: ~:":~""~:" Th~Capitol _ _ ~l'gnature '- -- --~ / -
:~', .~:'i!:~':':~Tallahassee, FL 3Z399-0250
i::~.:~.~.;!,:: ~ed Baldass~rre, Risk Manager
'*'~7';~,IBTt~EA~i~OF ARCHIVES & RECORDS MANAGEMENT REVIEW 8. NOTICE OF INTENTION
!:~r~,)R DIllON USE ONL Y) The scheduled records listed in Item 9 are to be disposed of in the
~BC'RNICI~'"'"3<'~' C~" REVIEW /-' t~----~ ' · % :~1,~/~ / / manner checked below {specify only one):
ANALYST REVIEW (~ z"~./~e~/// [[//(~/~/~_ ~_ a. Destruction -- b. Microfilming and Destruction
ARCHIVIST REVIEW -~.~v ! / c. Other
SUPERVISOR REVIEW
9. LIST OF RECORD SERIES
a. b. c. Retention e DispoSition
Schedule Item Title (Division Inclusive in Action and Date
No. No. use Only) Dates Cubic Feet Completed After
Authorization
9/89 9/86- 3
~C-1R~ 36~ Correspondence
9/82-
~C-iR~ 60~ Insurance Claims ~-~ 9/87 9
, 9/86-
BC-1R~ 137 0c Workers Compensation claims
9/89
6
· NOTE: FOR CONTINUATION USE Form LSSEIOS *
10. DISPOSAL AUTHORIZATION (FOR DIVISION USE ONLY) 11. DISPOSAL CERTIFICATE: The above listed records have been
Disposal for the above listed records is authorized. Any deletions or disposed of in the manner and on the date shown in column g.
modifications are indicated. .~i:,.~ '
Director, Division of Library Date ~n
and Information Services
~ j~Vitnes OI~TE: Up°sndisposition retain this form for your records.