HomeMy WebLinkAboutDispositions Forms_46-18_8/22/2018_FinanceNO. LP�I
RECORDS DISPOSITION DOCUMENT
PAGE 1 OF 2 PAGES
1. AGENCY NAME and ADDRESS
2. AGENCY CONTACT (Name and Telephone
VILLAGE OF TEQUESTA
Number)
345 Tequesta Drive
Lori McWilliams, MMC
Te uesta, FL 33469
(561) 768-0443
3. NOTICE OF INTENTION: The scheduled records listed in Item 5 are to be disposed of in the manner specified
below (specify only one).
Oa. Shred at Department Level O c. Send to Storage until 0 e. Recycle
Disposition Date Met
0 b. Send to Storage for Shredding O d. Removed from Server Of. Other
4. SUBMITTED BY:
I hereby certify that the re tp be disposed of are correctly represented below, that any audit requirements for the
records have bee III of nd that further retention is not required for any litigation pending or imminent.
Chris Quirk 08/22/18
Signature Name and Title (Senior Staff only) Date
S. LIST OF RECORD SERIES
a.
b.
C.
d.
e.
f.
g.
Schedule
Item
Title
Retention
Inclusive
Volume
Disposition
No.
No.
Dates
in
Action and
Cubic
Date
Feet
Completed
•,
After
Authorization
GS14
113
Utility Customer Records
3 FY.
2014 > \
1.5
GS14
113
Utility Customer Records
3 FY.
2014
1.5
I I 115- 4 13011
GS14
113
Utility Customer Records
3 FY.
Jan 2015 - Dec 2015
1.5
GS14
113
Utility Customer Records
3 FY.
Jan 2015 - Dec 2015
1.5
GS14
113
utility Customer Records
3 FY.
Jan 2015 - Dec 2015
1.5
TOTAL
CUBIC FEET THIS PAGE:
7.5
6. DISPOSAL AUTHORIZATION: Disposal for
7. DISPOSAL CERTIFICATE: The above listed records have been
the above listed records is authorized. Any
disposed of in the manner and on the date shown in column g.
'Aletions or modifications are indicated.
�,tmw 9 11 �
1, M
Records Liaison Officer Signature Date
Signature Name/Title Date
Routin
:
1. Originates with Department Senior Manager, then
1. Originates with Department Senior Manager, then
2. Village Clerk's Office authorizes disposition, and returns to
2. Village Clerk's Office authorizes disposition and/or storage
3. Originating department to dispose and document column g,
at the storage room and will contact Public Works to remove
then sends
records
4. Completed form to Village Clerk's Office for permanent
3. Clerk's Office will be responsible for final disposition of
archival
records at this point
Form Updated: 4/11/18
OR _
,
Continuation Page CSC O�
a.
Schedule
No.
b.
Item
No.
C.
Title
d.
Retention
e.
Inclusive
Dates
f.
Volume
in
Cubic
Feet
g.
Disposition
Action and
Date
Completed
After
Authorization
GS14
113
Utility Customer Records
3 FY.
Jan 2015 - Dec 2015
1.5
GS14
113
Utility Customer Records
3 FY.
Jan 2015 - Dec 2015
1.5
TOTAL
CUBIC FEET THIS PAGE:
3.0