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HomeMy WebLinkAboutDispositions Forms_67-19_2/12/2020_Utilities NO. RECORDS DISPOSITION DOCUMENT PAGE OF PAGES 1. AGENCY NAME and ADDRESS 2. AGENCY CONTACT (Name and Telephone VILLAGE OF TEQUESTA Number) 345 Tequesta Drive Lori McWilliams, MMC Tequesta, 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). a. Shred at Department Level c. Send to Storage until e. Recycle Disposition Date Met b. Send to Storage for Shredding d. Removed from Server f. Other 4. SUBMITTED BY: hereby certify that the records to be disposed of are correctly represented below, that any audit requirements for the records have be fully justified, and that further retention is not required for any litigation pending or imminent. �160X C- ZP1141h4 AM? 3 Signatu Name and Title ( e or Staff only) Date 57,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 CYEsc-s� 1-7 JAa h/II 2.c�1 e �► Af s t7 �-SC- 3 q� TOTAL CUBIC FEET THIS PAGE: 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. d letions or modifications are indicated. f l uv / f I(,(,Q sc,,s t a>r Records Liaison Officer Signature Date nature Name/Title D e .._:, a- r.>,i y- ,,,t.r .< --::s',.- -2T� y,-' Y .s �esf. •r a1n cc L Lame 4__ 1,�On( nates with De ,artment Sen►or_Ilanage„cfhen r 1 Originates with DepartmenSen►or Nana er;then^ y _�.�r .. e. :t `Rt3;. ;gars •�- `:+ i. 2 V►Ila e Clerk's Office,authorize d►sposit►on,and returns to 2 Village Cler s OfFce authorizes disposit►on,andlorstnrage;!, 3 Originating departrnentto dispose and documentUR ME column g, . a#fhe storage room and will contact Rubl►c Works to remove then ends y recortls F L F ' 4_ Comptefedform to V►Ilage Clerk'sOffice for permanent 3 Clerk's Office w►II be responsiin ble for fai d►spos►tion of archival = recortls at this point e _ _ � _ Form Updated 4/91/18;: