HomeMy WebLinkAboutDispositions Forms_10-20_3/13/2020_Fire NO. I
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RECORDS DISPOSITION DOCUMENT PAGE 1 OF 1 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).
Qa. Shred at Department Level Q c. Send to Storage until O e. Recycle
Disposition Date Met
Qb. Send to Storage for Shredding d. Removed from Server Q f. Other
4. SUBMITTED BY:
I hereby certify that the records to be disposed of are correctly represented below, that any audit requirements for the
records ve been fully justified, and that further retention is not required for any litigation pending or imminent.
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Wure Name and Title (Senior Staff only) Date
6. 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
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TOTAL CUBIC FEET THIS PAGE: 01
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.
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Records Liaison Officer Signature Date - nature Name/Title Date
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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
Village o Te uesta
345 Tequeste Drive $61-768-0704
Tequesta, FL 33469 www.taqueste.org
Village Clerk's Office
Lori McWilliams, MMC
Letter of Transmittal
561-768-0440
Date: 3/12/20
To: Chief Trube
The records on the attached records disposition forms are approved for disposition.
• Once you have shredded or recycled the records, notate "shredded or recycled and the date"
in column g
•The person who disposes of the records should sign under Item 7 and date
• Return original to Clerk's Office
❑ For Your Records ❑ For Recording
❑ As Requested F-1 Returned for Corrections
❑ For Review and Signature Other:
(return to Clerk's Office) Please shred, sign and return
Staff Comments:
Vice-Mayor Kristi Johnson Mayor Abby Brennan Council Member Vince Arena
Council Member Laurie Brandon Council Member Kyle Stone
Village Manager Jeremy Allen