HomeMy WebLinkAboutDispositions Forms_04-19_2/14/2020_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
belo (specify only one).
a. Shred at Department Level ( ". Send to Storage until e. Recycle
Disposition Date Met
b. Send to Storage for Shredding d. Removed from Server 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 have been fully justif' , nd that further retention is not required for any litigation pending or imminent.
- ; / ra
Signature Name and Title (Senior Staff only) Date
-5 = LIST OF RECORD;SERIES
a. b. C. 9.
Schedule Item Title Retention Inclusive Volume Disposition
No. No. Dates in Action and
Cubic Date
Feet .Completed
After
Authorization
O'Xgo-4a I oZ01 .sh fedde
ykI,kcj S( .) +t s 5 F` �30 3 I//
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SL 3�� �SbuN,Uuh��,c QJ 5 F
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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.
del
'Ins or modifications are indicate
d. r`'���
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R.:cor Liaison Officer Signature Date gnature Name/Title Date
_ Rou in -
-=..:sm '*'S u' `• '.' `r4 ": =::= .C._� g
a .a x.-
Or.� mates_w th_De. arfinent Sensor anerg he, J
1 Qnginates with:Department Sensor Manager, then
j�S.ViI( r""fe Glerk's OfFice`authonzes dis os_�t�on 4and:returrts to: 2 U�Ilage Clerk s OfFice:authonzes disposit o and/or.storage
3Or�gtnafing department to dispose and docurne�ncolumn g, at the storage room and will contact Rublic Wokstoirernove
then sends r fi records
4; Completed form to Village Clerks Office for permanent: 3 Clerk's Office w►I{ be responsible for final d1sposit�an of
archival - records at this point
_ m Update
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