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HomeMy WebLinkAboutDispositions Forms_86-21_9/21/2021_ManagerNO. (p_af 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 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). 0 a. Shred at Department Level O c. Send to Storage until 0 e. Recycle Disposition Date Met Ob. Send to Storage for Shredding O d. Removed from Server Of. 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 justified, and that further retention is not required for any litigation pending or imminent. DigJeremy Allen Datea2021.09.1 lly signedby Jeremy Jeremy Allen, Village Manager 09/14/21 Signature Name and Title (Senior Staff only) Date 5. 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 10a 122 Administrator Records: Agency Director/ 10 Anv.Yr: 1/1/1999-6/15/2010 .3 gfa,/IX/ Program Manager 10b 122 Administrator Records: Agency Director/ Program Manager OSA 1 /1 /1999-1 /1 /2021 .3 q/� f �/ TOTAL GUBIC FEET THIS PAGE: .6 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. deletions or modifications are indicated. y/1J1J-1 Debra A. Telfrin °,:,�"-0,ar Debra A. Telfrin 09H4/2t' ecords 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 4. Completed form to Village Clerk's Office for permanent records 3. Clerk's Office will be responsible for final disposition of archival records at this point Form Updated: 4/11/18 OR