HomeMy WebLinkAboutDispositions Forms_89-21_9/22/2021_UtilitiesNO. 09rAlPAGE
RECORDS DISPOSITION DOCUMENT
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
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 e. Recycle
Disposition Date Met
0 b. Send to Storage for Shredding � d. Removed from Server 0 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 havepbeen fully justified, and that further retention is not required for any litigation pending or imminent.
4
40-1�----
J - L)+ - %
. -, ✓ oZ
Sign ture Name and Title (Senior Staff only) behe
5. LIST OF RECORD SERIES
After the Item #, place an "a" for record copy or "b" for duplicate
a.
b.
C.
d.
e.
f.
g.
Schedule
Item
Title
Retention
Inclusive
Volume
Disposition
No.
No.
Dates
in
Action and
Insert "a"
Cubic
Date
or °b°
Feet
Completed
after item
After
# (247b)
Authorization
GS14 PU
135a
Utility Records: Reporting Compliance
5FY
11/1998-12/1998
0.03
flt�
10/2004
07/1999-09/1999
QkJ
GS14 PU
135a
Utility Records: Reporting Compliance
5FY
10/1999-09/2000
0.12
Q
10/2005
GS14 PU
135a
Utility Records: Reporting Compliance
5FY
11/2000
0.01
10/2006
41 a
TOTAL CUBIC FEET THIS PAGE:
0.16
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.
eletions or modifications are indicated.
' y glablaI4�i
Records Liaison fficer 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, 1/26/21
OR