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HomeMy WebLinkAboutDispositions Forms_93-21_9/29/2021_Clerk93-21 RECORDS POSITION 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, MPA, MMC, (561) 768-0443 or Tequesta, FL 33469 Mary Ann Grieser, CMC, (561) 768-0445 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 0 d. Remove from Server f. Other 4. SUBMITTED BY (Department Head/Senior Staff Member Only): 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. ligLori MCWIII18r11S Dat'e:202tally 1..092ned 9122 McWilliams Lori McWilliams 09/29/2026 Signature Name and Title (Dept. Head/Senior Staff only) Date i, 5. LIST OF RECORD SERIES VMS 10' a. b. C. d. e. 17inActPion . Schedule Item Title Retention Inclusive sition No. No. Dates and Cubic Date Feet (Completed After Authorization GS1-SL 269 EMPLOYEE ASSISTANCE PROGRAM 2 anniv 12/17 and 7/2019 .001 Shred - RECORDS years 9/29/21 2 ADMINISTRATIVE CONVENIENCE OSA 2012 - 2015 .001 Shred - RECORDS 9/29/21 TOTAL CUBIC FEET THIS PAGE: .002 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. Lori McWilliams Dom 021.0 9122409.pg00s 09/29/2021 Lori McWilliams MWW Y ,9 �sY Data 2o2;092912:2418-NW Lori McWilliams 09/29/2021 Clerk's Office Signature Date Signature of Person Disposing of Records Name/Title Date Routin : 75 1. Originates wit Ifi ©epaftm'ehf 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 storages 3. Originating department to dispose and document column g, at the storage room and will contact Public Works tt3 rem.,.v Then sends records 4. Completed form to Village Clerk's Office for permanent 3. Clerk's Office will be responsible for final dis archival records at this point LWwwwwwww", Form p ated 9121/ 1, Updated: 2