HomeMy WebLinkAboutDispositions Forms_98-21_11/5/2021_UtilitiesNO. q ? _ mPAGE
RECORDS DISPOSITION DOCUMENT
1 OF all 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).
0 a. Shred at Department Level 0 c. Send to Storage until e. Recycle
Disposition Date Met
Qb. Send to Storage for Shredding 0 d. Remove from Server 0 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 hav en f y justified, and that further is not required for any litigation pending or imminent.
IIretention
/� 11*V�,N , �'w':'d U41.14�5 v A
Signature Name and Title (Dept. Head/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
GS1-SL
167
Environmental Regulation Compliance Records
5 FY
10/1993
07/1988
0.01
GS1-SL
64
Contracts/Leases/Agreements: Capital
10FY
05/1988 & 06/1988
0.01
Improvement
10/1998
GS1-SL
64
Contracts/Leases/Agreements: Capital
10FY
10/1989 & 01/1990
0.01
Improvement
10/2000
"
GS1-SL
433
Subdivision Plans: Preliminary Plans/Drawings
10AY
03/1996
0.01
03/2006
dw
GS1-SL
433
Subdivision Plans: Preliminary Plans/Drawings
10AY
05/1996
0.01
05/2006
f
TOTAL CUBIC FEET THIS PAGE:
0.05
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
111 Il__ 1 A M6.il4tA PIW19-1
Clerk's Offlce Signature Date
Signature c0ersbn Di
ing of Records 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:9/21/21
OR
Continuation Page
a.
Schedule
No.
b.
Item
No.
C.
Title
d.
Retention
e.
Inclusive
Dates
f.
Volume
in
Cubic
Feet
g.
Disposition
Action and
Date
(Completed
After
Authorization)
GS1-SL
433
Subdivision Plans: Preliminary
Plans/Drawings
10AY
11 /2005
11/1995
0.01
11
1/704411-1
GS1-SL
435
Financial Transaction Records:
Detail
5FY
10/2002
03/1997
0.01
TOTAL CUBIC FEET THIS PAGE:
0.02