HomeMy WebLinkAboutDispositions Forms_02-22_1/26/2022_UtilitiesNO. v
RECORDS DISPOSITION DOCUMENT PAGE OF PAGES
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 F 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 Q c. Send to Storage until e. Recycle
Disposition Date Met
Ob. 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
reco have b �fullyjustified, and that further retention is not required for any litigation pending or imminent.
4r)ZA J_Signature Name and Title (Dhior Sta on y -7 Date
a. c. d. e. f. g.
Schedule Item Title Retention Inclusive Volume Disposition
No. No. Dates in Action and
Cubic Date
Feet (completed After
Authorizatio
GS1-SL 70 Bid Records: Capital Improvement ^�c 10/1996 .04
Successful Bids r�� tili"d o(2Z
GS1-SL 71 Bid Records: Capital Improvement 5FY 10/1992 I 02
Unsuccessful Bids 10/1998 ��Zro�ZZ
6. DISPOSAL AUTH RIDisposal or
the above listed records is authorized. Any
letions or modifications are indi ated.
/ t11 A�-
Clerk's Office gignature bate
TOTAL CUBIC FEET THIS PAGE:
7 MPOSAL CERTIFICATE: The above listed records have been
disposed of in the manner and on the date shown in column g.
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