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HomeMy WebLinkAboutDispositions Forms_08-22_5/13/2022_UtilitiesNO. 0PAGE RECORDS DISPOSITION DOCUMENT ! OF I 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). Oa. Shred at Department Level O c. Send to Storage until Q e. Recycle Disposition Date Met b. Send to Storage for Shredding O d. Remove from Server O 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 record h been full justified, and that further retention is not required for any litigation pending or imminent. 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 SG1-SL 27 LITIGATION CASE FILES 5AY after 2010 2er-4apd closed 01 © 5 t ZZ SG1-SL 27 LITIGATION CASE FILES 5AY after 2011 .02 KeC4CAeCp closed 51 IS I2Z TOTAL CUBIC FEET THIS PAGE: ,03 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. 5-110 4 - Clerk's Office Signature Date Sign ure of Person Disposing 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