HomeMy WebLinkAboutDispositions Forms_16-23_7/6/2023_Fire4
RECORDS DISPOSITION DOCUMENT
PAGE 1 OF 2 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 0 e. Recycle
Disposition Date Met
b. Send to Storage for Shredding 0 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
records ve been fully justified, and that further retention is not required for any litigation pending or imminent.
Sign re Name and Title (Dept. Head/Senior Staff only) Date
5. LIST OF RECORD SERIES
b.
C.
d.
e.
f.
g.
'e Item
Title
Retention
Inclusive
Volume
Disposit',on
No.
Dates
in
Action and
Date
(Completed After
Cubic
Feet
Authorization
70
RUN REPORTS: EMERGENCY
7 AY
2001
1.5
@ W d
Zj
GS4
70
RUN REPORTS: EMERGENCY
7 AY
2009-2010
1.5
GS4
70
RUN REPORTS: EMERGENCY
7 AY
2014
1.5
GS4
70
RUN REPORTS: EMERGENCY
7 AY
2014
1.5
GS4
70
RUN REPORTS: EMERGENCY
7 AY
2014
1.5
TOTAL CUBIC FEET THIS PAGE:
7.
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 man r and on the date shown in column g.
de etions or modifications are indicated.
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C Is Office Signature Date
Signature of Person Disposing of Records Name/Title ate
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
r-4
v
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
GS4
70
RUN REPORTS: EMERGENCY
7 AY
2014
1.5
A0
'7L3
GS4
10
RUN REPORTS: EMERGENCY
7 AY
2014
1.5
TOTAL CUBIC FEET THIS PAGE: