HomeMy WebLinkAboutDispositions Forms_22-23_7/6/2023_Public Works��S�pv) 9 �
RECORDS DISPOSITION DOCUMENT
PAGES
1. AGENCY NAME and ADDRESS 2. AGENCY C, �� �` �ne
VILLAGE OF TEQUESTA Number) 1
345 Tequesta Drive Lori McWilli; I 43 or
Tequesta, FL 33469 Mary Ann G
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 0 e. Recycle
Disposition Date Met
b. Send to Storage for Shredding 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
recoo rds.have,,bp,ep.fulty'justified, and that further retention is not for anyMitigation pending or imminent.
/required
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
72
Bid Records: Non -Capital Improvement
1��2 22
11/2016
0.01
,
I
bl
TOTAL CUBIC FEET THIS PAGE:
0.01
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.
� M
Clerk's Office Signature Date
Signature of Person Disposing of Records a e itle 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