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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 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 have been fully justified, and that further retention is not required for any litigation pending or imminent.
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Sign re 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
2
ADMIN CONVENIENCE RECORDS
OSA
2003-2019
1.5
5h1664
2
GS1-SL
358
PENSION RECORDS: PLAN/FUND
5 FY
1996-2007
1.5
GS1-SL
108
FINANCIAL REPORTS: LOCAL
5 FY
2004-2016'
'
GOVERNMENT ANNUAL REPORTS
GS1-SL
436
FINANCIAL TRANSACTION RECORDS
10 FY
2005-2006
SUMMARY
GS1-SL
241
INCIDENT REPORT FILES
5 FY
2003
,
TOTAL CUBIC FEET THI
X'
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.
letions or modifications are indicated.
-
-S g/ y1 13
Signature of Person Disposing of Records Name/Title Date
Clerk's Office Signature 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.
b.
C.
d.
e.
f.
9.
Schedule
Item
Title
Retention
Inclusive
Volume
Disposition
No.
No.
Dates
in
Action and
Cubic
Date
Feet
(Completed
After
Authorization
GS1-SL
405
LEIN DOCUMENT FILES
5 FY
200 -2017
GS1-SL
271
FEE/SERVICE SCHEDULE
5 FY
2000-2016
GS1-SL
87
BARGAINING RECORDS
5 FY
2000
GS1-SL
27
LITIGATION FILES
5 AY
1999-2015
GS1-SL
397
BALLOTS
30 DAYS
2004-2005
,
GS1-SL
223
EQUIPMENT REFERENCE FILES
OSA
1998
GS1-SL
373
SUBJECT REFERENCE FILES
OSA
1994-2017
i/ .dam
GS1-SL
325
HIPAA SECURITY STANDARDS
6 AY
2010-2014
IMPLEMENTATION RECORDS
GS1-SL
137
PROJECT FILES: FEDERAL
5 FY
1998-2009
GS1-SL
422
GRANT FILES
5 FY
2000-2003
GS1-SL
111
INSURANCES RECORDS
5 FY
19 01
.r o
GS1-SL
324
HIPAA HEALTHCARE COMPONENT
6 AY
2009
RECORDS
GS1-SL
210
DISASTER PREP PLAN
5 FY
1996-2013
TOTAL CUBIC FEET THIS PAGE:
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