HomeMy WebLinkAboutDispositions Forms_02-25_1/31/2025_Public Works NO. 002
RECORDS DISPOSITION DOCUMENT OZS
PAGE OF 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 O c. Send to Storage until e. Recycle
Disposition Date Met
Ob. Send to Storage for Shredding O d. Remove from Server O f. Other
4. SUBMITTED BY (Department Head/Senior Staff Member Only):
I hereby certLfy that the rec rd to be disposed of are correctly represented below, that any audit requirements for the
recor ave b n s * d, and that further retention is not required for any litigation pending or imminent.
Doug Chambers, Director of Public Works
S i g n a t u rtr`�� Name and Title (Dept. Head/Senior Staff only) at�
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 193 Inspection Records: 4 CY 2018 LCgr(C
Fire/Security/Safety/Health .01 31 azs-
GS1-SL 41 Property Transfer Records 1FY 2017-2020 .02
GS1-SL 104 Equipment/Vehicle Maintenance Records 1FYafter 2002-2019 .01
disposition or
5FY after
ervi a/maintena
GS1-SL 136 Project Files: Capital Improvement 10FY 2002 .01
GS1-SL 238 Public Program/Event Records 5FY 2018 .01
TOTAL CUBIC FEET THIS PAGE: 06
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.
deleti n r modifications are indicated.
I `1�1 Janet McCorkle, Admin Ashrx y" fflV4=== q I f/3� ZoZS
Clerk's ce Signat re Date gnature 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