HomeMy WebLinkAboutDispositions Forms_06-25_2/11/2025_Utilities RECORDS DISPOSITION DOCUMENT PAGE d 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).
Oa. Shred at Department Level O c. Send to Storage until O e. Recycle
Disposition Date Met
Ob. 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.
Marjorie Craig, Utilities Director �/�/�25
Signer 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
GS-14 133 UTILITY RECORDS: MANAGEMENT AND 10AY 1998, 1999, 2000 1
MONITORING �^
GS-14 135 UTILITY RECORDS: REPORTING 5FY 1999, 2000, 2001 1
COMPLIANCE
TOTAL CUBIC FEET THIS PAGE:
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.
d I ions or modifications are indicated.
&L4-- anaJ-- „ zs
Jerk's Office Signature Date Sigbhture of FVson Disposing of Records N me/Title ate
o (�►c,tM r
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