HomeMy WebLinkAboutDispositions Forms_23-25_12/18/2025_Utilities NO.
RECORDS DISPOSITION DOCUMENT PAGE 1 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 Q c. Send to Storage until Q e. Recycle
Disposition Date Met
0 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 ha been fully justified, and that further retention is not required for any litigation pending or imminent.
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 167 Environmental Regulation Compliance Records 5FY 11/2017 expiration date 0.01
10/2023
TOTAL CUBIC FEET THIS PAGE: 1 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.
y� I ( ��
Clerk's Office Signature Date Signature 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
NO.
RECORDS DISPOSITION DOCUMENT PAGE 1� 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 c. Send to Storage until 0 e. Recycle
Disposition Date Met
0 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.
Signatur 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
GS14 133 Utility Records: Management and Monitoring 10AY 09/2014 0.01
10/2024
TOTAL CUBIC FEET THIS PAGE: 1 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.
Clerk's Office Signature Date Signature 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
NO.
RECORDS DISPOSITION DOCUMENT PAGE OF PAGES
1. AGENCY NAME and ADDRESS 2. AGENCY CONTACT (Name and Telephone
VILLAGE OF TEQUESTA Number)
345 Tequesta Drive Lori McWilliams, MMC
Tequesta, FL 33469 561 768-0443
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 c. Send to Storage until e. Recycle
Disposition Date Met
b. Send to Storage for Shredding d. Removed from Server Of. Other
4. SUBMITTED BY:
I hereby certify that the records to be disposed of are correctly represented below, that any audit requirements for the
records,have been fully iustified, and that further retention is not required for any litigation pending or imminent.
i'��t �,✓ VV1M d 6 >1
Signature Name and Title (Senior Staff only) Date
S. LIST OF RECORD SERIES
After the Item #, place an "a" for record copy or"b" for du licate.
a. b. C. d. e. f. g.
Schedule Item Title Retention Inclusive Volume Disposition
No. No. Dates in Action and
Insert"a" Cubic Date
or„b" Feet Completed
after item After
#(247b) I Authorization
GS1 SL 167a Environmental Regulation Compliance Records 5FY 101� 06/2019 0.01
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. yh�L
Records Liaison Officer Signature Date Signature KamefTitle 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: 4/11/18, 1/26/21
OR
NO.
RECORDS DISPOSITION DOCUMENT PAGE OF PAGES
1. AGENCY NAME and ADDRESS 2. AGENCY CONTACT (Name and Telephone
VILLAGE OF TEQUESTA Number)
345 Tequesta Drive Lori McWilliams, MMC
Te uesta, FL 33469 561 768-0443
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 Q c. Send to Storage until 0 e. Recycle
Disposition Date Met
Ob. Send to Storage for Shredding O d. Removed from Server Of. Other
4. SUBMITTED BY:
I hereby certify that the records to be disposed of are correctly represented below, that any audit requirements for the
records ha bee justified, and that further retention is not required for any litigation pending or),.,-,
r I
Sig 6ature Name and Title (Senior Staff only) ate
5. LIST OF RECORD SERIES
After the Item #, place an "a"for record copy or"b" for duplicate
a. b. C. d. e. f. g.
Schedule Item Title Retention Inclusive Volume Disposition
No. No. a3 I Dates in Action and
Insert"a" Cubic Date
or"b" QS r�� Feet Completed
after item After
#(247b) Authorization
GS1-SL 70a Bid Records: Capital Improvement Successful 10FY 02/2013 0.01
Bids 10/23
TOTAL CUBIC FEET THIS PAGE: 1 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. �1 I r
Records Liaison Officer Signature uate Signature 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: 4/11/18, 1/26/21
OR
NO.
RECORDS DISPOSITION DOCUMENT PAGE OF PAGES
1. AGENCY NAME and ADDRESS 2. AGENCY CONTACT (Name and Telephone
VILLAGE OF TEQUESTA Number)
345 Tequesta Drive Lori McWilliams, MMC
Tequesta, FL 33469 561) 768-0443
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
Qb. Send to Storage for Shredding O d. Removed from Server Of. Other
4. SUBMITTED BY:
I hereby certify that the records to be disposed of are correctly represented below, that any audit requirements for the
records have een fully justified, and that further retention is not required for any litigation pending or imminent.
Signature Name and Title (Senior Staff only) ate
5. LIST OF RECORD SERIES
After the Item # lace an "a" for record copy or "b" for duplicate
a. b. C. d. e. f. g.
Schedule Item Title Retention Inclusive Volume Disposition
No. No. Dates in Action and
Insert"a" Cubic Date
or"b" Feet Completed
after item After
#(247b) Authorization
GS1-SL 435a Financial Transaction Records: Detail 5FY 10/2017 0.04
10/2023
GS1-SL 435a Financial Transaction Records: Detail 5FY 11/2017 0.04
10/2023
GS1-SL 435a Financial Transaction Records: Detail 5FY 12/2017 0.04
10/2023
GS1-SL 435a Financial Transaction Records: Detail 5FY 01/2018 0.15
10/2023
GS1-SL 435a Financial Transaction Records: Detail 5FY 02/2018 0.10
10/2023
TOTAL CUBIC FEET THIS PAGE: 0.37
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.
Records Liaison Officer Signature Date Signature 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: 4/11/18, 1/26/21
OR
Continuation Page
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 435a Financial Transaction Records: 5FY 03/2018 0.13
Detail 10/2023
GS1-SL 435a Financial Transaction Records: 5FY 04/2018 0.15
Detail 10/2023
GS1-SL 435a Financial Transaction Records: 5FY 05/2018 0.10
Detail 10/2023
GS1-SL 435a Financial Transaction Records: 5FY 06/2018 0.14
Detail 10/2023
GS1-SL 435a Financial Transaction Records: 5FY 07/2018 0.13
Detail 10/2023
TOTAL CUBIC FEET THIS PAGE: 0.65