HomeMy WebLinkAboutDispositions Forms_24-25_12/18/2025_Public Works NO. C_�
RECORDS DISPOSITION DOCUMENT PAGE / OF n 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).
Qa. Shred at Department Level c. Send to Storage until 0 e. Recycle
Disposition Date Met
0 b. Send to Storage for Shredding 0 d. Removed from Server 0 f. 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 bee fully 'ustified, and that fu5 r retention is not required for any liti ation pending or imn}in nt.
es(r
Sign atur Name and Title (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
GSI-51- 34r b )'&V(S(WaA (Zccdck L,-6 S-F y lit -sec L , Z '
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 letions or modifications are indicated.
�� -
Re o s 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
OR
tin �
RECORDS DISPOSITION DOCUMENT PAGE `' OF Y' 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).
0 a. 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
recor have been fully justified, and that further retention is not required for any litigation pending or imminent.
J/ G , (5 - (,�-o L
Si ture Name and Title (S nior 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
N-C)c qZ8 tillI�Akvns 55T`/
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.
etions or modifications are indicatedlr
(V� M U,4)A4-, k 1 \ lmw �
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
OR