HomeMy WebLinkAboutDisposition Forms_02-15_01/12/2015_Building RECORDS DISPOSITION DOCUMENT NO. 1 1-15
Revls 12/20/11 PAGE OF 1 PAGES
1.AGENCY 2. DEPARTMENT [ 3. BUREAU
Village of Tequesta d;" (�.� �� -'� N/A
4. ADDRESS (Street, City, and Zip Code) 5. CONTACT (Name and Telephone Number)
345 Tequesta Drive Lori McWilliams, MMC
Tequesta, FL 33469 561- 768 -0443
6. SUBMITTED BY: I hereby certify that the records to be disposed of are 7. NOTICE OF INTENTION
correctly represented below, that any audit requirements for the records
have been fully justified, and that further retention is not required for any The scheduled records listed in Item 8 are to be disposed of in the
litigation pending or imminent. I _ manner checked below (specify only one):
Sfignature c Date Y a. b. Microfilming and Destruction
/4AZF� 0e � A J a.1 Shred Destruction a.2 Recycle
—/ (PC IN i'r , gkv rFt c. Imaging and Destruction
Name (( and �TTitle 6 d. Other
8. LIST OF RECORD SERIES
a. b. C. d. e. f. g.
Schedule Item Title Retention Inclusive Volume Disposition
Item No. Dates in Action and Date
Cubic Completed After
l r (_,� Feet Authorization
9. DISPOSAL AUTHORIZATION: Disposal for the above listed records 10. DISPOSAL CERTIFICATE The above listed records have been
authorized. Any deletions or modifications are indicated disposed of in the manner and on the date shown in column g.
(Witness to the Records Disposition)
Signature: Date: l ��r / Signature , Date -'
Print Name: Lori McWilliams Print Name: '�V ti 1 A/ 5
Print Title: Village Clerk Print Title:
NOTE: upon disposition retain this form for your records - -� O F F�
CG Cori
CERTIFICATE OF SUBSTANTIAL COMPLETION
PROJECT: Water Treatment Plant and Water System Renovation
DATE OF ISSUANCE: March 6, 2015
OWNER: Village of Tequesta
OWNER's Contract No.: N/A
CONTRACTOR: TLC Diversified, Inc.
ENGINEER: ARCADIS -US, Inc.
This Certificate of Substantial Completion applies to all Work under the Contract Documents or to the following
specified parts thereof:
All Parts
TO: TLC Diversified, Inc.
And To: Village of Tequesta
The Work to which this Certificate applies has been inspected by authorized representatives of OWNER,
CONTRACTOR and ENGINEER, and that Work is hereby declared to be substantially complete in accordance with the
Contract Documents on
March 4, 2015
DATE OF SUBSTANTIAL COMPLETION
A tentative list of items to be completed or corrected will be forwarded under separate cover. This list may not be all-
inclusive, and the failure to include an item in it does not alter the responsibility of CONTRACTOR to complete all the
Work in accordance with the Contract Documents. The items in the tentative list shall be completed or corrected by
CONTRACTOR in accordance with the contract requirements.
EJCDC No. 1910 -8 -D (1990 Edition)
Prepared by the Engineers Joint Contract Documents Committee and endorsed by The Associated General Contractors of America.
From the date of Substantial Completion, the responsibilities between OWNER and CONTRACTOR for security,
operation, safety, maintenance, heat, utilities, insurance and warranties and guarantees shall be as follows:
RESPONSIBILITIES:
OWNER: All per contract.
CONTRACTOR: All per contract.
The following documents are attached to and made a part of this Certificate:
Contractor's email requesting Substantial Completion.
[For items to be attached see definition of Substantial Completion as supplemented and other specifically noted
conditions precedent to achieving Substantial Completion as required by Contract Documents.]
This certificate does not constitute an acceptance of Work not in accordance with the Contract Documents nor is it a
release of CONTRACTOR's obligation to complete the Work in accordance with the Contract Documents.
Executed by ENGINEER on G > 2015
ARCADIS -US, INC.
ENGINEER
By:
(Authorized Signature)
3 2015
CONTRACTOR accepts this Certificate of Substantial Completion on ,
TLC DIVERSIFIED, INC
CONTRACTOR
By:
(Authorized Signature)
OWNER accepts this Certificate of Substantial Completion on 3 I la , , 2015
VILLAGE OF TEQUESTA
OWNER
By:
(Authorized Signature)
/O= EXCHANGELABS /OU= EXCHANGE ADMINISTRATIVE GROUP (FYDIBOHF23SPDLT) /CN =RECI1
From: Linwood Lee <LLee @ticdiversified.com>
Sent: Wednesday, March 04,2015 10:24 AM
To: Reese, William
Subject: 133201 Tequesta Project
Bill,
We would like to request Substantial Completion, and request that a punchlist be compiled.
Linwood (Lin) Lee
Project Manager
7233 Southern Blvd., Suite B -1
West Palm Beach, Fl. 33413
Office- 561.478.2025, X -10214
Cell- 561.719.1531
Fax- 561.478.7159
wwwAlcdiversified.com
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