HomeMy WebLinkAboutDisposition Forms_38-15_05/20/2015_Parks and Recreation REC ORDS '• • DOCUMENT NO. I
Revised: 1/22/14 PAGe of - PAGES
1. AGENCY 2. DEPARTMENT 3. BUREAU
Village of Tequesta �� �( N/A
4. ADDRESS (Street, City, and Zip Code) S. CONTACT (Name and Telephone Number)
345 Tequesta Drive Lori McWilliams, MMC
Tequesta, FL 33469 561- 768 -0440
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) manner checked below (specify only one):
1 ,.
Only the Depa e Hea h he q to sign off on Item 6.
Signature Date CJ
Name
Title i` C. 8'
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
Feet Authorization
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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 RVcords Disposition)
Signature Date C! �`l ) Signature Date
Print Name: Lori McWilliams, MMC Print Name `i � v
i It Print Title: Village Clerk Print Title 'i P o
NOTE: JDon disposition retain this form for your records
Light gray shading indicates a field required to be completed by department.
Print For
Light blue requires a signature
•'� � '• • �• NO. � 8'fs
Revised: 1/22/14 PAGE . OF R PAGES
1.AGENCY 2. DEPARTMENT 3. BUREAU
Village of Tequesta (:S ion N/A
4. ADDRESS (Street, City, and Zip Code) S. CONTACT (Name and Telephone Number)
345 Tequesta Drive Lori McWilliams, MMC
Tequesta, FL 33469 561- 768 -0440
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 immine . manner checked below (specify only one):
Only the Dep rt ent He a a he u rity to sign off on Ite 6.
Signatur Date
Name 111,14
Title t C 7
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
Feet Authorization
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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.
(e (Witness to the Re rds Disposition)
Signature 6U, Date `�' '�� Signature Date �'1 �� 19
Print Name: Lori McWilliams, MMC Print Name 04
Print Title: Village Clerk Print Title if V 0 �� L
NOTE: Upon disposition retain this form for your records
Light gray shading indicates a field required to be completed by department.
Print Form
Light blue requires a signature
REC ORDS . DOCUMENT NO. 3g -Is
Revised: 1/22/14 PAGE OF -PAGES
1.AGENCY 2. DEPARTMENT 3. BUREAU
Village of Tequesta ���5,Pj�� -�0� 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 -0440
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 teat further retention is not required for any The scheduled records listed in Item 8 are to be disposed of in the
litigation pending or immine 1: manner checked below (specify only one):
Only the Dep nt Hea a he u ority to sign off on It 6.
Signature ' Date Z ,4 —
Name
Title
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
Feet Authorization
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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 Re ords Disposition) s,
Signature ��� Date `�'`I, I�� Signature Date / ) / "
�r
Print Name: Lori McWilliams, MMC Print Name
l `
Print Title: Village Clerk Print Title �� a %/ (( 1 / iKCC
NOTE: Upon disposition retain this form for your records
Light gray shading indicates a field required to be completed by department.
Print For
Light blue requires a signature
REC ORDS ' • • N DOCUMENT NO.
Revised: 1/22/14 PAGE OF 'PAGES
1.AGENCY 2. DEPARTMENT 3. BUREAU
Village of Tequesta V t QA-i 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 -0440
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, andAhat further retention is not required for any The scheduled records listed in Item 8 are to be disposed of in the
litigation pending or immin n . manner checked below (specify only one):
Only the Dep ,1 nt Hea h au h rity to sign off on Item 6.
Signature Date
Name ale t'
Title (j
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
Fe
r ett Authorization
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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 Re ords Disposition)
Signature Data �Q I (J� Signature Date
Print Name: Lori McWilliams, MMC Print Name 11 t
Print Title: Village Clerk Print Title 0" e 0
NOTE: Upon disposition retain this form for your records
Light gray shading indicates a field required to be completed by department.
Print For
Light blue requires a signature
RECORDS DISPOSITION DOCUMENT
Revised: 1/22/14 "So - PAGES
1.AGENCY 2. DEPARTMENT 3. BUREAU
Village of Tequesta -f 'aVt/'Sks tCY 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 -0440
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 immure f7 manner checked below (specify only one):
Only the Depart ent Head s e t ority to sign off on Item 6.
Signature / Date
Name
Title
ir
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
p Feet Authorization
CA )l
NJ
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XI
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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 Re ds Disposition)
Signature (� �— Date �f 1 Signature Date"
Print Name: Lori McWilliams, MMC Print Name P'Z�
Print Title: Village Clerk Print Title h
NOTE: Upon disposition retain this form for your records
Light gray shading indicates a field required to be completed by department.
Print Form
Light blue requires a signature
•'� '• • �• NO. O
Revised: 1/22/14 PAGE OF —PAGES
1.AGENCY 2. DEPARTMENT 3. BUREAU
Village of Tequesta hr-, b Re �Q,B- cs� 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 -0440
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 immi nt manner checked below (specify only one):
Only the Dep ent Ne h thority to sign off on Ite 6. T
Signatur Date
Namee e / /`1���f OL
Title
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
Feet Authorization
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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 Roc rds Disposition)
Signature �F Date I 03- Signature Date /,J(
Print Name: Lori McWilliams, MMC Print Name
Print Title: Village Clerk Print Title : • f
NOTE: Upon disposition retain this form for your records
Light gray shading indicates a field required to be completed by department.
Print For
Light blue requires a signature
REC ORDS '• • DOCUMENT WW
Revised: 1/22/14 PAGE OF PAGES
1.AGENCY 2. DEPARTMENT 73.BUR
Village of Tequesta
4. ADDRESS (Street, City, and Zip Code) 5. CONTACT (Name and Telephone Number)
345 Tequesta Drive Lori McWilliams, MMC
Tequesta, FL 33469 561- 768 -0440
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 immine t.' manner checked below (specify only one):
Only the Dep rt nt Head s e a h ity to sign off on Ite 6.
Signature Date
i
Name L���f/
Title 121 /* q
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
Feet Authorization
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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 Rec ds Disposition)
Signature Date YI 1 J Signature Date : �!
Print Name: Lori McWilliams, MMC Print Name
Print Title: Village Clerk Print Title Y/
NOTE: Upon disposition retain this form for your records
Light gray shading indicates a field required to be completed by department.
Print For
Light blue requires a signature
REC ORDS '• • DOCUMENT NO. MO IS
Revised: 1/22/14 PAGE Or PAGES
1.AGENCY 2. DEPARTMENT 3. BUREAU
Village of Tequesta N/A
4. ADDRESS (Street, City, and Zip Code) 6. CONTACT (Name and Telephone Number)
345 Tequesta Drive Lori McWilliams, MMC
Tequesta, FL 33469 561- 768 -0440
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: manner checked below (specify only one):
Only the Depart ent Hea h� he u y1brity to sign off on Ife 6.
Signatur /�,L Date
er
Name
Title f / `-
/ 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
Feet Authorization
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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.
r (Witness to the Re ords Disposition)
Date 1 « Signature Date Signature j.3
Print Name: Lori McWilliams, MMC Print Name
Print Title: Village Clerk Print Title -�
4 1 2
NOTE: Upon disposition retain this form for your records
Light gray shading indicates a field required to be completed by department.
Print Form
Light blue requires a signature
REC ORDS '• • DOCUMENT
Revised: 1/22/14 PAGE OF PAGES
1.AGENCY 2. DEPARTMENT 3. BUREAU
Village of Tequesta 7 @ , O ^ Zz> , P) e-Cre- at cff 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 -0440
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 r immine t. manner checked below (specify only one):
Only the Depa nt Hea h the ut rity to sign off on 1t9m 6.
Signature
Date
Name LAG
Title j
/ S. 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
-,V Feet Authorization
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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 cords Disposition)
Signature Date Signature Date 3 � I
Print Name: Lori McWilliams, MMC Print Name
Print Title: Village Clerk Print Title ` f
NOTE: Upon disposition retain this form for your records
Light gray shading indicates a field required to be completed by department.
Print For
Light blue requires a signature
Revised: 1/22/14 PAGE Of PAGES
1.AGENCY 2.DEPARTME 3. BUREAU
Village of Tequesta C red -h�t 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 -0440
S. 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 th 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 manner checked below (specify only one):
Only the Depa m t Head e a h ity to sign off on Ifern 6.
Signature Date
Name
LL If
Title / f� Q
8. LIST OF RECORD SERIES
a. b. C. d.
Schedule Item Title Retention Inclusive Volume Disposition
Item No. Dates in Action and Date
Cubic Completed After
Feet Authorization
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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 Signature Date 44
Print Name: Lori McWilliams, MMC Print Nam `
Print Title: Village Clerk Print Title i t k
NOTE: Upon disposition retain this form for your records
Light gray shading indicates a field required to be completed by department.
Print Form
Light blue requires a signature
•' '• I I Lei t• NO. �l
Revised: 1/22/14 PAGE OF .PAGES
1.AGENCY 2. DEPARTMENT 3. BUREAU
Village of Tequesta ` S �t Cx&*Cr) 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 -0440
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., manner checked below (specify only one):
Only the Dep nt Head s� au or y to sign off on Ite 6.
Signature '!J�` Date
Name / e
Title y -_
8. LIST OF RECORD SERIES
a. b. C. d. e. f• 9•
Schedule Item Title Retention Inclusive Volume Disposition
Item No. Dates in Action and Date
Cubic Completed After
Feet Authorization
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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 R ords Disposition)
Signature Date Signature Date�j ��► A j !`
Print Name: Lori McWilliams, MMC Print Name cyst 6 r �•
Print Title: Village Clerk Print Title M ze C la/
NOTE: Uoon disposition retain this form for your records
Light gray shading indicates a field required to be completed by department.
Print Form
Light blue requires a signature
REC ORDS '• • DOCUMENT NO. ltJ
Revised: 1/22/14 I MW A ftiiM i &9= �
1.AGENCY 2.DEPARTME4 N
Village of Tequesta f Kt� >�� -(_'V �-�
4. ADDRESS (Street, City, and Zip Code) 5. CONTACT (Name and Telephone Number)
345 Tequesta Drive Lori McWilliams, MMC
Tequesta, FL 33469 561- 768 -0440
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 thft further retention is not required for any The scheduled records listed in Item 8 are to be disposed of in the
litigation pending or imminen manner checked below (specify only one):
Only the Depa t Head s e jo t rlty to sign off on Ite 6.
Signature Date
Name
Title ` g. 4 er h ✓
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
Feet Authorization
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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 Rec rds Disposition)
Signature Date Signature Date
Print Name: Lori McWilliams, MMC Print Name 1 ✓✓
Print Title: Village Clerk Print Title 'Ar -c ' ecle/
NOTE: Upon disposition retain this form for your records
Light gray shading indicates a field required to be completed by department.
P rint For
Light blue requires a signature