HomeMy WebLinkAboutDisposition Forms_15-18_02/21/2018_Public Works NO.
RECORDS DISPOSITION DOCUMENT
PAGE OF / PAGES
1. AGENCY NAME 2. AGENCY CONTACT(Name and Telephone
VILLAGE OF TEQUESTA Number)
Lori McWilliams, MMC
DEPARTMENT: Public Works (561) 768-0443
3. NOTICE OF INTENTION: The scheduled records listed in Item 5 are to be disposed of in the manner checked
below(specify only one).
0a. Shred 0b. Imaging and Destruction �c. Recycle
0 d. Removed from Server e. 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 f III ' stified, and that further retention is not required for any litigation pending or imminent.
Doug Chambers _ _
Signatur Name and Title (Senior Staff only) Date
5. LIST OF RECORD SERIES
6.
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
. jrco/r�,
GS1-SL 186 Directives/Policies/Procedures 2 yrs 2013 •1 r-T7 c_i.
TOTAL CUBIC FEET THIS PAGE: I
7. DISPOSAL AUTHORIZATION: Disposal for 8. DISPOSAL CERTIFICATE: The above and below listed records have
the above listed records is authorized. Any been disposed of in the manner and on the date shown in column g.
deletions or modifications are indicated. ",7 to the r ord disposition)
��— pis��a Sig_ to V6 Date1
Custodian/Records Liaison Officer Date
Name and e 1 �r
Form Updated: 1/3/17