Laserfiche WebLink
City of Santa Ana <br />=* r Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />Please complete this farm in its entirety when the attached agreement and <br />amendments (if any) are no longer in effect. <br />Nate: If your agreement is grant related, please ensure that all grant retention requirements <br />have been satisfied prior to signing the termination form. <br />Is the agreement(s) a permanent record? Yes No <br />Return form to the Clerk of the Council Office (M-30). <br />Call 647-1520 if you have any questions. <br />The agreement with <br />No. ` 201 (0_ was completed on�Z-') 3) I6 <br />s -- <br />(List all amendments. Use space below if needed.) <br />Department: <br />r'agreerrentVorrns4orm - agreement termination form_goldenrod.doc <br />COTC Office Use_9nlY <br />czo�(D <br />5 <br />and final payment has been made. <br />Phone/Ext.: 42. <br />n } <br />Signature: <br />Date: H <br />