Laserfiche WebLink
City of Santa Ana <br />Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />COTC Office Use Only <br />Please complete this form in its entirety when the attached agreeme rlo#1 / <br />amendments (if any) are no longer in effect. did 4' 36 <br />Note: If your agreement is grant related, please ensure that all grant retention requireme9d T Y Qr C F .' <br />have been satisfied prior to signing the termination form. CLERK O �,0' A A Ny 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. N-'2-at" • 02c� was completed on <br />(List all amendments. Use space below if needed.) <br />Revised: 10-1 & 16 <br />It Z r f and final payment has been made. <br />Department: <br />pWA <br />Phone/Ext.: <br />Signature:Y�— <br />Date: 3 I `7 -2-0 <br />