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City of Santa Ana <br />Clerk of the Council <br />Cu )l <br />AGREEMENT TERMINATION FORM <br />Please complete this form in its entirety when the attached agreement and all <br />amendments (if any) are no longer in effect. <br />Note: 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 MWAV ►' 6 <br />No. l�V�� ` ✓tfr was completed on �I <br />(List all amendments. Use space below if needed.) <br />Department: <br />/� yy����j I Phone/Ext.: <br />Mi)Irn/r r V/r f t� • k- ' p DI Signature: <br />A—�1'v'Q--,'— Date: <br />i,lagreementsVormsVorm- agreement termination form_gol enr doc <br />COTC Office Use Oni <br />OF THE COUNCIL <br />6'21 Pm.23:5 <br />and final payment has been made. <br />fdaMAW � � bA <br />