Laserfiche WebLink
City of San *"Ana <br />Clerk of the Council <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amendments (if any) are no longer in effect.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 <br />a WIM <br />[I'10" `QAVMC'r n'If Of OMAY L4ur1 <br />No. 'A-1021-107-07A was completed on flz:�'U ;-�' <br />(List all amendments. use space below if needed.) <br />Department: <br />Phone/Ext.: <br />Signature: <br />Date: <br />i:�agreements�formsVorrn - agreement termination form —golden red.doc <br />COTC Office Use Only <br />C2_ozz <br />City of Santa Ana <br />JAN 11 2024 <br />C,ity Clerks Office <br />and final payment has been made. <br />C�Pr <br />