Laserfiche WebLink
City of Santa Ana <br />Clerk of the Council <br />AGREEMENT TERMINATION FG <br />Please complete this form in its entirety when the attached agreement and all <br />amendments (if any) are no longer in effect. <br />Mote: If your agreement is grant related, please ensure that all grant retention requirements <br />have been satisfied prier 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 />ChwiTN <br />COTC Office use O <br />C2,022", <br />t~& of Sari A <br />Clerks Of, <br />N-2022-110 \' <br />No. - was completed on and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: C, p E1 <br />Phone/Ext.: j S <br />Signature: L ftA.&ZNj�. <br />Date:F <br />i:�agreementsldorms\form - agreement termination forrn_goldenrod.doc <br />