Laserfiche WebLink
City of Santa 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amendments (if any) are no longer in effect.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 />COTC Office Use Only <br />OF =1- E COUNCIL <br />11122 A.14E3: s <br />The agreement with GQrdm G(ftile uai CA &661 0113 -ICA <br />N-2022-249 <br />No. was completed on and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: ��CS <br />Phone/Ext.: <br />Signature: <br />Date: ( VYs-, <br />i1agreementslformstlorm - agreement termination form_goldenrod.doc <br />