Laserfiche WebLink
City of Santa Ana <br />_mow <br />_DV City Clerk <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amendments (if any) are no longer in effect.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 farm to the City Clerk's Office (,M-30). <br />Call 647-6520 if you have any questions. <br />The agreement with Ir V1 r1-ILt,V+ C/CAACAVI'lMSG% C <br />No. - W2023_209 was completed on <br />(List ail amendments. Use space below if needed.) <br />Department: <br />COTC Office Use Qnl <br />(2 <br />City of Santa Ana <br />JAN 11 zon <br />City Clerk's Office <br />and final payment has been made. <br />Phone/Ext.: "�,]s <br />Signature: <br />r <br />Date: <br />i.tagreementsVormsVorm - agreement termination form —golden rod.doc <br />