Laserfiche WebLink
City of Santt- ,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amendments (if any) are no longer in effect.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 />l <br />ff t V <br />No. A - 20 )Sr I vrr 7 was completed on <br />(iis€a!1amend ments. Use space below Mneeded.) <br />Department: <br />Phone/Ext.: <br />Signature: <br />Date: <br />i:{806mensVarWOm - agmememtarminallon fOM _galdsrad,doa <br />COTC Office Use OnN <br />and final payment has been made. <br />