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 ally Ivnll ' fir <br />; <br />amendments (if any) are no longer in effect. - a j <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. Ft` <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 />5/20 i,b <br />The agreement with / - tJ 5 <br />e — (l <br />No. was completed on and final payment ment has been made. <br />(List all amendments. Use space below if needed.) <br />S N'20tQ-0g3[S) COM Department: PO✓Sallnld/ 9JAL 6a <br />Phone/Ext.: p �® <br />Signature: �C <br />Date: 1�t7 <br />Revised: 10-18-16 <br />