Laserfiche WebLink
City of Santa Ana <br />Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />Please complete this form when the attached agreement and all Aid rr:r } '� <br />amendments (if any) are no longer in effect. <br />Note: If your agreement is grant related, please ensure that all grant retention requirements C i V v f ° <br />have been satisfied prior to signing the termination form. <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 />No. N-2016-104 was completed on ) -] and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: P A- <br />Phone/Ext.: <br />Signature: fi{1Gti�\ A1�s\�C <br />Date: <br />Reeked: 01-07-16 <br />