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 ' <br />amendments (if any) are no longer in effect. 2017 SEEP 25 <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. CITY OF S# <br />CLERK t� <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-2016-131 was completed on <br />(List atf amendments. Use space below if needed.) <br />Revised: 01-07-16 <br />C 2 o;i <br />COTC Office Use Only <br />,✓ <br />?14 3* i <br />ON ANA <br />�: 1' <br />I r <br />"{ Gl f Li and final payment has been made. <br />Department: 1 <br />Phone/Ext.: <br />Signature: Aiy 4_ ,(°@JQ-Jvfek1 <br />Date: <br />V <br />