Laserfiche WebLink
City of Santa Ana <br />Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />use uniy <br />Please complete this form when the attached agreement and all <br />amendments (if any) are no longer in effect. ]ail! nfT 22 rnI y,'2b <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. r <br />F SMNTA.P <br />CITY J <br />Return form to the Clerk of the Council Office (M-30). <br />CLElti <br />Call 647-1520 if you have any questions. <br />The agreement with G �\��n�eNV bev��o�r <br />No, 1� - Z-.L was completed on CQ (3a(Z,�x Y and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: I W OUL <br />Phone/Ext.: (ZU ZI Q <br />Signature: d✓- �� ��^ �� <br />Date: t o 1 7 8 1 t `� <br />Revised: 01-07-16 <br />