Laserfiche WebLink
City of Santa P. na <br />Clerk of the Cou _ d corc <br />-- <br />AGREEMENT TERMINATION FORM <br />Please complete this form in its entirety when the attached agr(P?@) fE"4 M ti; 2 I <br />amendments (if any) are no longer in effect. <br />Note: If your agreement is grant related, please ensure that all grant retention requliReheMs O F SA N �3A A N A <br />have been satisfied prior to signing the termination form. CLERK OF COUNCIL <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 />No. N-2017-060 was completed on <br />(List all amendments. Use space below if needed.) <br />Use Only <br />5/6/ZDII and final payment has been made. <br />Department: NC -SA <br />Phone/Ext.: �d Ic1 <br />Signature: AMa,D AWIw— <br />Date: "L13 hot <br />Revised: 10-18-16 <br />