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 all <br />amendments (if any) are no longer in effect. <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. <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 />COTC Office Use Only <br />21119 AM 22 PH 4: 1, 4 <br />ITY OF SANTA ANA <br />CLERK OF COUNCIL <br />No. N-2017-101 was completed on . and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: <br />Phone/Ext.: j> <br />Signature: �kyyck' iLl( <br />Date: J b-(V I I <br />Revised: 1 P I & 16 <br />