Laserfiche WebLink
City of Santa Ana <br />Clerk of the Council cmc orr �e u5e <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amendments (if any) are no longer in effect. ?--1 IE€ -J F"! 3: �2 <br />Note: If your agreement is grant related, please ensure that all grant retention requirements r <br />have been satisfied prior to signing the termination form.'' o {'d <br />,t3 <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 F-rlbk D ✓Ecm <br />No. N-2017-119 was completed on -7 i[ t F7 and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: <br />Phone/Ext.: DSs / <br />Signature: ` Q iOA <br />Date: L O 16d q <br />Revised: 10-18-16 <br />