Laserfiche WebLink
City of Santa Ana <br />QPClerk of the Council <br />AGREEMENT TERMINATION FORM <br />COTC Office Use Only <br />Please complete this form in its entirety when the attached agreement and all <br />amendments (if any) are no longer in effect. 20_70 MAY 1 P3 4, 13 <br />Note: If your agreement is grant related, please ensure that all grant retention requirements T Y Or S <br />have been satisfied prior to signing the termination form. t I I COUNCIL )�,I TA A NA <br />Is the agreement(s) a permanent record? Yes _ No� CLERK DF <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 />�F 1 <br />No. A- Z0) S' W3— 02' was completed on 62 and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: _r IN 4 <br />Phone/Ext.: /X a2�1,0 L <br />Signature: <br />Date: I. L4 1201.? <br />Revised: 10-18-16 <br />