Laserfiche WebLink
�. City of Santa Ana <br />t Clerk of the Council corcOffice Use Only <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amendments (if any) are no longer in effect.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 W T H' C1139UNCIL <br />AUG 2'21 -m31:32 <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 />N-2017-236 <br />No. was completed on <br />(List all amendments. Use space below if needed.) <br />Revised: 10-18-16 <br />and final payment has been made. <br />Department: PR <br />Phone/Ext.: q�p/t ) q <br />Signature: <br />Date: <br />