Laserfiche WebLink
City of Santa A,-7 <br />>r Clerk of the Coun...i <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amendments (if any) are no longer in effect.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 />JIA 19 M 3: 12 <br />Y OF SANTA ANA <br />ERK OF COUNCIL <br />No. N-2017-235 was completed on 11119)IJ and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: <br />Phone/Ext.: 5d n <br />Signature: < .�IuM lAjQA1 L/ <br />Date: sIs4l(W <br />Revised: 10-18-16 <br />