Laserfiche WebLink
000TCr <br />City of Santa /` is <br />t Clerk of the Cou—il <br />Office Use only <br />AGREEMENT TERMINATION FORM <br />Please complete this form in its entirety when the attached agreement and all i <br />amendments (if any) are no longer in effect. <br />Note: If your agreement is grant related, please ensure that all grant retention requirements City of Santa Ana <br />have been satisfied prior to signing the termination form. <br />Is the agreement(s) a permanent record? Yes _ No o 2 2621 <br />Return form to the Clerk of the Council Office (M-30). ClerW, of the Council <br />Call 647-1520 if you have any questions. <br />The agreement with <br />A-2019-180 <br />No. _ was completed on 91301ox and final payment has been made. <br />(l an amendments. Use space below if needed.) <br />Department: pRt"E'-A J Aq�m,l yk " <br />Phone/Ext.: E;Ds <br />Signature: s� 6 t (y> 2 6"M) <br />Date:-7bA;xl <br />Revised: I C-1 & 16 <br />