Laserfiche WebLink
City of Santa Ana <br />.- City Clerk <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amendments (if any) are no longer in effect.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 City Clerk's Office (M-30). <br />Call 647-6520 if you have any questions. <br />The agreement with <br />N-2023-129 <br />J i o'nrn vnt <br />No. _ was completed on <br />(List all' -amendments. Use space below if needed.) <br />i:\agreements�formslform - agreement termnaticn form_goldenrod.doc <br />COTC Office Use Only <br />GZo 23 <br />E�it,V of Bantu Ana <br />JAN 11 20M <br />y Clerk",,; Office <br />and final payment has been made. <br />Department: <br />Phone/Ext.: <br />,q <br />Signature: <br />Date: <br />