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STATE DEPARTMENT OF REHABILITATION (3) -2012
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STATE DEPARTMENT OF REHABILITATION (3) -2012
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Last modified
4/17/2020 12:24:56 PM
Creation date
9/27/2012 10:55:49 AM
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Contracts
Company Name
STATE DEPARTMENT OF REHABILITATION
Contract #
A-2012-124
Agency
COMMUNITY DEVELOPMENT
Council Approval Date
6/4/2012
Destruction Year
0
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.'.r>. City of Santa Ana <br /> a , COTC Office Use Only i <br /> x, �, Clerk of the Council <br /> „. , <br /> '"'.` AGREEMENT TERMINATION FORM <br /> • <br /> Please complete this form when the attached agreement and all • <br /> amendments (if any) are no longer in effect. <br /> i <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 /> • <br /> Return form to the Clerk of the Council Office (M-30). <br /> Call 647-1520 if you have any questions. <br /> 1 <br /> / ////e./a44-7-friejt.)7 <br /> / <br /> The agreement with %, Dr= 1�,E- /96'/G/),T / /of <br /> No. 7- — 2 0/ 2 - /2 Li: was completed on 1 _Fv/2_0,c c and final payment has been made. <br /> (List all amendments'. Use ace below if needed.) / <br /> A <br /> Department: ei6e9 <br /> Phone/Ext.: o2Z.2/ <br /> r <br /> Signature: / 6pf247-/ .-n,4v C."/ 6�� <br /> Date: 1 9 // <br /> Revised:01-07-16 <br />
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