Laserfiche WebLink
City of Santa Ana <br />Clerk of the Council COTC Office Use Only <br />AGREEMENT TERMINATION FORM <br />Please complete this form in its entirety when the attached agreement au�� �,l �(, ,2 �y(� �6 <br />amendments (if any) are no longer in effect. v <br />Note: If your agreement is grant related, please ensure that all grant retention requirements have been satisfied prior to signing the termination form. CITY <br />(� Y T Y O () F SUM TA COUNCILAPiANA <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 />NA)-N_2016-175 <br />(List ell amendments. <br />was completed on ? n, and final payment has been made. <br />Use space below if needed.) <br />N-20(3--0)1 <br />IIV- 2-6 i s - o6'? <br />Department: QRCESA <br />Phone/Ext.: <br />Signature: <br />Date: �201� <br />Revised: 10-18-16 <br />