Laserfiche WebLink
(a <br />City of Santa Ana <br />Clerk of the Council <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amendments (if any) are no longer in effect.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. r"`i p: <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 />No N-2017-131 was completed on <br />(List all amendments. Use space below if needed.) <br />Revised: 1 Pl & 16 <br />N17 T 41= COUNCIL <br />s2s PN3:29 <br />7v <br />y/,-) (- i_ and final payment has been made. <br />Department: PRS4 <br />Phone/Ext.: Wig <br />Signature: Doan/' <br />Date: Q fi Liz0 <br />