Form Ogc-S-1998-39 - Notice Of Contract Cancellation
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1Form No. OGC-S-1998-39
Notice of Contract Cancellation
Customer Name: ___________________________________
Contract Amount: ________________________
TMAC Engineer: ___________________________________
Contract Start Date: ______________________
Description of Services: ____________________________
Contract End Date: _______________________
____________________________________________________
IN ORDER FOR THIS NOTICE TO BE EFFECTIVE, IT MUST BE DELIVERED IN PERSON OR BE
SENT BY CERTIFIED MAIL, RETURN RECEIPT REQUESTED, TO THE FOLLOWING ADDRESS:
University of Houston
Texas Manufacturing Assistance Center
815 TMAC Building
Houston, TX 77204-6023
To be completed by the Customer:
In accordance with the terms of the above-referenced contract with the University of Houston, TMAC
Gulf Coast, I hereby give notification to terminate said contract. I understand that termination will be
effective 30 days from the date of receipt of this notification by the University of Houston. As the duly
authorized representative for the above mentioned firm, I acknowledge responsibility only for services
rendered by UH TMAC Gulf Coast prior to the effective termination date of the contract, as amended
by this notification (30 days from receipt by UH TMAC).
___________________________________________________
___________________________________________
Signature of Customer’s Authorized Representative
Date
___________________________________________________
___________________________________________
Printed Name
Title
To be completed UH/TMAC Engineer:
Signed Notification received on ____________________
Received by: ______________________________
Date
TMAC Engineer
____ No Services were rendered under this contract. A full refund of all fees paid in advance is due to
the Customer.
____ No services were rendered under this contract, and no funds were received in advance from the
Customer.
____ Services were rendered of ____ hours @ $____ per hour. A refund is due to the Customer from
funds received in advance of the contract.
____ Services were rendered of ____ hours @ $____ per hour. Customer should be billed for amounts
due TMAC in excess of any advance fees paid.
Cancellation Acknowledged by: _____________________________________________________________________
Ann Pham, Director, TMAC
Date
Please submit a copy with all required signatures to the Business Office for processing/records retention.
Note: Modification of this Form requires approval of OGC
Office of the General Counsel
TMAC Gulf Coast Agreement Cancellation
OGC-S-1998-39 Revised 09.24.09
Page 1 of 1
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