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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amendments (if any) are no longer in effect.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. <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. <br />N-2018-077 was completed on 5I y <br />(List all amendments. Use space below if needed.) <br />COTC Office Use <br />JUL 19 PM 3: n b <br />Y OF SANTA ANA <br />ERK OF COUNCIL <br />and final payment has been made. <br />Department: V U-9 A <br />Phone/Ext.: ��� <br />Signature: 'tz�a—p�]��4 Al�/J a <br />Date: � 10 <br />I I <br />Revised: 10-18-16 <br />