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City of Santa Ana <br />Clerk of the Col. .Gil <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amendments (if any) are no longer in effect.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 />OF THE COI INC7L <br />i 2S'23 PM4:32 <br />A-2018-135-03 <br />No. was completed on 14 (?i Z and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: CQa <br />Phone/Ext.: bs�('o' <br />Signature: 1C11� <br />Date: <br />Revised: 10-18-16 <br />