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City of Santa Ana <br />,,•- t Clerk of the Council i COTC Office Use Only <br />AGREEMENT TERMINATION FORM <br />Please complete this form in its entirety when the attached agr nFMqV 4, 23 <br />amendments (if any) are no longer in effect. <br />Note: If your agreement is grant related, please ensure that all grant retention regl{IT T1Yt1OF S A 1JTA A N A <br />have been satisfied prior to signing the termination form. CL ERK GF COUNCIL <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-2018-226 was completed on <br />(List all amendments. Use space below if needed.) <br />%/ s li y and final payment has been made. <br />Department: MC- <br />Phone/Ext.:iq <br />Signature: <br />Date: <br />Revised: 10-18-16 <br />