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City of Santa Ana <br />t City Clerk <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amendments (if any) are no longer in effect. r R EG <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 City Clerk's Office (M-30). <br />Call 647-6520 if you have any questions. <br />The agreement with <br />COTC Office Use Only ' <br />OF THE COUNCIL <br />! 10'23 Am9:30 <br />No. /V -Zola — 034 was completed on ZO Z®1 and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />— nc,. A -?.o1a - 03u-cl1 <br />Department:y 0 Tc <br />Phone/Ext.: <br />Signature: <br />Date: to 2� c;L�cl <br />