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a,4 wry Or ,3unru Hnu <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amendments (if any) are no longer in effect.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 />COTC Office Use Only <br />City of Santa Ana <br />JUN 2 3 W1 <br />Clerk of the Council <br />No. N-2019-050 was completed on, ig ,?-C% and final payment has been made. <br />(List all amendments. Use space below if needed.) f Ck <br />Department: <br />Phone/Ext.: <br />N-2019-050-01 <br />Signature: <br />Date: <br />Revised. 10-1 B-16 <br />