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City of Santa Ana <br />rt Clerk of the Coy II COT- Office Use Only <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amendments (if any) are no longer in effect.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 ✓ CLERK Cl T€)E CO NCIL <br />JUL 2E522 P44:27 <br />Return form to the Clerk of the Council Office (M-30). <br />Call 647-1520 if you have any questions. <br />The 0nraamant with <br />A-2018-124-01 <br />W l <br />No. was completed on <br />(List all amendments. Use space below if needed.) <br />Revised: 10-18-16 <br />Cafes rots i o" <br />�?l j2fL and final payment has been made. <br />Department: <br />Phone/Ext.: �rpGj� <br />Signature: <br />Date:/3l �- <br />