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., <br />City of Santa Ana <br />�• <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amendments (if any) are no longer in effect.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 farm. <br />Is the agreement(s) a permanent record? Yes — No <br />Return form to the Clerk of the Council Office (M-30). <br />Call ,S47-1520 if you have any questions. <br />The agreement with <br />tUJ a a i <br />COTC Office Use Only <br />C2,C2-C <br />A-2019-094-07 <br />was completed on st a and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: OLA <br />Phone/Ext.: <br />Signature: <br />Date: <br />Revised: 10-18-1 b <br />