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0City of Santa Ana <br />'�'� Clerk of the Council <br />of <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amendments (if any) are no longer in effect.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. f; `: <br />Is the agreement(s) a permanent record? Yes _ No L <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. <br />N-2020-039 was completed on <br />(List all amendments. Use space below if needed.) <br />i9agreements\forms\form- agreement termination form_goldenrod.doc <br />COTC Office Use Only <br />i tF THE COUNCIL <br />Pp l: rl <br />1J 1( <br />and final payment has been made. <br />Department: <br />I M <br />Phone/Ext.:� <br />Signature:Al�n%Cn!Z— <br />11 <br />Date: <br />7130 <br />