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6 <br />City of Santa Ana COTC Office Use Only <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amendments (if any) are no longer in effect.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 1:1 No �✓ CLERK OF THE COUNCIL <br />U! ? 3'22 AMB:41; <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 TRB+ ASSOCIATES <br />No. A-2019-199-12 was completed on M and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />�Vei�jDy- �l�Vi��� 1'1� Department: Planning and Building <br />yu s ed , ND payryCntS Phone/Ext.: x2717 <br />1 d 1�ilt�� Veer Signature: <br />Date: <br />r1agmemenlsUams4orm- agmement termination fomn—goldenrod.dm <br />07/12/2022 <br />