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City of Santa Ana <br />Clerk of the Council l <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amendments (if any) are no longer in effect. C1 P <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 V <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 Vj � e- I� � <br />No. A-2020-043-18 was completed on <br />(List all amendments. Use space below N needed.) <br />i]agreementsVormslform - agreement termination form_goldenrod.doc <br />COTC Office Use Only <br />� HE s°€1UNPP <br />131'23 PM3:59 <br />a and final payment has been made. <br />Department: <br />Phone/Ext.: <br />Signature: <br />Date: <br />