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City of Santa Ana <br />Q9Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />Please complete this form in its entirety when the attached agreement and <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amendments (if any) are no longer in effect.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 <br />Return form to the Clerk of the Council Office (M-30). <br />Call 647-1520 if you have any questions. <br />i <br />The agreement with <br />COTC Office Use Only <br />OF THE COLII~fr: <br />131'2S PM$:59 <br />No. 6- 20=) - 01-43 -G-'as completed on ��nnd final payment has been made. <br />(List off amendments. Use space below if needed.) <br />Department: <br />C/1� <br />Phone/Ext.: <br />t <br />Signature: <br />Date: <br />iiagreementslfarms\farm- agreement termination form_goldenrod.doa <br />