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t„ City of Santa Ana <br />Clerk of the Council V <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amendments (if any) are no longer in effect.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— No <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 />_t' <br />(J6 <br />COTC Office Use Onlv <br />OF THE COUNCIL <br />131'23 Prn3:57 <br />A-2020-043-03 <br />No. was completed on %r`A _ a) -and final payment has been made. <br />(List all amendments. Use space below N needed.) <br />Department: �jlPA <br />Phone/Ext.: <br />Signature: -� <br />Date: <br />i:lagreemmts\tomn;V m-agreement termination form_goldenrod.doc <br />