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City of Santa Ana ' l <br />Clerk of the Council I <br />AGREEMENT TERMINATION FORM <br />Please complete this form in its entirety when the attached agreement <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amendments (if any) are no longer in effect.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 />COTC Office Use Oniv <br />OF 1 ;F COUNCIL <br />31'23 P148:57 <br />The agreement with A n U/I l (; <br />No. A-2020-157-03 was completed on !J"7 —d��-and final payment has been made. <br />(List ice below if needed.) <br />Department: <br />Phone/Ext..- <br />Signature: <br />Date: <br />i]agreementearmi - agreement termination brm_ goldenrod.doc <br />c:::,OA <br />