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a. City of Santa Ana <br />Cfvrk 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amendments (if any) are no longer in effect.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 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 />N-2020-202 <br />No. was completed on I (I 7 bow <br />(List afl amendments. Use space below N needed.) <br />Department: <br />Phone/Ext.: <br />COTC Office Use On <br />City of Santa Ana <br />AUG 02 2021 <br />Clerk of the Council <br />and final payment has been made. <br />,��� C�rSII-� <br />5� `T <br />Signature: ;,yA).V ja �W00 <br />Date: -7/a7 b-1 <br />iaagreementsBormsWorm- agreement termination form_goldenrodAm <br />