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City of Santa Ana <br />S� Clerk of the Council <br />AGREEMENT TERMINATION FORM 1 �J <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amendments (if any) are no longer in effect.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 />The agreement with <br />A-2020-251-01 <br />No. was completed on <br />(List all amendments. Use space below if needed.) <br />i:lagreemenlslforms4arm -agreement termination form_goldenrod.doc <br />COTC Office Use Only <br />OF THE COUNCIL <br />131'23 PM3:5$ <br />t! and final <br />payment has been made. <br />Department: a- <br />Phone/Ext.: // (0 �� ( <br />Signature: �If C <br />Date: 1 �_ (4 ZZ <br />