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City of Santa Ana <br />Clerk 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amendments (if any) are no longer in effect.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 />COTC Office Use Onlv <br />The agreement with A I CM Iris Gmt e60 <br />No. N-2021-002 was completed on and final payment has been made. <br />(List all amendments. Use space below if needed.) nrt <br />Department: [DAy R05 3 %+uxt"' <br />• - y a U, 11,^�. <br />nagreements formsrtorm- agreement termination form goldenrod doc <br />