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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amendments (if any) are no longer in effect.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 />COTC Office Use Only <br />fli: THE COUNCIL <br />Return form to the Clerk of the Council Office (M-30). <br />Call 647-1520 if you have any questions. i <br />The agreement with 1 YUZ, M 1 <br />N-2019-254-02 <br />No. was completed on and final payment has been made. <br />(List all amendments. Use space below N needed.) <br />Department: <br />Phone/Ext.: <br />Signature: bft A" �C <br />Date: <br />ilagreements6ormsNorm-agreement termination form _goldenrod.doc <br />