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City of Santa Ana <br />Clerk of the Council <br />�k <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amendments (if any) are no longer in effect.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 />psco�te � <br />No. N-2022-010 was completed on <br />(List all amendments. Use space below if needed.) <br />^agreementsiforms�form - agreement termination form^goidenrod.doo <br />COTC Office Use Onl <br />C, W 72-, <br />-MA GL E IRIK <br />k Q 3n. <br />- <br />and final payment has been made. <br />is <br />Department: b► <br />Phone/Ext.: x <br />Signature: Ao�ok <br />Date: 07 11 / Z-6 <br />