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City of Santa Ana <br />Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />COTC Office Use Only <br />C2-(S)Z9 <br />Please complete this form in its entirety when the attached agreement and all <br />amendments (if any) are no longer in effect. <br />Date: 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 N <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 />No. N-2022-224 <br />(List all amendments. <br />I <br />was completed on and final payment has been made. <br />Use space below it needed.) <br />Department: u-sk <br />Phone/Ext.: _Ll i <br />Signature: <br />Date:' <br />