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City of Santa Ana S 93 <br />zT +• t Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />Please complete this form in its entirety when the attached agreement and <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amendments (if any) are no longer in effect.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 J <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 1 J &q-- r LQ u) e, <br />COTC Office Use On <br />OF THE COUNCIL <br />' 1'22 Am 0:20 <br />N-2022-236 8J296[2 L <br />No. was completed on and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: fp-c-'�IA <br />Phone/Ext.: C-3e <br />Signature: <br />Date: <br />ilagreementsUormslform - agreement termination form_goldenrod.doc <br />