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0 <br />City of Santa Ana <br />✓ Clerk of the Council �I <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amendments (if any) are no longer in effect.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 />N-2023-051 <br />No. was completed on <br />(List all amendments. Use space below if needed.) <br />iiagreemene farms\Farm - agreement termination form_goldenrod.doc <br />COTC Office Use Only <br />City of Santa Ana <br />JUL 0 6 2023 <br />City Clerk's Office <br />6 Z and final payment has been made. <br />Department: PKSPS- <br />Phone/Ext.: �2 -7 <br />Signature: <br />� / 2 <br />Date: �Ila I %iJ <br />