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- City of Santa Ana <br />City Clerk <br />t <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amendments (if any) are no longer in effect.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 />s the agreement(s) a permanent record? Yes No <br />Return form to the City Clerk's Office (M-30). <br />Call 647-6520 if you have any questions. <br />The agreement with <br />N-2023-072 <br />No. was completed on <br />(List all amendments. Use space below if needed.) <br />L agreementslformsVorm - agreement termination forrn_golden rod.doc <br />COTC Office use onto <br />City off Santa AIM <br />JAN 11 2024 <br />City Clerk's Office <br />and final payment has been made. <br />Department: <br />Phone/Ext.: V <br />Signature. - <br />Date: <br />