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Or City of Santa ,Ana <br />Y'* City Clerk <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amendments (if any) are no longer in effect, 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 agreements) a permanent record? Yes No <br />Return form to the City Clerk's Office (M-30) . <br />Cali 647-6520 if you have any questions. <br />The agreement with Y <br />COTC Office Use Onf <br />C -�,3 <br />City Of Santa Are, <br />JAN 11 2024 <br />City Clerk's Office <br />No. N-2023-237 ? Z? <br />was completed on and final payment has been mad <br />(List all amendments. Use space below if needed.) e. <br />i:�agreementstiformslform - agreement termination form ❑oidenrod.dor. <br />f . <br />Department:t� <br />Phone/Ext.: <br />Signature: - <br />Date: <br />