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City of Santa Qna <br />Clerk of the Cou:._il <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amendments (if any) are no longer in effect.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 />i <br />The agreement with <br />COTC Office Use Only <br />City of Santa Ana <br />t;1e 02 2021 <br />Clerk of the Council <br />No. A—ao iLl—tO`Z—C.c; was completed on op/L721 12M� and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />A—DD I L{--LD 9 <br />A----ac I Y t0 �-'- 01 <br />pt--a01W-- I &-0 :�L <br />Revised: 10-18-16 <br />Department: M--BA <br />Phone/Ext.: <br />Signature:fldw <br />Date: ISO <br />