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City of Santa Ana <br />t = Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />Please complete this form in its entirety when the attached agreement anEr i <br />amendments (if any) are no longer in effect. <br />Note: If your agreement Is grant related, please ensure that all grant retention requirements CITv <br />have been satisfied prior to signing the termination form. CLE. <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 />COTC Office Us? Only <br />12 AM 9- 50 <br />OF COUNCIL <br />The agreement with ECOm <br />No. �% f5 �l� was completed on / and final payment has been made. <br />(List all amendments. Use space below N needed.) <br />P <br />Z?' <br />Re•,ised: 10-73-16 <br />-/6'�-r)/ <br />-1(!� '�-0--�- <br />Department: Ayl q 1J') <br />Phone/Ext.: x �d 3 <br />Signature: J �� <br />Date: t%c <br />