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City of Santa t -a <br />f Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />Please complete this form 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amendments (if any) are no longer in effect.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 />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 />COTC Office Use <br />-Mg JUL 19 PM 3, 0 <br />CITY OF SANTA ANA <br />CLERK OF COUNCIL' <br />No. N-2016-036 was completed on �/ I and final payment has been made. <br />(List all amendments. Use space below if needed.) _ <br />Department: �j91��Y1LIN�J <br />Phone/Ext.: <br />Signature: AkNokn <br />Date: -7Lgoi,ty <br />Revised 01-07-16 <br />