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nr City of Santa Ana <br /> Clerk of the Council COMOf..._ce....UseO........... .__._...._...._ <br /> { COTC Office Use Only <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 amendments (if any) are no longer in effect.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 /> • <br /> Is the agreement(s) a permanent record?Yes No X <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 L.L . by e_ (',j v <br /> No. A-2 On - 1% -0 \ was completed on gjif I and final payment has been made. <br /> (List all amendments. Use space below if needed.) 'Sty : C ., h' i . 6 X'O+56K <br /> Onyi QL'l raL4-1(1A41 Department: r)A — 'd . Hi vc . <br /> 11 ' Phone/Ext.: l\c i i ow/ -0I VYI o n <br /> Signature: <br /> DELIVERED FEB 2 2 2010 Date: d/ ?t/ /i. <br /> Revised: 10-18-16 <br />