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L City of Santa Ana <br />Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />Please complete this form in its entirety when the attached agreement andy�rlb <br />amendments (if any) are no longer in effect. <br />Note: If your agreement is grant related, please ensure that all grant retention requirements+T <br />have been satisfied prior to signing the termination form. r" <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 />The agreement with kfPL. % go -(6-(a" Irj C.. <br />COTC Office Use Only <br />No. (J • 2,01%, 01-`t was completed on ty I I S and final payment has been made. <br />(List all amendments. Use space below N needed.) <br />Department: IOW* <br />Phone/Ext.: 5;61el <br />Signature: 1 <br />o <br />Date: <br />Revised: 10-18-16 <br />