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City of Santa Ana <br />'f Clerk of the Cot. :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amendments (if any) are no longer in effect.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 />The agreement with <br />No. A-2018-082 was completed on <br />(List all amendments. Use space below if needed.) <br />COTC Office Use Only <br />2020 Fro -6 PH 3 37 <br />fTY OF <br />LERK CLERK OSA TA AAA <br />14311d and final payment has been made. <br />Department: Y kSr <br />Phone/Ext.: Li14 M <br />Signature: <br />Date: j0� <br />Revised: 10-18-16 <br />