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City of Santa Ana <br /> E4' Clerk of the Council COTC Office Use Only <br /> AGREEMENT TERMINATION FORM '0 .IR 30 3 7 <br /> Please complete this form in its entiretywhen the attached agreement and dl i' 5 <br /> p g �-,{ ; �f �"r kJ—, <br /> I,i� <br /> amendments (if any) are no longer in effect. -~R? O� f, . I L.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 J•R <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 i 'ic -,r.1 `rra- N INc, 9i C-c'N N14r. Ltd <br /> No. 2 C>1 ' • dqS was completed on f":.5a1 lel and final payment has been made. <br /> (List all amendments. Use space below if needed.) <br /> Department: ivdA- <br /> Phone/Ext.: <br /> Signature: l'.41011Letdr\----• <br /> Date: <br /> Revised: 10-18-16 <br />