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w� 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 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amendments (if any) are no longer in effect.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 L�/(3 tn �y— <br />At�Ao <br />COTC Office Use Only <br />City of Santa Ana <br />A'U i 02 2021 <br />Clerk of the Council <br />No. N-2018-194 was completed on 10113)lk and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: P lz—u�'P� lwArnk-, <br />Phone/Ext.: sac—Z - n <br />Signature: C2- <br />Date: %1D-71,DA <br />Revised: 10-18-16 <br />