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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amendments (if any) are no longer in effect.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 � <br />r <br />COTC Office Use Only <br />OF THE COUNCIL. <br />1 31'23 PM3:5' <br />No. A-2020-043-13 was completed on and final payment has been made. <br />(List all amendments. Use space below N needed.) (ram <br />Department: (-�Id'IAG� <br />Phone/Ext.: �� r <br />Signature: <br />Date: <br />ilagreementOmmslfarn - agreement termination form_goldenrod.doc <br />