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City of Santa Ana n <br />Clerk of the Council nn �VI <br />AGREEMENT TERMINATION FORM l <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amendments (if any) are no longer in effect.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. / , SON <br />Is the agreements) 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. P 1 ` dD90 Jsl ' 63 was completed on <br />(List all amendments. Use space below if needed.) <br />COTC Office Use Only <br />AFA CITY CILERK <br />14123 A.ml1:33 <br />and final payment has been made. <br />Department: <br />Phone/Ext.: <br />Signature: I/ <br />Date: I zz' <br />rlagreements'forms 'form agreement termination form_goldenrod doe <br />