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City of Santa Ana G COTC Office Use OnN <br />Clerk of the Council J <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amendments (if any) are no longer in effect.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 CLERK OF € HE r r <br />have been satisfied prior to signing the termination form. ,,0' 44 <br />j�j PI# 2^ ,t, "' � ��wi:�� <br />Is the agreement(s) a permanent record? YesEl 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 />STEPHEN H. SOLOMON <br />No. N-2022-042 was completed on 06/23/2022 and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />M- ZaZ2--Bt{Z-bl <br />i:14mementsVom Vorm - agreement tenninagon form_goldemodAm <br />Department: Planning and Building <br />Phone/Ext.: X2717 <br />Signature: v' V "— - <br />Date: 08/23/2022 <br />