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City of Santa Ana A� I <br />Clerk of the Co .cil l" <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amendments (if any) are no longer in effect.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. CCLERi <br />a� 1 <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 />COTC Office Use Only <br />017 T FE COUNCIL <br />1 222 H.1t8:05 <br />The agreement with Ne'lH6�e, Noire ��I'a <br />No. N-2022-294 �, <br />was completed on I � and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: P'(Sfi <br />Phone/Ext.: <br />Signature:% KV� <br />U I <br />Date: 1 F)/(l0 <br />i.lagreementslformeVorm -agreement termination form_goldenrod.doc <br />