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.. City of Santa Ana <br /> p�':�:r•. t Clerk of the Council COTC Office Use Only <br /> L• +ems. <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 amendments (if any) are no longer in effect.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 litraill (�41� 7 -1-)/kt -e--- <br /> �� ee <br /> No. Ai- /4- -/-7 was completed on 5-41f and final payment has been made. <br /> (List all amendments. Use space below if needed.) le,•,.cser <br /> ,q <br /> Department: pen <br /> Phone/Ext.: ?.5-61 <br /> Signature: - �/ <br /> Date: �l (�` l t ! <br /> Re,n=d. 10-13-I6 <br />