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City of Santa Ana <br />i 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amendments (if any) are no longer in effect.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 />COTC Office Use Only <br />,1111. 19 I M 31 12 <br />:ITY OF SANTA ANA <br />CLERK OF COUNCIL <br />The agreement with �G il� Fti ti FNCYI (1190 'lrt . f lck <br />hG <br />N-2018-035 was completed on Jf �41y <br />(List all amendments. Use space below if needed.) <br />and final payment has been made. <br />Department: <br />9 V—C-5��4 <br />Phone/Ext.: <br />u <br />Signature: <br />c!^a <br />" '�' <br />�� i QyJIL �• L,vCN(V) <br />Date: <br />2J.'/ L V <br />Revised: 10-18-16 <br />