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'y1 City of Santa Ana Q ,1 I os <br />�'� J J" <br />t 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amendments (if any) are no longer in effect. City of Santa Ana <br />Note. If your agreement is grant related, please ensure that all grant retention requirements have been satisfied prior to signing the termination form. AUn <br />o 02 2021 <br />Is the agreement(s) a permanent record? Yes_ ,4o ✓ Clerk of the Council <br />Return form to the Clerk of the Council Office (M-30). <br />Call 647-1520 if you have any questions. i <br />The agreement with 1� U o S w'A u Yn (( i1 t1 n �1L% 1 JQ 5f 4 V 1 CCU <br />N-2018-058 <br />No. was completed on �4 /9/racl?) and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: ?RrsA <br />Phone/Ext.: li'dkal <br />Signature: 44 t <br />nn9fi+ <br />Date: _\ 0. <br />Revised: 1618-16 <br />