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City of Santa Ana <br />Clerk of the Council COTC Off ice Use Only <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amendments (if any) are no longer in effect.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 />City of �anta Ana <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 />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. <br />� <br />The agreement with <br />��.20���^i55 <br />No. � woscnmpletodon and final payment has been made. <br />(List all amendments. Use space below ifneeded] <br />Department: VRcGA <br />Phone/Ext.: Ltalct <br />Signature: <br />Date: ° <br />novisou)wm^ <br />