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City of Santa Ana <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amendments (if any) are no longer in effect.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 ,, <br />have been satisfied prior to signing the termination form. ' -a 02 LU`2ni <br />Is the agreement(s)apermanent record? Yes _ No Clerk ofthcCouncil <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 MJ/1 1 1s c�`P-KA �j. <br />No. N-2018-178 was completed on %cl l I K and final payment has been made. <br />(List all amendments. Use space below if needed.) �7 <br />Department: <br />Phone/Ext.: GDtS7-1 <br />Signature: <br />Date <br />Revised: 10-18-16 <br />SU U <br />