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City of Santa Ana <br />Clerk of the Council <br />CAI <br />AGREEMENT TERMINATION FORM <br />Please complete this form in its entirety when the attached agreement arUbltl <br />amendments (if any) are no longer in effect. <br />Note: If your agreement is grant related, please ensure that all grant retention requirements CITY <br />have been satisfied prior to signing the termination form. CLEZ <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 <br />A-2018-135-10A <br />No. _ was completed on <br />(List all amendments. use space below if needed.) <br />F <br />;'.j 1pJ1�Cn�`1°1e <br />90 hm s: 19 <br />S �, d fA A tN, <br />OF COUNCIL <br />and final payment has been made. <br />Department: <br />Phone/Ext.: <br />Signature: () <br />Date: <br />Revised: 10-18-16 <br />