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�., City of Santa Ana <br />1 Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />Please complete this form in its entirety when the attached agreement and4M ! M', ?O Am p; <br />amendments (if any) are no longer in effect. <br />Note: If your agreement is grant related, please ensure that all grant retention requirements C) T C`'� OF SF NIA A NA <br />have been satisfied prior to signing the termination form. CLE,"Rr i OFCOUNCIL <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-2018-135-24A <br />No. was completed on V `% and final payment has been made. <br />(List all amendmenrs. u3e apace below if needed.) <br />/ 2 <br />Department: <br />(J P Phone/Ext.: �((/ <br />Signature: <br />Date: <br />Revised: 10-18-16 <br />