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w <br />City of Santa Ana <br />k <br />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amendments (if any) are no longer in effect. <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. CLE} <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 />N-2018-193 <br />No. <br />(List all amendments. <br />Revised: 10-18-16 <br />OF THE COUNCIL <br />2'21 PM3:27 <br />was completed on \OA;1'201and final payment has been made. <br />Use space below if needed.) <br />Department: Nal;, <br />Phone/Ext.: ua 1 0i G1 <br />Signature: (y A���i� <br />Date: �`( `2A1 A <br />