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City of Santa Ana <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amendments (if any) are no longer in effect.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. <br />Is the agreement(s) a permanent record? Yes No *41 <br />Return form to the Clerk of the Council Office (M-30). aid@=`P"2;5-5 <br />Call 647-1520 if you have any questions. <br />The agreement with <br />N-2018-224 <br />No. <br />(List all amendments. <br />Revised: 10-18-16 <br />was completed on 12 131 I10ft and final payment has been made. <br />Use space below ff needed.) <br />Department: fK5A I man <br />Phone/Ext.: 5 219 <br />Signature: <br />Date: <br />