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City of Santa Ana <br />Clerk of the Council COTC Off Ice Use <br />l.. .... ..... - <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amendments (if any) are no longer in effect.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 -PJUW� <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 />No. N-2019-074 was completed on 46130 14020 and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: 99VO% <br />Phone/Ext.:'►9 <br />Signature:. <br />Revised: 1 P1 & 16 <br />