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0�„ 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 a <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amendments (if any) are no longer in effect.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 <br />Return form to the Clerk of the Council Office (M-30). <br />Call 647-1520 if you have any questions. <br />OF THE COILIMIL <br />9'22 Am11:1H <br />The agreement with Ma - ` ri o we'S <br />N-2019-091-01 <br />No. was completed on /P gib and final payment has been made. <br />(List all amendments. Use space below if needed.) �r� <br />Department: (' FCS--)nv— <br />Phone/Ext.: <br />Signature: <br />Date:���- <br />Revised: 10-18-16 <br />