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City Of Santa Ana ' COTC Office Use Only <br />.r y Clerk of the COL —Al <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amendments (if any) are no longer in effect.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 gra etention requirements <br />have been satisfied prior to signing the termination form. SPI"ITA, AFAR MY CLERK <br />Is the agreement(s) a permanent record? Yes No MAR 13'23 PmM <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-2020-157-01 <br />No. was completed on and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: <br />Phone/Ext.: <br />Signature: <br />Date: `/ —�/ `� — a `-;,— <br />ilagreements�formslform - agreement termination form_goldenrod.coo <br />