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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amendments (if any) are no longer in effect.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 � <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 I'Via Way," 1j - ?bVyes MukRign Lymovwnaq <br />COTC Office Else Oniv <br />coo 2v-Z-' <br />City of Santa Ana <br />O ty Clerk's Office. <br />No. N _2 V2 Z_0 19 was completed on )7 and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: C <br />Phone/Ext.: ' <br />Signature: <br />Date: �' <br />i:lagreementsiformsVorm - agreement termination form—goldenrod,doc <br />