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,-City of Santa Ana <br />�► Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />core attics use onj <br />T.. <br />�. fg},�T, 61 IN rT H ; F--R <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amendments (if any) are no longer in effect.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 1 00 <br />No. N-2022-046 <br />was completed on <br />(List a.!! amendments. Use space below if needed.) <br />hagreementslformsVorm - agreement termination form,geldenred,dec <br />io V1-3 <br />Department: <br />Phone/Ext.: <br />Signature: <br />Date: <br />C2- <br />and final payment has been made. <br />