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r 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amendments (if any) are no longer in effect.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 tM-Ay0 AyeVAo d <br />No, N-2022-066 <br />was leted on <br />(List all amendments. Use space below pneea d• <br />COIL Office Use oni <br />CZ-C)2- <br />'iy Of Santa Ana <br />JAR I V <br />City Clerk's Office <br />-VI II V and final payment has been made. <br />Department: <br />Phone/Ext.: <br />Signature: <br />Date: <br />i-la9reemenislformslfQrm - agreement termination farm—goldenrod.doc <br />