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City of Santa Ana <br />Clerk of the Council <br />AGREEMENT TERMINATiUN FARM <br />Please complete this form in its entirety when the attached agreement and all <br />amendments (if any) are no longer in effect. <br />Mote: 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 <br />Vk' <br />ie' tx.Yl' <br />N <br />No. N-2022-139 was completed on <br />(List all amendments. Use space below it needed.) <br />i:',agreernentslformslform - agreement termination form_go[denrod.doc <br />cg G ice Ilse <br />C 2, C) L"L' <br />City of Santa Ana, <br />JAN 11 2024 <br />City Clerk's Office <br />and final payment has been made. <br />Department: <br />Phone/Ext.: <br />Signature: <br />Date: 2-opb <br />