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-� City of Santa Ana <br />�T, 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amendments (if any) are no longer in effect.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 />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 />ovl'za�u <br />0-46 <br />No.was completed on <br />(List all amendments. Use space below if needed.) <br />hagreementsVormsVorm - agreement termination form—goldenrod.doc <br />Department <br />COTC Office Use Only <br />City of Sang Ana <br />JAIL 11 2024 <br />City Clerk's Office <br />and final payment has been made. <br />Phone/Ext.: <br />Signature: <br />Date: 17 <br />