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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amendments f if any) are no longer in effect.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 <br />0-202-2-249 <br />No. <br />{List all amendments. <br />�Am�cs 00 C;C(o <br />was completed on <br />Use space below N needed.) <br />Department: <br />Phone/Ext.: <br />Signature: <br />Date: <br />CaTC Office Use Onl <br />C 2U 2,2 <br />ow of Santa AM <br />City Clark's Office <br />and final payment has been made. <br />V0�3 <br />2 <br />