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Ja- <br />City of Santa Ana <br />'-1 Clerk of the Council <br />ti• <br />AG1 �l�nr�Er�r r��nn�rvATION FoRn� <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amendments (if any) are no longer in effect.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- i 520 if you have any questions. <br />The agreement with <br />1tl �-sU M <br />CQTC [3ftiee Use Qn! <br />C1Crz--1?-- <br />City of Santa Ana. <br />JAN 11 2024 <br />City Clerk's Office <br />No. N-2022-331 . <br />aisf all amendments. Uses ae as completed an and final payment has <br />� e below if needed'. been made. <br />Department <br />Phone/Ext..- <br />Signature: <br />i:lagreementsVormsVorm- agreement termination form Date. <br />�gofdenrad.doc <br />