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City of Santa Ana <br />City Clerk <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amendments (if any) are no longer in effect, .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 City Clerk's Office (M-30). <br />Call 647-6520 if you have any questions. <br />The agreement with -DQ U SCkoo <br />m-2023-27 <br />Ci_ty_Clerk's Office Use Only <br />C- wz.3 <br />No. was completed on ubl lv7 and final payment has been made. <br />(List all amendments. Use space below if needed.) I <br />Department: <br />Phone/Ext.: �, <br />Signature: <br />Date: <br />i_tagreementsVormsVorm - agreement termination form goldemod.doc <br />