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City of Santa Ana <br />.� Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />Please complete this form when the attached agreement and all <br />amendments (if any) are no longer in effect. <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 Ken <br />C aoli <br />COTC Office Use Only <br />g,>.^ ? o # <br />fr,? z <br />dig$g Fr 0�, <br />Ct.[ 017 <br />No. A-2003-175BCk�wM — was completed on 12/31/2008 and final payment has been made. <br />L (List all amendments. Use space below if needed.) <br />4 t' A6 - 00( ( IQ) Department: PWA- Water <br />Phone/Ext.: 3379 <br />Signature: <br />Date: 12/17/2015 <br />Revised 10.31-12 <br />