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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 al(' <br />amendments (if any) are no longer in effect. <br />Return form to the Clerk of the Council Office (M -30) <br />Call 647 -6520 if you have any questions. <br />The agreement with Antech <br />2®0 ✓ <br />COTC Office Use Only <br />No. N- 2003 -143 was completed on 6/30/04 and final payment has been made. <br />(List all amendments. Use space below 11 needed.) <br />Department: PRCSA <br />Phone /Ext.: 5254 % <br />Signature: �A <br />Date: 717114 <br />Revised 0 &2310 <br />