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>, City of Santa Ana h" Clerk of the Council <br /> r_. COTC Office Use Only i <br /> eit AGREEMENT TERMINATION FORM �, <br /> TD ! i ': 5 <br /> Please complete this form when the attached agreement and all <br /> amendments (if any) are no longer in effect. ,, r,- c A° :; l. <br /> Note: If your agreement is grant related,please ensure that all grant retention requirements I r i �1 : I <br /> have been satisfied prior to signing the termination form. <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 . M i)(RC ? K- C v ( <br /> No. ! -()C' V '- 0 ( *2) was completed on /6 . a1-6 and final payment has been made. <br /> (List all amendments. Use space below if needed.) /�ff/IkJ <br /> Department: ` UCJ fi — bS( <br /> Phone/Ext.: X S-0 f 7 <br /> Signature: i ,...._ , <br /> Date: 7/4/8 <br /> Revised:01-07-16 <br />