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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amendments (if any) are no longer in effect.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 />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 />Return form to the Clerk of the Council Office (M-30). <br />Call 647-1520 if you have any questions. <br />The agreement with <br />cul <br />GOTC <br />[t AMU I 1i 15 T- e <br />CIT 1'= F <br />No. Zrgc)o, 6 07% was completed on and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: <br />Phone/Ext.: S <br />Signature: <br />qSo n <br />Date: to <br />Revised: 01-07-16 <br />