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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amendments (if any) are no longer in effect.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 -6520 if you have any questions. <br />The agreement with Orchard Supply Hardware <br />C z0aq <br />s <br />COTC Office Use Only <br />aS'Ikf —D JAM v: :S5 <br />No. -2005- 066 -01 was completed on June 30, 2009 and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Revised 08 -2310 <br />Department: PWA Admin. <br />Phone /Ext.: <br />Signature: <br />714- 647 -5088 <br />Date: 5 -1 -15 <br />