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' ~ ;,, City of Santa Ana ~-~~~~''~ ~~ <br />Clerk of the Council <br />.;~ <br />AGREEMENT TERMINATION FORM <br />. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br />COTC Office Use Only <br />~mn F! <br />Please complete this form when the attached agreement and all amendments (if`ari'y}~~~ ~ ~ k~ ~~ 33 <br />are no longer in effect. <br />~~-~-t ;~,,~ <br />Return form to the Clerk of the Council Office (M-30). n; r, .:!~~ ~` <br />Call 647-2520 if you have any questions. <br />The agreement with _ ~~~a-- ~I-~s~j <br />No. ~ ~ ~Q,~ -~.~- ~ ~ ~j was completed on ~ ~j~i~ lj ~ and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />~'~~ ~ ~~ ~ ~ 3 ~ ~' Department: C/~I'~" <br />Phone/Ext.: °~ ~ ~ ~~ <br />Signature: ~~i ll~~~~ ~~~ _ I,~ ~ ~ ~~, ~: ~ `, <br />Date: '~~ N ~ ~~D <br />Revised 07-22-09 <br />