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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amendments (if any) are no longer in effect.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 />The agreement with Gtr�VcSC <br />No. A -5 W1 - 253C►)it M was completed on <br />(List all amendments. Use space below if needed.) <br />3�f 00(0- 1Zb`0) GIG) <br />A - -,? <br />Revised 0472 10 <br />Di /C?l (!o <br />Department: <br />Phone /Ext.: <br />cA3 <br />,° <br /><I A , A <br />and final payment has been made. <br />CDA <br />x 53% <br />Signature: iCL "P ^i°e <br />Date: <br />