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_ City of Santa Ana <br />~..Y ' Clerk of the Council <br />.. <br />.~~ <br />AGREEMENT TERMINATION FORM <br />COTC Office Use Only <br />Please complete this form when the attached agreement and all amendments (if any) <br />are no longer in effect. ~~ ~ =y <br />Return form to the Clerk of the Council Office (M-30). <br />Calt 647-2520 if you have any questions. <br />The agreement with "r~ ~' (~,.~'ICAI ~ CYIYYI ( ~10r1~ <br />No. ~-7008-I~ 0 was completed on ~ ~ 0 ~ and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: C(~J'~ <br />Phone/Ext.:,)r?j~ <br />Signature: 0.. ~G1J11~-~ <br />Date: a <br />Revised 07-22-09 <br />