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City of Santa Ana C 2013 <br />Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />COTC Office Use Only <br />358 <br />Please complete this form when the attached agreement and all amendments (If any) <br />are no longer in effect. <br />Return form to the Clerk of the Council Office (M-30). <br />The agreement with L C✓L /0�}��� <br />N-2009-136 ( <br />No. was completed on (,Q 17>D I } and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />�2 <br />jE rl- 2004 13b-00) Department: <br />" 2 Qq -136 QO Z Phone/Ext.: L> <br />N- 2004 -13b'003 <br />Signature: <br />Date: 4): �1,i <br />Revised 07-22-09 <br />