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City of Santa Ana <br /> �� �' Clerk of the Council <br /> fli <br /> AGREEMENT TERMINATION FORM COTC I..` ................. �......................................................._..............._...._._ <br /> Office Use Only <br /> i... <br /> . I l <br /> Please complete this form when the attached agreement and all I <br /> amendments (if any) are no longer in effect. I <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 3 .-'C) /)IS <br /> No. /L/-,c20/47 ' QO3 was completed on 9-30 - /O and final payment has been made. <br /> (List all amendments. Use space below if needed.) <br /> Department: Pot is 6 <br /> Phone/Ext.: (7 it/) `AT-- <br /> Signature: 1 :::?/(----2--‘*2P`Vr- (14)1/4/e77-1) <br /> Date: <br /> Revised 08-23-10 <br />