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City of Santa Ana <br />................ <br />6-6 <br />Clerk of the Council <br />.............. .. .. .............. . . . . . <br />AGREEMENT TERMINATION FORM <br />4-3 <br />Please complete this form when the attached agreement and all <br />amendments (if any) are no longer in effect. CITY GV 11 MT <br />A <br />CI ERK 01i <br />Return form to the Clerk of the Council Office (M-30). <br />Call 647-1520 if you have any questions. <br />The agreement with <br />70 W IS . N& <br />No. �-?-C>ID-071 _ was completed on (f3D I and final payment has been made. <br />(List all amendments. Use space below if needed.)-- F —f <br />7- C) I c) Z— <br />Revised 10.31-12 <br />Department: PUJ A - TP\-F F I C <br />Phone/Ext.: <br />60� <br />Signature: (2 C� <br />Date: 611 C3 f t5— <br />