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., City of Santa Ana <br />Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />ryR' ` I -. <br />Li <br />Please complete this form when the attached agreement and all - <br />amendments (if any) are no longer in effect. p <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 <br />G 1®t z <br />COTC Office Use Only <br />s71 al <br />No. N -2011 -066 was completed on final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: F P— Z A - <br />Phone/Ext.: 15D>sx- <br />Signature: 'GAku1(`., <br />Date: L-f Irj 11 <br />Revised 0 8-2310 <br />