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City of Santa Q a <br />CI-71 <br />Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />Please complete this form when the attached agreement and all <br />amendments (if any) are no longer in effect. <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 />H <br />COTC Office Use Only <br />^anta Ana <br />No. A— Oil —ill —O I was completed on 6/301 V3 and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: PRc Sly <br />Phone/Ext.: Wig <br />Signature: rL�yG'a <br />Date: glIgIaa1a <br />Revised 08-23-10 <br />