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Na <br />City of Santa Ana C20i3 <br />Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />COTC Office Use Only <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amendments (if any) are no longer in effect.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 A VT <br />f (3ca� C/ <br />No. �' �0/� q� was c mpleted on � and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />0- -LOWR3 COMC3) <br />* IN -1-00-0143 - 002 C3b) <br />Revised 0 8-2370 <br />Department: po-sA <br />Phone /Ext.: tam <br />Signature: C, i a \o{T VQ/11OWO <br />Date: SJIDAq <br />