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City of Santa Ana <br />Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />COTC Office Use Only . <br />2011s'.s: 1 II <br />Please complete this form when the attached agreement and all .. _ <br />amendments (if any) are no longer in effect.'' <br />bi <br />.__.,._L. <br />Return form to the Clerk of the Council Office (M-30). <br />Call 647-6520 if you have any questions. <br />i <br />The agreement with <br />No. N-2012-075 was completed on <br />(List all amendments. Use space below needed.) <br />Revised 08-23-10 <br />UIZ045 and final payment has been made. <br />Department:? <br />Phone/Ext.: <br />Signature: ,\ ( lyle� <br />Date: qh�� <br />