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City of Santa Ana <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amendments (if any) are no longer in effect.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 (W30). <br />Call 647-6520 if you have any questions. <br />The agreement with <br />G 2®13 <br />COTC Office Use Only <br /><i!!fyI -7 PH 4 j <br />No. N-2012-095 was completed on and final payment has been made. <br />(fist all amendments. Use space below if needed.) <br />Department: *?�sA- <br />Phone/Ext.: _-jaiS—I <br />Signature: Sx k2 U /yesv k/0 <br />Date: 41 r? I i -q <br />Revised 05-23 10 <br />