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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amendments (if any) are no longer in effect.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 (M -30). <br />Call 647 -6520 if you have any questions. <br />The agreement with <br />G 2012 <br />COTC Office Use Only <br />I'MI <br />No. 'N- 2012 -107 was completed on G l 1– and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: P <br />Phone /Ext.: �u <br />Signature: an `�'` C r a °�(An- <br />Date: "f <br />Revised 0 8-2 3-10 <br />