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City of Santa Ana <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 amendments (if any) are no longer in effect.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 2520 if you have any questions. <br /> The agreement with l.(6 - 0 L. Cs1t\ÔiQit tra Glitf <br /> No. A-4 -D P-1 2was completed on (CI 2201 I and final payment has been made. <br /> (List all amendments. Use space below if needed.) <br /> Department: CIDA1 <br /> Phone/Ext.: LI_--_ <br /> Signature: <br /> Date: � \VEA". <br /> Revised 04-12-10 <br />