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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amendments (if any) are no longer in effect.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 647 -6520 if you have any questions. <br />The agreement with 1W6 pmw-as (2 � � Cog plc , LLC <br />No. was completed on a f and final payment has been made. <br />(List all amendments. Rse space below if needed.) <br />Department: <br />Phone/Ext.:� ` -- <br />Signature: <br />Date: <br />