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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amendments (if any) are no longer in effect.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 -1520 if you have any questions. <br />The agreement with <br />C 20j✓ <br />COTC Office Use Only <br />14 i 9 <br />CITY U lc L Nv� T l <br />No. N -2013 -016 was completed on I ?a4 [ and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: W4 s4 <br />Phone /Ext.: 55 jL-V <br />Signature: S 0 J-) A kn ai-0 <br />Date: -] cL I tS <br />Revised 70.31 -12 <br />