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City of Santa Ana <br /> Clerk of the Council COTC Office Use Only <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 amendments (if any) are no longer in effect.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 F $50-91 Goc‘S' <br /> No. N-2013-061 was completed on U1 ? and final payment has been made. <br /> (List all amendments. Use space below if needed.) <br /> Department: C--4 or 110 -C->44I <br /> Phone/Ext.: 7 2 Z 1 <br /> Signature: .�44 <br /> Date: C2 (S f �6 <br /> Revised 10-31-12 <br />