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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amendments (if any) are no longer in effect.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 />G24 <br />COTC Office Use Only <br />SEP A 71 M r. <br />o - <br />Sri MA <br />U r <br />I ; li <br />No. N-2013-064 was completed on and final payment has been made. <br />(List ail amendments.. Use space below if needed.) <br />Department: -{ msw <br />Phone/Ext.: [ <br />Signature: <br />Date: 9 b-t,l ) [L <br />Revised 10-31-12 <br />