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City of Santa Ana <br />i 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amendments (if any) are no longer in effect.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 />COTC Office Use Only <br />4 _ <br />tzE 'S <br />a <br />No. N-2013-092 was completed on LL (I y and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: TIZJLS-4 <br />Phone/Ext.: <br />Signature: <br />Date: C ['Dei P <br />Revised 10-31-12 <br />