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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 agr ent an II <br />amendments (if any) are no longer in effect. <br />Return form to the Clerk of the Councilffice (M-30). <br />Call 647-6520 if you have any questions. <br />The agreement with <br />No. _ G� l 1was completed on <br />(List all amendments. Use space below if needed.) <br />Revised 08-23-10 <br />G201S <br />COTC Office Use Only <br />r°r"i07 <br />.k GL• Z): r5 <br />0;' <br />�„ l,-` <br />N <br />V4 i � <br />and final payment has been made. <br />Department: G <br />DA- <br />Phone/Ext.: <br />Signature: <br />Date: <br />