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�2A ✓ <br />City of Santa Ana <br />Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />i COTC Office Use Only <br />Please complete this form when the attached agreement and all <br />amendments (if any) are no longer in effect. <br />CITY <br />01 6, 5 , ) <br />Return form to the Clerk of the Council Office (M -30). CLE S t <br />Call 647 -6520 if you have any questions. <br />f RdNA`l ( <br />The agreement with burl° il) �1t\A !wm 111 e(c-CA <br />No. G�71 7�� was completed on and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: <br />Phone /Et.: <br />Signature: <br />Date:��� <br />