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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amendments (if any) are no longer in effect.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 647-6520 if you have any questions. <br />The agreement with <br />1�vel-s <br />COTC Office Use <br />,I` `11i. <br />No. M gc13 (& / was completed on f (, /5- and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />O<)3 57( 6VIA'I Department: X/7 17 � <br />Phone/Ext.: 5 Le cr-5 <br />�J <br />r <br />Signature: <br />Date: / r/( /4-, <br />Revised 08-2310 <br />