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,, City of Santa . .a <br />�E" -®�� Clerk of the Council corc <br />�" <br />AGREEMENT TERMINATION FORM <br />rp Ai1G 2 i j Pf9 �` S <br />Please complete this form when the attached agreement and all CITY Or SANTA ANA <br />amendments (if any) are no longer in effect. CLERK OF COUNCIL <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 />No. N-$015-096 <br />was completed on <br />(List all amendments. Use space below if needed.) <br />Use <br />NOkG and final payment has been made. <br />Department: <br />PRIL SA <br />Phone/Ext.: <br />Signature: <br />Date: <br />I Ia IIq <br />Revised 10-31-12 <br />