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City of Santa Ana <br />Clerk of the Council COTC Office Use Only <br />AGREEMENT TERMINATION FORM <br />Please complete this form when the attached agreement and all <br />amendments (if any) are no longer in effect. ZV9 A_UG ?1 PM 4 nq <br />Note: If your agreement is grant related, please ensure that all grant retention requirements hMvc <br />been satisfied prior to signing the termination form. C' TY OF SA N TA ANA <br />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 />i <br />The agreement with �1 x: �Gck Ylnf �A"V,1 � V <br />N � <br />No. -o2OJ a -60o 0 was completed on ��3t l 1 to and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: V, "Is tor <br />Phone/Ext.: �S <br />Signature: <br />Date: <br />Revised. 01-07-16 <br />