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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amendments (if any) are no longer in effect.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 />Note: If your agreement is grant related, please ensure that all grant retention requirements <br />have been satisfied prior to signing the termination form. <br />Return form to the Clerk of the Council Office (M-30). <br />Call 647-1520 if you have any questions. <br />CIO <br />Only <br />OCT 3! kit i1r 3) <br />OF SANTA ANA <br />Rif OF i UN <br />The agreement with EA (\Ao l at 1 K"t)C% Cb <br />No. A— <br />M15 y"1� was completed on J'`/ I5 .15 and final payment has been made. <br />(List all amendments. Use space below if needed.) h , <br />Department: ill <br />clt�jf�V1�C{"P �'kS CL <br />Phone/Ext.: e� <br />1 <br />Signature: <br />Date: <br />Revised: 01-07-16 <br />