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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amendments (if any) are no longer in effect.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 />C. <br />6 OCT 31 AM tt 35 <br />CITY OFCLERK STtF�k <br />� <br />#P�1C <br />The agreement with C-16 T -f, iq Ai ve� C- %f' -k -y' L1 V U <br />No. A-7011— cIM was completed on 415/3,11(p and final payment has been made. <br />(list all amendments. Use space below if needed.) <br />Department:G)�•tY'S (Ace <br />Phone/Ext.: RVi <br />Signature: <br />Date: <br />Revised_ 01-07-16 <br />