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City of Santa Ana r� 7-0 <br />. .. .. .. .. .. .. .. .. . .. ... .. .. .. .. .. .. .. .. .. .. ... <br />Clerk of the Council <br />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amendments (if any) are no longer in effect. 7 f791f'T 2 3 "T <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. CN <br />!TY <br />S AN A <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 />N-2016-090 <br />No. was completed on 47141hp and final payment has been made, <br />(List all amendments. Use space below if needed.) <br />Department: F4 S4 <br />Phone/Ext.: 6&S7+ <br />Signature: LQ Af AVD <br />Date: <br />� I <br />Revised: 01-07-16 <br />