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' 0City of Santa Ana <br />Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />?lal Please complete this form in its entirety when the attached agreement and all {2 <br />amendments (if any) are no longer in effect. �Q <br />Note: If your agreement is grant related, please ensure that all grant retention requirements CL_ - S>F;,�' j <br />have been satisfied prior to signing the termination form. j AN <br />Is the agreement(s) a permanent record? Yes _ No e� �C�L� <br />Return form to the Clerk of the Council Office (M-30). <br />Call 647-1520 if you have any questions. <br />i <br />Only <br />The agreement with CN(L. �i�l�-C t/( <br />No. fi —��� —2—k3 was completed on / rr and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: _ pliti�} — l4XElC dV <br />Phone/Ext.: <br />Signature: <br />Date: <br />Revised: I a 18-16 <br />