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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 agre67WrH1Wn2ZIl M 8' 0 t <br />amendments (if any) are no longer in effect. <br />Note: If your agreement is grant related, please ensure that all grarlI ff k 5r"W F AN <br />have been satisfied prior to signing the termination form. tft [ <br />Return form to the Clerk of the Council office (M-30). <br />Call 647-1520 if you have any questions. <br />} <br />The agreement with f S OV"E L)'% V OF C SSG <br />r 2r)[Z <br />COTC Office Use Only <br />No. /q-2016 --5 1 C" was completed on 2-2R- Zo and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: E MS y'* _ �3' [) C�AA&=-I— <br />Phone/Ext.: <br />5' <br />DELIVERED MAR 2 2 2616 Signature: <br />Date: 1-2 <br />Revised: 01-07-16 <br />