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City of Santa Ana <br />Clerk of the Council <br />l AGREEMENT TERMINATION FORM <br />Please complete this form in its entirety 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amendments (if any) are no longer in effect.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 />Is the agreement(s) a permanent record? Yes No <br />Return form to the Clerk of the Council Office (M-30). <br />Call 647-1520 if you have any questions. <br />OCT 23 M S' 30 <br />The agreement with FF-a At,Ttye (-0`1Sv4V-rW 6 C-Izoa L_t_<-- <br />SANTA ANA <br />Qf C.0l�NCll <br />No. N - 2-C� 1-1' 035 was completed on f 1 3 IQJ and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: FWA <br />Phone/Ext.: 3 3111 <br />Signature: <br />Date: I. o i y Y 11 U' <br />Revised: 10-18-16 <br />