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�� . City of Santa Ana <br />e 11 Clerk of the Council COTC Office <br />..... ....- <br />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amendments (if any) are no longer in effect.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 �';i L T COi F X--:, <br />have been satisfied prior to signing the termination form. r,€,= <br />Is the agreement(s) a permanent record? Yes No V L <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 R)%1DM 'e Qqft 5pa ba lao% l.L <br />►r, <br />Onty <br />N-2019-047 was completed on 1q 1Al i_ _101a and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: MC <br />Phone/Ext.: <br />Signature: I <br />Date: not 12A 1201 <br />Revised: 10-18-16 <br />