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City of Santa Ana <br />Clerk of the Council COTc office use o <br />AGREEMENT TERMINATION FORM <br />15 M 2' <br />Please complete this form when the attached agreement and all rI T <br />amendments (if any) are no longer in effect. <br />i <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 Video Engineering Services <br />No. A-2003-269 was completed on 2/l/05 and final payment has been made. <br />(List aft amendments. Use space below if needed.) <br />Department: <br />PRCSA <br />Phone/Ext.: <br />5254 <br />Signature: <br />.0 <br />Date: <br />7/21/15 <br />Revised 1031-12 <br />