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City of Santa Ana C ~~ ~C' ~ '~~ <br />-~ ~ Clerk of the Council S ~/ <br />AGREEMENT TERMINATION FORM <br />.___ .............. <br />COTC Office Use Only <br />:................................... . <br />,~ ; ~ r~+ <br />Please complete this form when the attached agreement and all amendments (if any) j~..,. ? 4.,~ ! ~ ~~~ ~~: ~~ <br />are no longer in effect. <br />Return form to the Clerk of the Council Office (M-30). ~~ ` = ~~- <br />Call 647-2520 if you have any questions. <br />The agreement with 1Y1 ~ r <br />ro ~~~ <br />was completed on p and final Nayment has been made. <br />(List all amendments. Use sNace below if needed.) <br />Department: ~ <br />h ~ f r~Q <br />Phone/Ext.: ~ ~ I ~ ~ 3 <br />Signature: <br />Date: b,~A ~~ <br />Revised 07-22-09 -a <br />