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City of Santa Ana <br />~~=- <br />- .. Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />c~2ooy <br />COTC Office Use Only <br />_. <br />°~'; ~. <br />Please complete this form when the attached agreement and all amendments (if any) <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are no longer in effect.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 <br />No. ~ _ ~~ ~,_ ((~ ~ ~(~r~~p~~as completed on Y 3v b7 and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: ~,~ <br />Phone/Ext.: ~o ~~` <br />Signature: '1i1-~-~ <br />Date: S S D <br />Revised 07-22-09 <br />