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City of Santa Ana <br />Clerk of the Council I COTCOffice Use Only <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amendments (if any) are no longer in effect.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 ! City of Santa Ana <br />have been satisfied prior to signing the termination form. j <br />042 2621 <br />Is the agreement(s) a permanent record? Yes No <br />Clerk of the Council <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 �At}a�YA <br />No. N-2018-195 was completed on 1610)18, and final payment has been made. <br />(List all amendments. Use space below if needed.) ���} Department: 'i-�ntC,A1 ML r'l. ' <br />Phone/Ext.: ��.133-W <br />Signature: � U L0k_Q A,PNDI J <br />Date: -113F7 br-\ <br />Revised: 10-18-I6 <br />