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City of Santa Ana core office Use Only <br />Clerk of the Council <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amendments (if any) are no longer in effect.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 <br />have been satisfied prior to signing the termination form. <br />Is the agreement(s) a permanent record? Yes No -/ <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 <br />No. N-2019-251-02 was completed on 6 13(�� 024 and final payment has been made. <br />(List all amendments. Use space below if needed.) �'T <br />Department: J1_ <br />Phone/Ext.: <br />Signature: k—'6.) ( n, y✓�Q_N <br />Date: <br />i 'agreements icnns fum-agreem-n ralon`or m ]vr1r,tl Jot <br />