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City of Santa Ana COTC Office Use Only <br />I. Clerk of the Council <br />II 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amendments (if any) are no longer in effect.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. CLERK 5'E�it= THE COMM <br />Is the agreement(s) a permanent record? Yes No SE 11. 22 AMI-0'20 <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 WS NAVOL- Di A %Phb �ri��t'�A�r1v>Me✓td' <br />No. N-2021-156 was completed on ti� and final payment has been made. <br />(List all amendments. Use space below if needed.) p, <br />Department: <br />Phone/Ext.: <br />Signature: ��/j •�" <br />Date: <br />cagreements forms form -agreement termma6on form_goicenroa.doc <br />