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City of Santa Ana <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amendments (if arty) are no longer in effect.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 />COTC Office Use onl <br />C'-2 c)2� <br />City of Santa Arp�:,, <br />JABS 11 2024 <br />City Clerk"s Office <br />The agreement with U—Nyayi �u(FA Y ace"; 0 SU U11-t �- Vi CCA { i <br />No. A *09-�� • C701'3-' 0 ( was completed on <br />(List all amendments. Use space below if needed.) <br />lagreementsWormsVorm - agreement termination form_goldenfod doo <br />"-1 and final payment has been made. <br />Department: to <br />Phone/Ext.: <br />Signature: <br />Date: <br />