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,. ;•. City of Santa Ana <br /> ' r Clerk of the Council <br /> AGREEMENT TERMINATION FORM <br /> COTC Office Use Only <br /> Please complete this form when the attached agreement and all <br /> amendments (if any) are no longer in effect. <br /> Return form to the Clerk of the Council Office (M-30). <br /> The agreement with <br /> No. 12\ - 1 ► `--152!) was completed on (('130 / i and final payment has been made. <br /> (List all amendments. Use space below if needed.) <br /> Department: C.1 <br /> lJ <br /> Phone/Ext.: a(_, J <br /> Signature: <br /> Date: 'l g - J <br /> Revised 04-12-10 <br />