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City of Santa Ana <br /> Clerk of the Council COTC Office 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 amendments (if any) are no longer in effect. ?al()I AUG 7 I PO f}. r <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. CITY OF S A N f A AN A <br /> Is the agreement(s)a permanent record?Yes No <br /> CLERK OF 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 NCrCa Say- cki 7 <br /> No. A-2On— H° was completed on ia,ID /97and final payment has been made. <br /> (List all amendments. Use space below if needed.) <br /> Department: � C <br /> Phone/Ext.: l i q <br /> Signature: Aka/ <br /> Date: 3II"I aelq <br /> Revised:10-18-16 <br />