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City of Santa Ana <br />` Clerk of the Council <br />AGREEMENT TERMINATION FORM <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amendments (if any) are no longer in effect.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 />Call 647-6520 if you have any questions. <br />The agreement with White, Mat tie <br />COTC Office Use Only <br />8 P-1 <br />No. A-2003-181 was completed on 6/30/04 and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: PRCSA <br />Phone/Ext.: 5254 <br />Signature: s > �R, � ck <br />Date: <br />Revised 08-23-10 <br />E! <br />• <br />