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�2 <br />CUK <br />AGREEMENT TERMINATION <br />Please complete this form when the attached agreement is no longer in effect. <br />Return form to the Sr. Deputy Clerk of the Council (M -30). Call 647 -5238 if you have any <br />questions. <br />The agreement with Qbc j S (s r r 16 C No A _ � 005 — <br />was completed on e �% —(J 5� and fjual-payment has been made. <br />i� 20O 3 ' 152 <br />CO* (3) Department. <br />R 2001`117- (3a) Signature: <br />N (3b) <br />Date: <br />Revised 8 -7 -03 <br />City of Santa Ana <br />Clerk of the Council <br />