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City of Santa Ana <br />Clerk of the Council <br />AGREEMENT TERMINATION <br />C~2op 9 <br />1~n ,,,~ ~ <br />Please complete this form when the attached agreement is no longer in effec .~I` f <br />Retum form to the Clerk of the Council Office (M-30). ~ ,~jVq <br />Call 647-2520 if you have an ``''~' <br />y questions. ; ~_~~ jC <br />The agreement with i ~c ~ ~ ~ __ ____________________________________________ <br />G1~ <br />No. .~ ~~ ~ ~ ~ ~ ~ <br />'~ ~ was completed on ~j <br />tr 3Q y <br />and final payment has been made. JJ <br />AGREEMENT Department: ---~-y ~, , <br />NAME NUMQER SUFFIX <br />Phone/Ext.: ~ ' i,~-- ~ ~J <br />QUIROZ, LETICIA N-2004-133-01 1A ~ 'y S <br />QUIROZ, LETICIA N-2004-133-02 1 B <br />QUIROZ, LETICIA N-2004-133-03 1C ~--~~~~ <br />Signature: ~ <br />QUIROZ, LETICIA N-2004-133-04 1D ~`-'~ ''~ <br />Date: /j ~ J //~ ~~~ <br />Revised 05.04-0$ ~ ~-~ ('' 4J <br />