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City of Santa t -a <br />Clerk of the Coul ,,il <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amendments (if any) are no longer in effect.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 />ca14 <br />COTC Office Use Only <br />JLIL 28 ffl 5.03 <br />The agreement with Ir>I'Cx,, L Ctuc -Y-0 t lN`1 <br />SANTA ANC <br />O <br />was completed on )+ and final payment has been made. <br />It(List all amendments. Use space below if needed.) <br />4 A--X3-111 (l9)• Department: <br />4E fN---C3L()tC—C)q I.p(19)• 1 A-200y-lal (it) <br />Phone/Ext.: <br /># A--ao 11- * A -zUos -20 (IG) <br />i I) R 2007 229 (ld) Signature: __�```g ` �. )�.l✓l <br />4 p- 2013 - IDO (!J) V R- 2DD8-2b1 Cie.)* Date: `l I�-IE <br />Revised 08-2310 <br />