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City of Santa A-ia <br />Clerk of the COL,Jl <br />AGREEMENT TERMINATION <br />Please complete this form when the attached agreement is no fon;finjg- <br />Return form to the Clerk of the CI Off <br />ounce ice (M-30). h r <br />Call 647-6520 if you have any questions. CITY Or CLERK U <br />The agreement with <br />W <br />I <br />No. AijjW was completed on W` CAC "JO <br />and final payment has been made. <br />Revised 12-07-07 <br />Department:�v(��% <br />Phone/Ext.:�%j� <br />Signature: <br />Date: <br />i <br />