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„ City of Santa Ar . <br />Clerk of the Coupe.,.„ <br />AGREEMENT TERMINATION <br />(wS <br />Please complete this form when the attached agreement is no longer in effect. M 192 q. 03 <br />Return form to the Clerk of the Council Office (M -30). <br />Call 647 -6520 if you have any questions. I <br />---------------------------------------------- <br />NOTE: CLU4FA�nt ^„ OU. �r mentwith <br />No. jZ' 1-IRFS <br />was completed on <br />and final payment has been made. <br />Departmenrol o <br />Department: �Y�f° lA 4 t <br />Phone /Ext.: 1 y ` 1 ,0 <br />Revised 12 -07 -07 <br />Signature: �---- <br />Date: <br />n <br />