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City of Santa. la <br />Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />COTC Office Use Only <br />gin• <br />Please complete this form when the attached agreement and all <br />amendments (if any) are no longer in effect. CITY C F 5 !_, r, <br />Return form to the Clerk of the Council Office (M-30). - <br />Call 647-6520 if you have any questions. <br />The agreement with 1M)'AA ,d A 65506alt'S <br />No. A-%poS- J �oailooz) was completed on b 30 7o and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: ��Vt <br />Phone/Ext.: f <br />Signature: <br />Date: 6 �zL- <br />Revised 08-23-10 <br />°J <br />