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City of Santa :i <br />Clerk of the Council <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amendments (if any) are no longer in effect.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-� if you have any questions. <br />0570 <br />The agreement with <br />�� ,5 (1G) <br />No. � � was completed on <br />(List all amendments. Use space below if needed.) <br />i p-D-M-la8 (I) (t)M <br />iE a009 -13S -Vol (14) <br />A -se10 - 170 (1 b) <br /># A - 2011 - 220 Cjd) <br />Use Only <br />7017 <br />f and final payment has been made. <br />Department: 0-,iJ,,A <br />Phone/Ext.: <br />Signature: <br />Date: <br />Revised 04-12-10 <br />