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T 0.�,* City of Santa la <br /> Clerk of the Council <br /> AGREEMENT TERMINATION FORM <br /> COTC Office Use Only <br /> 7 - i _.__. <br /> ' 3 <br /> Please complete this form when the attached agreement and all �. <br /> V f i <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 amendments (if any) are no longer in effect.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 /> 9,The agreement with t /4/7 0 A.S.5 'lr, -e_s <br /> No. N-2012-011 was completed on 7 P and final payment has been made. <br /> (List all amendments. Use space below if needed.) _,- <br /> Department: <br /> P60/I --A84"1/11 <br /> Phone/Ext.: ,, S-6 <br /> oAinkSignature: <br /> Date: ME ,,, <br /> Revised 08-23-10 <br />