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City of Santa ja <br />i Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />2? S9 <br />Please complete this form when the attached agreement and all <br />amendments (if any) are no longer in effect. <br />Ct —U - <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 <br />COTC Office Use Only <br />PI -I 2= 5 <br />no was completed on � !/� and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />200q -131 CM (1) <br /># A -2-001-631A (I.1) <br />ILh•7010 -161 (1a) <br />Revised 08-2310 <br />gepartment: <br />Phone/Ext.: <br />Signature:% <br />I <br />Date: /9 <br />