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City of Santa <br />a���'j' Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />COTC Office Use Only <br />2020 FER 6 pM 3. ,9 <br />Please complete this form when the attached agreement and all <br />amendments (if any) are no longer in effect. CITY OF ANTA AMA <br />Return form to the Clerk of the Council Office (M-30). CLERK OF COUNCIL <br />Call 647-6520 if you have any questions.. c i <br />The agreement with yy,, Y1F <br />No. is 0 1 �— 0114�D was completed on Tf�I I I and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: <br />4A l C.k rckn�,( <br />Phone/Ext.: <br />Signature: \�CIAQMQLO <br />Date: =—XY J -)-z <br />Revised 08-23-10 <br />