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City of Santa is G?A� <br />Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />COTC Office Use Only <br />Please complete this form when the attadhedvagreement-and all <br />( y) 9 OF SAINT, Alli - <br />CI, <br />amendments rf an are no Ion er in effect. I;fT� �p ', <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 />N-2012-0 t p payment No. was completed on and final a ment has been made. <br />(List ai) amendments. Use space below if needed.) <br />Department: <br />P. one/Ext.: <br />f/Signature: <br />Date: <br />Revised 08-23-10 <br />