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City of Santa i a <br />F 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amendments (if any) are no longer in effect.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 -6520 if you have any questions. <br />The agreement with <br />C 2013 <br />COTC Office Use Only <br />2014 14 29 PM 5. [ 4 <br />sF' "`TA A HA <br />C! � ° <br />No. {M, was completed on Z o�i �Jand final payment has been made. <br />(List all amendments. Use space below if needed.) r <br />Department: ` p w N — W Ac- -c <br />1. <br />Phone /Ext.. <br />Signature: <br />Date: <br />Revised 0 8-2310 <br />