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City of Santa ° -ia <br />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amendments (if any) are no longer in effect.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 />f/i <br />n <br />No. g 1,2 - was completed on ',jam r Z_ and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: Ci) 14- 5/4 w <br />/ J <br />Phone /Ext.: <br />Signature: j/t/j�/ 7j, <br />Date: �z <br />ReAsed 0 &2 3 10 <br />