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City of Santa - is <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amendments (if any) are no longer in effect.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. C*fij)QC�Vl�hik, <br />The agreement with <br />*,Xiffto,6 Rqqr& <br />COTC Office Use Only <br />J4 <br />L <br />C-Y7,141 0 r j7 !'I 0� Iq 0 ��j /Ar'a uiq <br />(1- <br />No. # ®0=5-- was completed on and final payment has been made. <br />(List 611 amendments. Use space below if needed.) Department: 5-f � sti <br />Phone/Ext.: <br />Signature: L) - /7 <br />Date: 12 7�/ <br />Revised 0 &2310 <br />I <br />