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City of Santa P na <br />Clerk of the Cou _il <br />k J <br />k, AGREEMENT TERMINATION FORM <br />20?0 FED -6 PM 3. <br />Please complete this form when the attached agreement and all ! <br />amendments (if any) are no longer in effect. CITY OF SANTA <br />CLERK Or COU. <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 />No. was completed on <br />(List all amendments. Use space below if needed.) <br />Revised 08-23-10 <br />--.. <br />COTC Office Use Only <br />38 <br />0Iz�"and final payment has been made. <br />Department: <br />Phone/Ext.: Z <br />Signature:�Gi.. <br />Date:��� <br />