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City of Santa F j <br />g Clerk of the Council <br />AGREEMENT TERMINATION FORM A <br />i"It —- <br />(.®T� ce— <br />Use Only <br />✓C Q Ti <br />. 5 = <br />j <br />Please complete this form when the attached agreement and all U01 YWL <br />amendments (if any) are no longer in effect. <br />Return form to the Clerk of the Council Office (M-30). <br />Call 647-2520 if you have any questions. <br />The agreement with �!zi <br />7 7-1 � �� Ci �% was completed on and final payment has been made. <br />No.(List all amendments. Use space below if needed.) <br />Department: /r—s <br />Phone/Ext.: K- 5 3 8 <br />Signature: (J aa <br />Date: <br />5 <br />Revised 04-12-10 <br />