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City of Santa a <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amendments (if any) are no longer in effect.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 6�2520 if you have any questions. <br />The agreement with <br />No. ft -,WQ-0 3-- 1 was completed on <br />(List all amendments. Use space below if needed.) <br />COTC Office Use Only <br />CITY n aTA A't, <br />cl <br />and final payment has been made. <br />Department: CbA <br />Phone/Ext.: --7 K <br />Signature:T <br />Date: <br />Revised 04-12-10 <br />