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(9) <br />4 <br />City of Santa ,- _ a <br />Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />2014 SEP —2 <br />Please complete this form when the attached agreement and alICjTY OF Sj} <br />amendments (if any) are no longer in effect. CLERK OF <br />rt <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 />N-2010-063-002 C») 11 <br />No. _ _ - was completed on <br />Z (List all amendments. Use space below if needed.) <br />-- W-2010-0163 ca",Cl, <br />-p-2oo0-Ob3-o�i (�a) <br />lI IM -063-003 (10 <br />Revised 07-25-12 <br />e2.0I4 <br />COTC Office Use Only <br />FM I= 41 <br />4 T:A ANA <br />MVIN <br />v <br />a!r el and final payment has been made. <br />Department: <br />Phone/Ext.: <br />Signature: <br />Date: <br />