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City of Santa. la <br />Clerk of the Council <br />V n 1 <br />AGREEMENT TERMINATION FORM <br />Please complete this form when the attached agreement aWa,A,,I, <br />amendments (if any) are no longer in effect. City {/NTA j,, <br />Return form to the Clerk of the Council Office (M-30). CLERK O 1.,iU'nK, 1. <br />Call 647-6520 if you have any questions. <br />The agreement with <br />Nof A-2017 -7 � c0c) was completed on <br />n (List all amendments. Use space below if needed.) <br />R 2!0dti-z3,3 (3) eol <br />Revised 08-23-10 <br />cOTc Office Use Only i <br />1ST and final payment has been made. <br />n <br />Department: Y <br />Phone/Ext.: x .x t ) e� <br />Signature: <br />Date: <br />