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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amendments (if any) are no longer in effect.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 647 -1520 if you have any questions. <br />The agreement with <br />No. N -2013 -026 _was completed on <br />(List all amendments. Use space below if needed.) <br />Revised 10.31 -12 <br />czv1✓ <br />- <br />COTC Office Use Only <br />r.. , i � n <br />P. <br />and final payment has been made. <br />Department: �PWA <br />Phone /Ext.: <br />Signature: <br />Date: <br />j. <br />