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City of Santa . la <br />Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />Please complete this form when the attached agreement and all. 511"IN <br />amendments (if any) are no longer in effect. <br />CITE' OF <br />Return form to the Clerk of the Council Office (M-30). CLERK <br />Call 647-6520 if you have any questions. <br />The agreement with <br />No.��) was completed on <br />7 1 (List all amendments. Use space below if needed.) <br />P - X 10 - 23',-� (3) Coin, <br />Revised OB-23-10 <br />Department: <br />Phone/Ext.: <br />a <br />COTC Office Use Only <br />PM 11: 22 <br />�NTA A H A <br />and final payment has been made. <br />n <br />Signature: d6 <br />Date: /Z <br />