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City of Santa t _.aa C20I <br />------------------------------------------------------------------------------------------ <br />Clerk of the Council COTC Office Use Only <br />--------------- - -- <br />AGREEMENT TERMINATION FORM <br />71414 SP27 <br />i.' 6- ?1 <br />Please complete this form when the attached agreement and all C'1 T i n. 'S MrN TAr- 3 <br />amendments (if any) are no longer in effect. €4 t7-'- <br />Return <br />E - <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-2014-062 was completed on � and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: <br />Phone/Ext.: <br />Signature: A 3 <br />Date: i I i I p <br />Revised 10-31-12 <br />