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City of Santa : a <br />as t Clerk of the Cou,.cil <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amendments (if any) are no longer in effect.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 647-6520 if you have any questions. <br />The agreement with <br />COTC Office Use Only <br />€d� <br />f_k of Ih <br />No. A-9014—\C�5-0\ was completed on p and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />,,� ( j �w e'r"I, <br />Revised 08-23-10 <br />Department:�A <br />Phone/Ext.: ' _5 <br />Signature: ac til� t l v�.N(o <br />Date: 7 1 -7 b-, <br />