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City of Santa A. J <br />.......-. ...-.-.-------. <br />- Clerk of the Council core Office use only <br />- -- .......- ........ <br />AGREEMENT TERMINATION FORM <br />7�iS srry ap 7,,4 <br />Please complete this form whey, n the attached agreement and all CITY O SA -1t,, <br />rg rs' , <br />amendments (if any) are no longer in effect. C L EI _!,' v <br />Return form to the Clerk of ithe Council Office (M-30). <br />Call 647-1520 if you have any questions. <br />The agreement with <br />No. N-2014-134 was completed on 'qnd final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: <br />Phone/Ext.: <br />Signature: <br />Date: -L I IA-rV� <br />Revised 10.31-12 <br />