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City of Sant _ ` 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amendments (if any) are no longer in effect.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 />Office Use Only <br />14TY OF 4� -� <br />The agreement with <br />No. N- 2015 -061 was completed on and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: <br />PC- <br />Phone/Ext.: >n? <br />Signature: <br />Date: <br />Revised 10.31 -12 <br />