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City of Santa A - <br />Clerk of the Council <br />AGREEMENT TERMINATION FORM(Q7�Qffle only Y <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amendments (if any) are no longer in effect.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 />No. N-2015-141 was completed on C411 -05 - <br />and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: <br />Phone/Ext.: GZs <br />Signature: ifA0, �t%tom <br />Date: G bQI ILp <br />Revised 08-23-10 <br />