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City of Santa la <br />_ <br />Clerk of the Council COTC Office Use Only <br />.... <br />AGREEMENT TERMINATION FORM <br />I s 21 <br />Please complete this form when the attached agreement and all M ( OF CASANTA A <br />amendments (if any) are no longer in effect. L E fn AK a -, <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-2015-147 was completed on q j j3 hS and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department:I�� <br />Phone/Ext.:�67 <br />Signature: an <br />Date:il l <br />Revised 10-31-12 <br />