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City of Santa C a C ZOiS <br />Clerk of the Council <br />AGREEMENT TERMINATION FORMCOTC Office use Only <br />7,0V CED 27, Am 6' c if <br />Please complete this form when the attached agreement and all C, <br />amendments (if any) are no longer in effect. s , <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 Al kjn&& �r-C?AA I, <br />No. was completed on (1250 [ and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: <br />Phone/Ext.: <br />Signature: E� Q get Q C fI <br />Date: q ��W �D <br />Revised 08-23-10 <br />