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City of Santa P" 71 <br />Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />................................................. <br />- COTC Off <br />"T n3 IFN 3- <br />Please complete this form when the attached agreement and all r( i ,: Jr 4 A P, T, F§ M A <br />amendments (if any) are no longer in effect. v' E <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 />Only <br />N-2015-168 <br />No. was completed on and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: P -Pr <br />Phone/6d.; = `- <br />Signature: UkA V) <br />Date: v))Mr' <br />Revised 70.31-12 <br />