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City of Santa A i <br />Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />C2019 <br />... ........................................................ ........ I ............ ........... ... ..... ..I..-..,-- ............ ............ <br />COTC Office Use Only <br />................. .......... .. ..... ............. ...................... <br />�ri <br />Please complete this form when the attached agreement and all + A <br />amendments (if any) are no longerineffect. <br />02 <br />Return form to the Clerk of the Council Office (M-30). <br />Cl'erk of the Coo n- <br />Call 647-6520 if you have any questions. <br />The agreement with Pr,icrw� <br />2 ' <br />N -7, 0 j �- 1 <br />I was completed on and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: pGCSA <br />Phone/Ext.: LU I ci <br />Signature: &# C I I �-Pkts— <br />Le <br />Date: 1zo 19 <br />