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City of Santa A..a <br />'i Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />1018 nrT 22 M 4. 1 <br />Please complete this form when the attached agreemer�h�CITY SAIYTA AN <br />amendments (if any) are no longer in effect. nnnnnn .(." CrjUN <br />Return form to the Clerk of the Council Office (M-30). <br />Call 647-6520 if you have any questions. <br />COTC Office Use Only <br />The agreement with <br />No. t� -7,0I 6-2-o-7--Q I was completed on <br />(List all amendments. Use space below if needed.) <br />(-913o 1 2-� V and final payment has been made. <br />Department: ��%� I �i� �k- Cer- <br />Phone/Ext.: 5C Z.Co 2- <br />Signature: <br />Date: LO I l iC ` 15 <br />Revised 08-23-10 <br />