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City of Santa i a <br />Clerk of the Council COTC Office Use Only <br />r <br />AGREEMENT TERMINATION FORM <br />2020 FEB -6 4' 24 <br />I <br />Please complete this form when the attached agreement and 011TY OF s;t NTIA ANA <br />amendments (if any) are no longer in effect. CLtRK OF COUNCIL <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-2015-092 was completed on bo l y and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: <br />Phone/Ext.: <br />Signature: Q<�L Q @1i C1� <br />Date: aq#- <br />t <br />Revised 10-31-12 <br />