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City of Santa A..a <br />Clerk of the Council COTC Office Use Only <br />----- -- - -- --- --- ---------- -------- -- <br />AGREEMENT TERMINATION FORM <br />Please complete this form in its entirety when the attached agreement and all <br />amendments (if any) are no longer in effect. <br />Note: If your agreement is grant related, please ensure that all grant retention requirements <br />have been satisfied prior to signing the termination form. <br />Is the agreement(s) a permanent record? Yes Nod OF THE COUNCIL <br />JUL 26'22 FHA:26 <br />Return form to the Clerk of the Council Office (M-30). <br />Call 647-1520 if you have any questions. i <br />The agreement with V&J, [ JCA COrf0r] (1 0 <br />No. A-2018-124 was completed on and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />A - -M -19-+ Department: ?Oc� <br />-2 Phone/Ext.: <br />2 <br />Signature: � (z <br />(�I <br />Date: S <br />Revised: 10-18-16 <br />