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City of Santa ! 3 <br />p %,t Clerk of the Council core 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amendments (if any) are no longer in effect.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 No <br />CLERK OF THE COUKIl_ <br />Return form to the Clerk of the Council Office (M-30). <br />MIL 213'22 P` :2`` <br />Call 647-1520 if you have any questions. <br />The agreement with VGl�M4t (!/I� (iy1GL{x1 G �A1�0{�GL�1c�l� <br />No. A-2018AV was completed on 5 �1 2 <br />and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />lo�'6.Iay Department: <br />flzLcp <br />5;L-;5� <br />Phone/Ext.: <br />Signature: <br />Date: <br />Revised: 10-18-16 <br />