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City of Santa Ar <br /> Clerk of the CounLii COTC Office Use Only • <br /> • <br /> ll <br /> AGREEMENT TERMINATION FORM <br /> Please complete this form when the attached agreement and all 2020 ,PR 24 PM 3: 18 <br /> amendments (if any) are no longer in effect. <br /> Note: If your agreement is grant related, please ensure that all grant retention requirements C)T v_4 <br /> have been satisfied prior to signing the termination form. K r '` <br /> E' COUNCIL <br /> Return form to the Clerk of the Council Office (M-30). <br /> Call 647-1520 if you have any questions. <br /> . <br /> The agreement with �� O. ON-VA \M-VOL , as l0—• <br /> 1,) <br /> No. 14 ` 01 J' ('>( .--2) was completed on 1131 laC and final payment has been made. <br /> (List all amendments. Use space below if needed.) <br /> A -,3L�o�-- 001 Department: <br /> A - 3_0\'"'1 CSC), ® \ Phone/Ext.: cs asci' <br /> r- &on 0 CT) ' ,- Signature: cJ-tL_;1:n <br /> Date: ! I+Tt <br /> Revised:01-07-16 <br />