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City of Santa " na <br />Clerk of the Council �� I <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amendments (if any) are no longer in effect.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 CLER <br />have been satisfied prior to signing the termination form. A <br />Is the agreement(s) a permanent record? Yes _ No <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 />COTC Office Use Only <br />UE THE COUNCIL <br />28123 P,44.33 <br />A-2020-043-05 <br />No. was completed on���nd final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: C_/1�✓� <br />Phone/Ext.: <br />Signature: <br />Date: <br />i:lagreementsUormstform - agreement termination form_goldenrod.doc <br />