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City of Santa na <br />Clerk of the Council <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amendments (if any) are no longer in effect. CLER <br />Note: If your agreement is grant related, please ensure that all grant retention requirements M <br />have been satisfied prior to signing the termination form. / <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 />COTC Office Use Only <br />Or THE COUNCIL <br />R 2'23 PM2:25 <br />The agreement with �t 1/1 f l E «'— <br />A-2020-043-10 <br />No. was completed on —d-r7 ` �)'2 and final payment has been made. <br />(List all amendments. Use space below N needed.) <br />Department: <br />Phone/Ext.: �l <br />Signature: <br />i.lagreementslformsVorm - agreement termination form_goldenrod.doc Date: <br />