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City of Santa !' na <br />•r t Clerk of the Cou, rcil J <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amendments (if any) are no longer in effect.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. ul�/ SAW <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 1 <br />A-2020-157-02 <br />No. was completed on <br />(List all amendments. Use space below if needed.) <br />hagreementsVorms'form- agreement termination form—goldenrod.doc <br />COTC Office Use Only <br />€ NA CL T Y CLERK <br />:13'?3 pr+3:46 <br />_d-7i - 3- -�I--and final payment has been made. <br />Department <br />Phone/Ext.: G 1 <br />Signature: <br />Date: <br />