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City of Santa P---,a <br />Clerk of the Couircil <br />AGREEMENT TERMINATION FORM Qal)0� <br />Please complete this form in its entirety when the attached agreement and <br />amendments (if any) are no longer in effect. <br />Note: If your agreement is grant related, please ensure thatall grant retention requirements <br />have been satisfied prior to signing the termination form. <br />Is the agreement(s) a permanent record? Yes _ No X <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 OnN <br />OF THE COUNCIL <br />? 2'23 Prt4:25 <br />The agreement with LOS Ar4cirMs SMSA LIM t-IrrD PAII&TNIW SW 0193 A *4 Wt <br />ma-mm s <br />No. A- 2020 - Oy} pp was completed on 9 hkpza and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: Ptv A 10N • Ir N h. <br />Phone/Ext.: [114(�/�—(0✓4�11� 5�3 <br />Signature: j( ��--- <br />Date: 001. 14F. ZGZ'L <br />i'AagreemenLsVormsfarm - agreement termination form—galdenmd.da <br />