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City of Santa is <br />Clerk of the Council S� <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amendments (if any) are no longer in effect.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. <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 />A-2020-213 <br />No. was completed on <br />(List all amendments. Use space below if needed.) <br />i.lagreementslformeform - agreement termination form_goldenrod.doc <br />COTC Office Use Only <br />OF THE COUNCIL <br />28'23 PM-4:33 <br />t ( t30 2\ and final payment has been made. <br />Department: F—C'C h <br />Phone/Ext.: LPIG <br />Signature: <br />Date: I �— <br />