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City of Santa "na �pl <br />r' Clerk of the Cou..cil <br />AGREEMENT TERMINATION FORM <br />Please complete this form in its entirety when the attached agreement <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amendments (if any) are no longer in effect.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 V <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 />No. 18 spa' Oqa' fv was completed on <br />(List all amendments. Use space below if needed.) <br />i.lagreements\formslform - agreement termination form_goldenrod,doc <br />COTC Office Use Only <br />OF THE COUNCIL <br />131 s33 PH3:5944 <br />' ( Zsand final payment has been made. <br />Department: <br />Phone/Ext.:` <br />Signature: l� <br />Date: <br />