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per: City of Santa " na <br />t 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amendments (if any) are no longer in effect. <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 />COTC Office Use Only <br />Or T i ,_ PI jai? CIF <br />ry <br />'22 Ar4S•E,l5 <br />Return form to the Clerk of the Council Office (M-30). <br />Call 647-1520 if you have any questions. Q <br />The agreement with L�✓l, <br />No. N-2022-300 was completed on ) 0 `3 and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: PP.CM <br />Phone/Ext.: :S� <br />Signature: <br />Date: 1.0/10/'DL'-'�!— <br />ilagreementWormslform-agreement termination form_galdenrad.doc <br />