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City of Santa a ,~, <br />- Clerk of the Col <br />~~ ~ ~/ <br />AGREEMENT TERMINATION <br />:, <br />Please complete this form when the attached agreement is no longer in effect. ~~ ~~~ _ ~ t~g ~~ ~~ <br />Return form to the Clerk of the Council Office (M-30). <br />Call 647-5237 if you have any questions. ~~ `.I ~: <br />~, k, l ~S <br />_, } <br />---------------------------------- <br />--------------- <br />The agreement with <br /> <br />No. ~ "o2~Q ~-Qq was completed on y~~ ~ \S ~ ~O <br />and final payment has been made. <br />Revised 07-23-07 <br />Department: y~~,~. ~~9J . <br />ti L~ <br />Phone/Ext.: ~j ~-~ `~ <br />Signature: ~ ~ _ <br />Date: ~ ~ <br />