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City of Santa V <br />Clerk of the Coun� <br />AGREEMENT TERMINATION <br />Please complete this form when the attached agreement is no longer in effect�f ` --;ATA <br />r3 e ¢ Ar <br />Return form to the Clerk of the Council Office (M-30).Ua <br />Call 647-5268 if you have any questions. <br />The agreement with <br />No. R- AD69 — , 3;�.CI5) [Ott was completed on <br />and final payment has been made. <br />i <br />Revised 07-23-07 <br />M <br />Department: 0 A <br />Phone/Ext: X <br />Signature: <br />Date: <br />