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City of Santa. la <br />Clerk of the Council <br />} AGREEMENT TERMINATION FORM <br />COTC Office Use Only <br />Please complete this form when the attached agreement and all . ' ' 22 <br />amendments (if any) are no longer in effect. C,T t o(� <br />f 50a E A h tt . <br />Return form to the Clerk of the Council Office (M-30). # ? ` nr P, 1 F1 <br />Call 647-6520 if you have any questions. <br />The agreement with 1 f S <br />,/� tag) (3a) <br />No. /*^�(jo�— )2 oO Oo was completed on and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: w02y1 <br />Phone/Ext.: A27-12 <br />Signature:/ <br />Date: <br />Revised 08-23-10 <br />b1/ <br />