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My of Santa At*- <br />Clerk of the Count— <br />AGREEMENT TERMINATION FORM <br />COTC Office Use Only <br />-p <br />NP R 16 PH 4 <br />Please complete this form when the attached agreement and all <br />amendments (if any) are no longer in effect. <br />Return form to the Clerk of the Council Office (M-30). <br />Call 647-6520 if you have any questions. <br />The agreement with Le, Choc <br />No. A-2009-071 was completed on 6/30/13 and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />A-2009-071-001, A-2011-118, A-2012-153 <br />Revised 08-23-10 <br />Department: PRCSA <br />Phone/Ext.: 5254 ry <br />Signature:.Sr <br />Date: 6/11/14 <br />