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City of Santa i` a <br />Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />Please complete this form when the attached agr <br />amendments (if any) are no longer in effect. <br />Return form to the Clerk of the Council Office <br />Call 647-6520 if you have any questions. <br />7012 <br />and all <br />�R <br />C! <- <br />The agreement with Lo/ <br />No. F) 4 was completed on 0l%a <br />(List all amendments. Use space below if needed.) <br />-zoo co Y& (1) Departme <br />/ R - 09'131 -001 Pone/Ext <br />Signature: <br />Dilate: <br />Revised 08-23-10 <br />COTC Office Use Only <br />t........................................ <br />F "A <br />and final payment has been made. <br />No <br />