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®10 City of Santa ! i <br />a'" 1 Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />i COTC Office Use Only <br />2020 FEB _ __.. <br />Please complete this form when the attached agreement and all CITY OF I SANTA amendments (if any) are no longer in effect. CLERK F COUNCIL <br />Q QUNCiL <br />Return form to the Clerk of the Council Office (M-30). <br />Call 647 M if you have any questions. <br />i <br />The agreement with <br />No. `,(� —/ r' was completed on�� I and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: <br />Phone/Ext.: 5as""F <br />Signature: S,� Q-�� kkA/CUO <br />Date: c`f16Q� <br />Revised 04-12-10 <br />