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City of Santa / 3 <br />O <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 <br />amendments (if any) are no longer in effect. r <br />Return form to the Clerk of the Council Office (M-30). <br />Call 2520 if you have any questions. <br />The agreement with <br />No. I �V I,—���j�� C2) (Oft <br />was completed on <br />2 (List all amendments. Use space below if needed.) <br />*R -2011-113.01A (2R) <br />+R-2t12-obb c28) <br />_+k- 21012-060)(20 <br />* A -012-00 - OZ (2-4) <br />Revised 04-12-10 <br />Department: <br />Phone/Ext.: <br />Signature: <br />Dare: <br />and final payment has been made. <br />• <br />