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City of Santa is <br />Clerk of the Council <br />AGREEMENT TERMINATION FORM <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amendments (if any) are no longer in effect.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 <br />d <br />No. 4 " Z Oi /- 172 -0 / was completed on <br />A(List all amendments. Use space below if needed.) <br />Revised 08 -23-70 <br />6 >6) -/Z <br />COTC Office Use Only <br />2 <br />tea€ <br />and final payment has been made. <br />Department: C L7 <br />Phone /Ext.: <br />Signature: <br />r <br />Date: 3 <br />