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City of Santa xna <br />"3 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amendments (if any) are no longer in effect.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 `V GLA''Le," <br />No. A -r),D G- - ObI (lb) #was completed on <br />(List all amendments. Use space below if needed.) <br />/ R-200Q-13S (.OM <br />% A -%all - 223 L10 <br />Use Only <br />AMA <br />and final payment has been made. <br />Department: <br />Phone/Ext.: <br />Signature: <br />Date: <br />Revised 08-23-10 <br />