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City of Santa i" <br />n * Clerk of the Cou Al <br />AGREEMENT TERMINATION FORM <br />COTC Office Use Only <br />Please complete this form when the attached agreement and all FEB -6 PM 3: ?6 <br />amendments (if any) are no longer in effect. CI Y OF SANTA AN% <br />CLERK, DP COUNCIL <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 bz+erg ,.. o yChC Ja l <br />No. 20o— lock was completed on hols and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: p$cj:;A <br />Phone/Ext.: <br />Signature: � <br />Date: q I2g bn lq <br />Revised 08-23-10 <br />