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City of Santa t a <br />r 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amendments (if any) are no longer in effect.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 647-1520 if you have any questions. <br />The agreement with <br />No. N-2014-057 was completed on <br />(List all amendments. Usespacebelow if needed.) <br />Department: <br />Phone/Ext.: <br />Signature: <br />Date: <br />Revised 10-31-12 <br />COTC Office Use Only <br />Ri ;?P t -77 <br />, <br />Ci { E iJF � FAQ, ^j � A <br />CL Pi <br />final payment has been made. <br />P Q-5 <br />