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City of Santa . a <br />fl 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amendments (if any) are no longer in effect.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 />FFB -6 PM � 21 <br />CITY OF SAN- <br />CLFtK OF COiA AN6� <br />UNCIL <br />Only <br />No. N-2095-097 was completed on J1 1W,02GLS and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: Q Cs A <br />Phone/Ext.: y2�� <br />Signature: p <br />Date: - I?"�, bmCk <br />Revised 10-31-12 <br />