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City of Santa., .+a <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amendments (if any) are no longer in effect.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 647-1520 if you have any questions. <br />The agreement with <br />............. ......... <br />COTC Office Use Only <br />-7 1' - <br />fp h <br />No. <br />N-2015-145 was completed on 00 <br />and final payment has been made. <br />(List afl amendments. Use space below if needed.) <br />Department: ` A-- <br />Phone/Ext.: <br />Signature: <br />Date: <br />Revised 10.31-12 <br />