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(9) <br />City of Santa A -r <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amendments (if any) are no longer in effect.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 />Note: If your agreement is grant related, please ensure that all grant retention requirements <br />have been satisfied prior to signing the termination form. <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 />COTC Office Use Only <br />OF THE COUNCIL <br />0 2121 F43.32 <br />No. N-2016-057 was completed on 51,31111 and final payment has been made. <br />(List all amendments. Use space below if needed.) I,� i <br />Department: i� �-(�,&i�- 1 f�C4Y"16% <br />Phone/Ext.: �5as�-q <br />Signature:�Ull <br />Date: -7 labl <br />Revised: 01-07-16 <br />