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City of Santa r a <br />1 Clerk of the Coun. it <br />AGREEMENT TERMINATION FORM <br />Please complete this form when the attached agreement and all �� FEB I-6 PM <br />amendments (if any) are no longer in effect. <br />Note: If your agreement is grant related, please ensure that all grant retention requirements CITY OF S �, TA qy� <br />have been satisfied prior to signing the termination form. CLERK( TAACOUNCIL <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 Meyc-�03 ,'An L-N )A r aye, f)pq-�7 in 'L r� <br />No. A—'iM —0p2— was completed on IQ and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: <br />Phone/Ext.: <br />Signature: <br />Dater <br />Revised: 01-07-16 <br />