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City of Santa F -ha <br />Clerk of the Cou..,Al <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amendments (if any) are no longer in effect.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 />C Z© <br />--........... ........................................ <br />. <br />COTC Office Use Only <br />20116 SM �17 <br />"i 4 i •i r` ` '- <br />Cl LE <br />s <br />No. i4 Wil} j Lk— nic was completed on 301 and final payment has been made. <br />(list all amendments. Use space below if needed.) <br />Department:La <br />Phone/Ext.: <br />Signature: <br />�L 0-I01tA, , 2VAt&Z,� <br />Date: <br />N—.)xk 1� P <br />Revised: 01-07-16 <br />