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City of Santa a <br />Clerk of the Council <br />AGREEMENT TERMINATION FORM __.___ ....... <br />COTC Office Use Only <br />2�'9 J!!! I9 pI9 3: n5 <br />Please complete this form when the attached agreement and all <br />CITY OF COUNCIL <br />AI amendments (if any) are no longer in effect. CLERK � OF COUNCILL <br />Return form to the Clerk of the Council Office (M-30). <br />Call 647-6520 if you have any questions. <br />The agreement with 14 <br />No W7® (QI was completed on 3 Z01U and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Department: ' DA <br />Revised 08-23-10 <br />Phone/Ext.: &'s-o <br />Signature: <br />Date: t9 [ <br />