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City of Santa Ai <br /> COTC Office Use Only <br /> � Clerk of the Council �--------- <br /> r <br /> AGREEMENT TERMINATION FORM <br /> 2020 APR 24 PM Please complete this form when the attached agreement and all 8 <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 amendments (if any) are no longer in effect.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 `' T��' 1'i(� <br /> have been satisfied prior to signing the termination form. CLtt�{ F OUNCiL <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 3 l '1� �� �� '?r "� J1( VActan*naF\ ► t "10_, <br /> No. ► - -acirLc—(---)Dti was completed on NI i `c7-C�� and final payment has been made. <br /> (List all amendments. Use space below if needed.) ,��+ a, <br /> �, j per? Department: .1) J'-5 <br /> - _ Phone/Ext.: ` - ' <br /> Signature: )CL,Q.A/C&.) <br /> Date: <br /> Revised:01-07-16 <br />