Laserfiche WebLink
_r City of Santa - 'a <br /> r.r; Clerk of the Cou1.cil COTC Office Use Only <br /> "" AGREEMENT TERMINATION FORM <br /> • <br /> Please complete this form in its entirety when the attached agreement and all ill 3: 25 <br /> amendments (if any) are no longer in effect. CITE <br /> j` • <br /> Note: If your agreement is grant related,please ensure that all grant retention requirements CL � r `'l T, Ahave been satisfied prior to signing the termination form. y t�'V l.i?1JI'Il,'(L • <br /> • <br /> Is the agreement(s)a permanent record?Yes No <br /> Return form to the Clerk of the Council Office (M-30). • <br /> Call 647-1520 if you have any questions. <br /> NA.AL.Ta vJ :��1srem r,\Jc- . <br /> The agreement with <br /> No. N-2018-023 was completed on I'P-I. 1 , Icb and final payment has been made. <br /> (List all amendments. Use space below if needed.) <br /> Department: F'v,i A <br /> Phone/Ext.: 33 7 <br /> Signature: 3/41)Lil \-- - <br /> Date: 31301 � <br /> Revised:10-18-16 <br />