HomeMy WebLinkAbout20170404_StateFarmASORhodes_ReleasePROPERTY DAMAGE RELEASE
KNOW ALL MEN BY THESE PRESENTS; ��
That the Undersigned, being of lawful age, for sole consideration of Seven
Hundred Seventy -Four and 07/100 Dollars ($774.07) to be paid to State Farm Mutual Insurance Company as
Subrogee for Debra.'Marie Rhodes do/does hereby and for my/our/its heirs, executors, administrators; suc6essors and
assigns release, acquit. and forever discharge the City of San Luis Obispo, CA -and Charles Carrow and his, her, their,
or its agents, servants, successors, heirs, executors, administrators and all other persons, firms, corporations, associations
or partnerships for and from any and all claims, actions, causes of action, demands, rights, damages, costs, loss of service,
expenses and compensation whatsoever, which the undersigned now has/have or which may hereafter accrue on account
of or in any way growing out of any atid all known and unknown, foreseen and unforeseen property damage and the
consequences thereof resulting or to result from the occurrence on or about the 12th day of December, -2016, at or near
the intersection of Madonna Road and El Mercado, San Luis Obispo, CA. It is understood and agreed that this
settlement is the compromise- of a doubtful and disputed claim, and that •the payment made is not to be construed as an
admission of liability on the part of the party or parties hereby released, and. that said releasees deny liability therefor and
intend merely to avoid litigation and buy their peace. The undersigned further'declare(s) and represent(s) that no promise,
inducement or agreement not; herein expressed has been made to the undersigned, and that the Release contains the entire
agreement between the parties hereto, and that the terms of this Release are contractual and not a mere recital.
It is further understood and agreed that all rights under Section 1542 of the Civil Code of California and any similar law
of any state or territory of the United States are hereby expressly waived. Said section reads as follows:
"1542. Certain claims not affected by general release. A general release does not. extend .to claims which
the creditor does not 'know �or suspect to exist in his favor at the time of executing the release, which if
known by him must have materially affected his settlement with the. debtor."
FOR YOUR PROTECTION CALIFORNIA LAW REQUIRES THE FOLLOWING TO APPEAR ON THIS FORM:
Any person who knowingly presents false or fraudulent claim for the payment of a loss is guilty of a crime and may be
:subject to fines and confinement "in state prison.
THE UNDERSIGNED HAS READ THE FOREGOING RELEASE. AND FULLY UNDERSTANDS Tr.
STATUTE OF LIMITATIONS ON YOT IR INRMY CLAIM, IF ANY, EXPIRES ON NIA.
Section 11583 of the Insurance Code requires that notice be made to you of the following: 1. The statute of limitations for
bodily injury actions expires two years .from the date of accident unless the injured party is a minor. In that case, the
statute expires two years from the date the minor reaches majority. (Section 335.1, Code of Civil Procedure). 2. The
statute of limitations for bodily injury against a Governmental entity expires six months from the date of the .notice of
rejection. (Section 945.6 of the California Government Code.)
Signed, sealed and delivered this day of
Witness Si nature
Print Name and Title
'
Address
� ,
Address
ve, State Farm Mutual Insurance
CW File:1953655 - State Farm Claim No. 55-0394-5Z2 CW082