HomeMy WebLinkAbout20170601 StateFarmForWells PDRelease 1964956PROPERTY DAMAGE RELEASE
KNOW ALL MEN BY THESE PRESENTS:
That the Undersigned, being of lawful age, for sole consideration of One Hundred
Ninety -Four and 291100 Dollars ($194.29) to be paid to State Farm Mutual Automobile Insurance Company as
Subrogee for Rob Wells do/does hereby and for my/our/its heirs, executors, administrators, successors and assigns
release, acquit and forever discharge the City of San Luis Obispo, CA 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 and all known and unknown, foreseen and unforeseen property damage and the consequences
thereof resulting or to result from the occurrence on or about the 26th day of January, 2017, at or near the intersection
of Marsh Street and Osos Street, San Luis Obispo, CA 93401. 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 IT.
STATUTE OF LIMITATIONS ON YOUR INJURY 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 -�h ( 2. z;/ 7
CAU N: READ E SIGNI BELOW
Witness Signature A orized Representative,
State Farm Mutual Automobile Insurance Company
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Print Name and Title
Address
Address
CW File: 1964956-Sfx2 - State Farm Claim No. 55-9521-137 Cw082