HomeMy WebLinkAbout20160603 Fram Release 1936716RL'LLASL OF ALL CLAIMS
KNOW A[ -L MEN t3Y TI IE.SE PRESENTS:
That the Undersigned, being Of lawful age, for sole consideration of Seven Hundred
Twenty -Seven and 0$1101} Dollars ($727.08) to be paid to Joseph Henry Frani do/does hereby and for my/our/its heirs, executors,
administrators, successors and assigns release, acquit and forever discharge City of San Luis Obispo, California and Granite Construction
Company and his, her, their, or its agents, servants, successors, heirs, executors, administrators and all other persons, firms, corporations,
associations or partnerships of and fi-orn any and all clairns, actions, causes of action, demands, rights, damages, costs, loss of service, expenses
and cornponsation whatsoever, which the undersigned now haslhavc or which may hereafter accrue oil account of or in any way growing out of
any arid all known and unknown, foreseen and unforeseen bodily and personal injuries and property damage and the consequences thereof
resulting or to result from the accident, casualty or event which occurred on or about the 27"' day of April, 2016, at or near Los Osos Valley
Road and the llighway 101 overpass, San Luis Obispo, CA 93405.
It is understood and agreed that this settlement is the cornprornke of a doubtful and disputed claim, and that tiro payment iyaacle, iti not to be
construed as an admission of liability on the; part of the party or parties hereby released, and that said releases deny liability therefor and intend
merely to avoid litigation and buy their peace.
It is further understood and agreed that all rights under Section 1542 ofthe Civil Code of Calil:'umia and any similar law of any starts or territory of
the United States are hereby expressly waived. Said section reads as Ulm":
"1 i42. Certain clairns 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 tinge of executing the release, which if known by him must have materially affected
his settlernenl with the debtor."
Thc. urrdersigrted liereby declare(;) arid rcpresent(s) that the injuries sustained erre or may be permanent attd progressive and that recovery
therefrom is uncertain and indefinite and in making this Release it is understood and agreed, that the undersigned rety(ies) wholly upon the
a.rndersigned's judgment, belief and knowledge ofthe mature, extent, effect, and duration of said injuries and liability therefor and is made without
reliance- upon any statement or representation of the party or parties hereby released or their representatives or by any physician or surgeon by
thein employed.
The undersigned finrthear declare(s) and rcpresent(s) that no promise-, inducement or agreement not herein expressed bas been made to the
undersigned, and that. this Release contains the entire agreement behveen thy; parties hereto, and that the terms of this Release are contractual and
not a mere, recital,
1 hereby represent that at the tirite I sign this ttelease I ann not hospitalized in a medical facility nor was I admitted to a medical facility within the
past 15 days_
THI UNDERSIGNED IiAS IATAD T11Y, ABOVE AVIA FIJI.LY i'Nt ERSTANDS IT TO RE A Plst..I, ANI) FINAt, RIFI,hASt•: 01.AL,t, Cf .�kiAifi.
q
Signed, ;ogled and dehvc:red this day of�
Address of ld nrre
Signature
Witness to signature
Aofdresof Witness
Si�tiature
For your protection California law requires the following to appear on this form.
Any person wlrc krnlFvingl,.� presents t3 false or fraudulent claim Cor the payment 01'a loss is guilty of a crime and may be subject to fines
and co nfinc anent in stale prison.
State of
C.crurrty of
Before me this clay of
ACKNOWLEDGMENT UNDER OATH
SS
came
]mown to the to be the individt.tal who executed this release, and acknowledged that fully understood its
contents and fi-cely executed sarrrc for the sole consideration therein express-,, w ." & 6
SUN p 26% Notary Public
C'14' file: 1936716M072
sANLUIS OBISPO, CA