HomeMy WebLinkAbout20160824 Fiore Release 1937398RE LEASE OF ALL, CLAIMS
KNOW ALL, MFN F3Y `FI1F.Si:? t'RI,ti1. N"I'S:
That the Undersigned, being of lawful age, for sole consideration of One Hundred Seveuty-
Tr►°o ,and 00/100 Dollars (5172.00) to be paid to Dana Fiore do/does hereby and for my/our/its heirs, executors, administrators, successors and
assigns release, acquit and forever discharge City of San Luis Obispo and his, her, their, or its agents, servants, successors, hears, executors,
administrators and all other persons, firms, corporations, associations or partnerships of and from any and all claims, actions, causes of action,
dernands, rights, dannagcs, costs, logs of service, expenses and compensation whatsoever, which the undersigned now bas/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 bodily and personal
in -juries and property darnagle and the consequences thereof resulting or to result from the accident., casualty or event which occurred on or about
the 5"' dart of M19 y, 2016, at or near 4392 Wavertree Street, San Luis Obispo, CA 93401.
It is understood anal agreed that this wttletnent 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 releases deny liability therefor and int€:nd
rrnc-rely to avoid litigation and buy their peace.
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 territ<;ry of
the 13nited States are hereby expressly waived. Said section reads as follows:
"1542. Certain claims tint affected by general release. A general release aloes not extend to claims which the creditor dunes not
know or suspect to exist in his favor at the time of executing the release, which if known by him must have rnare-rially affected
his settlement with the deMor,"
The undersigned he l-eby dechare(s') and represent(s} that the injuries sustained are or may be permanent and progressive and that recovery
the.retiom is uncertain and indefinite and in making this Release it is understood and agreed, that the undersigned rely(ies) wholly llpon the
antelersigned`s judo anent, belief and knowledge of the mature, extent, effect, and duration of said injuries and liability therefor and is made without
reliance upon any staternnent or represcintation of the. party or parties hereby released or their representatives or by arty physician or surgeon by
them employed.
The unelersigncd Further declare(s) and represerrt(s) that no promise, inducement or agreement not herein expressed has been made to the
unde.rsioned, and that this Release contains the entire agreement between the parties hereto, and that the terms of this Release are contractual and
not a nneae recital.
I hereby represent that at the time I sign this Release I arra not hospitalized in a tuedical facility nor was 1 admitted to a medical facility within the
past 15 days.
'I'llEIA, D .RSI(;NPA) IIAS RVAID'I"}Ik; ABOVE AND FULLY IIND :RSTANDS ITTO Tai. A U1 TI, AND FINAL RELEAgE OF ALL CLAINIS.
Sianed, seeded and deliversd till's day of �'l.i - _ �0 1 62 .
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Avllnes5 t[ S*'nature'.
.Ad'tlres:s of' witness
to : ignaturt
Addres<of 4�it.nrss �
Signature -
signature
For your protection California law requires the following to appear on this form.
Atiy person who knowingly presents a false or fraudulent claim for the payment of a loss is guilty of a crime and may be subje-et to fines
and confinement in state prison.
State of
Courtly of
Before me this
dray of
ACKNOWLED(.MENT UNDER GATT!
-- SS
carne
known to me to b the individual who executed this release, and acknowledged that
contents and freely executed sante for the sole consideration therein expressed. f" ,
co
C. File: 19.7108,
fully understood its
Notary Ptablic
M(I T.'