HomeMy WebLinkAbout20170905 Martinez 19197361 RELEASE OF ALL CLAIMS
KNOW ALL MEN BY THESE PRESENTS:
That the Undersigned, being of lawful age, for sole consideration of Twenty Thousand and
00/100 Dollars ($20,000.00) to be paid to Yolanda Martinez 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 his, her, their, or its agents, servants, successors, heirs,
executors, administrators and all other persons, firms, corporations, associations or partnerships of 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 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 191s day of September, 2015, at or near South Higuea Street at 3985 South Higuera 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 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 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."
The undersigned hereby declare(s) and represent(s) that the injuries sustained are or may be permanent and 'progressive and that recovery
therefrom is uncertain and indefinite and in making this Release it is understood and agreed, thatthe undersigned rely(ies) wholly upon the
undersigned's judgment, belief and knowledge of the nature, 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
them employed.
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 this Release contains the entire agreement between the parties hereto, and that the terms of this Release are contractual and
not a mere recital.
I hereby represent that at the time I sign this Release I am not hospitalized in a medical facility nor was I admitted to a medical facility within the
past 15 days.
THE UNDERSIGNED HAS READ THE ABOVE AND FULLY UNDERSTANDS IT TO B1EA FULL AND FINAL RELEASE OF ALL CLAIMS.
Signed dell day of
Witness to sign We
Address of Witness Signature
For your protection California law requires the following to appear on this form.
Any person who knowingly presents a 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.
/ ACKNOWLEDGMENT UNDER OATH
State of
County of _
Before me this
known to me to be the individual
contents and freely executed same
CW File: 1919736
day of
I Ss
executed this release, and acknowledged that
to sole consideration therein expressed.
came
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fully understood its
Notary Public
CW072
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the
document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of California )
County of 2aIl L1 c\ -p ``��JVAV ,no /� ) ` , A {�
Ont3e�J�ew�her�J, oLv�i before me, l `�Q1J��A f t• C.Ax,2geSSI i�o�CLt�I P�b�1,G
Date Here Insert Name and Title of the O rcerff
personally appeared eZ-
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person(,) whose name(e) is/aFe-
subscribed to the within instrument and acknowledged to me that he/she/they--executed the same in
tris/her/their authorized capacity(ies), and that by hWher/their signature(s) on the instrument the person(,);
or the entity upon behalf of which the person(s) acted, executed the instrument.
-------------------
CHELSEA M.BURGESS
Commission # 2126704
< -v Notary Public - California z
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San Luis Obispo County
My Comm. E ifres Sep 14, 2019
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph
is true and correct.
WITNESS my hand and official seal.
Signature IINUINI 1.1.�I/�U
Signature of Notary Public
Place Notary Seal Above
OPTIONAL
Though this section is optional, completing this informal
fraudulent reattachment of this form to
Description of Attached Do
Title or Type of Docbment:
Number of Pages: —�
Signer(s) Other Than Named
Capacity(ies) Claimed by Signer(s)
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑ General
❑ Individual ❑ Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
❑ Other:
Signer Is Representing:
can deter alteration of the document or
unintended document.
Document Date: 1; ,aY.JCA JI zi
ve: LeAA01 A\?vQm (Cr and AlldA MojVi() .L
Name:
❑ Coroorate Officer — Title(s):
❑ Partner — ❑ Limited ❑ General
❑ lndi�ldual El Attorney in Fact
11 Trustee ❑ Guardian or Conservator
❑ Other:
Signer Is Representing:
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