HomeMy WebLinkAbout20190414_Butler ReleaseRELEASE OF ALL CLAIMS
KNOW ALL MEN BY THESE PRESENTS:
That the Undersigned, being of lawful age
Bight Hundred Eleven and 64/100 Dollars ($2 31__, U4) to -be paid to Sherry Bud do/does
administrators, successors and assigns release, acquit and Forever discharge the City of San ]
servants, successors, heirs, executors, administrators and all other persons, firms, corporatio
any and all claims, actions, causes of action, demands, rights, damages, costs, loss of servic
which the undersigned now has/have or which may hereafter accrue on account of or in any
unknown, foreseen and unforeseen bodily and personal injuries and property damage and thi
from the accident, casualty or event which occurred on or about the 181 day of March. 2
intersection of Peach &tMt and Santa Rosa Street San Luis Obi o CA 93401.
for sole consideration of Two Thousand
hereby and for my/our/its heirs, executors,
uis Obispo and his, her, their, or its agents,
s, associations or partnerships of and from
,. expenses and compensation whatsoever,
way growing'out of any and all known and
consequences thereof resulting or to result
U, at or near the northeast corner at the
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 patty or parties hereby released, artd that said releases deny liability therefor
and intend merely to. avoid litigation and buy their peace.
It is further understood and agreed tharall rights under Section 1542 of the -Civil Code of Cifomia•and any similar law ofany state or
territoty,of the United States are hereby expressly waived. Said section reads as follows:
"1542. A general release does not extend to claims that the creditor or releasing party does not know or suspect to exist in his
or her favor at the time of executing the release and that, if known by hits or her;! would have materially affected his or her
settlement with the debtor or released party." I
The undersigned hereby declare(s) and reprmcnt(s) that the injuries sustained are or may be p I anent and progressive and that recovery
then Wm. is uncertain and indefinite and in making this Release it is understood and agreed, that the undersigned re1y(ies) wholly upon
the•undei§igtted's' judgmehi':belief and knowledge of the nature, extent, effect, and duration of said injuries and liability therefor and is
made wiii Ent reliance upon any staterhetit.or. representation of,the party or parties hereby r leased or their representatives or by any
physician or surgeon by them employed: I '
The undersigned further declare(s) and represent(s) that no promise, inducement or agreement, not herein expressed Itas been made to
the undersigned, and that: this Release contains the entire agreement betweeni 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 O BEA FULL AND FINAL RELEASE
'OF ALL CLAIMS,
Signed, sealed -and delivered this %/ day of
Witness to , attire
Address of Witn sP Signature
Witness to signatum
Address of Witness —� Signature
For your protection California law requires the following to appear on this form.
Any person who knowingly presents a false-orfraudulentclaim for the payment of a loss is g i lty of a crime and may be subject to fines
and confinement -in state prison.