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HomeMy WebLinkAbout*Other - BOCC (002)RELEASE IN FULL OF ALL PROPERTY DAMAGE CLAIMS Claim Number. 87 5 900U04/ FS48 I/we, Grant County Releasor(s), of Bridge #229, M - SE and 5 - SE Roads, City of Moses Lake, State Washington, Being over the age of majority, for and in consideration of a draft for the sum of Forty -Three Thousand Five Hundred Ten Dollars and 43/100 Dollars ($43,510.43), lawful money of the United States of America to me/us in hand paid, the receipt of which is hereby. acknowledged, do for myself/ourselves, my/our heirs, executors, administrators, successors and assigns, hereby remise, release, and forever discharge Carol Hull, Releasee(s), successors and assigns, and/or his, her or their associates, heirs, executors and administrators, and all other persons, firms or corporations of and from any and every claim, demand, right or cause of action, of whatever kind or nature, on account of or in any way growing out of any and all property damage resulting or to result from an accident that occurred on or about the 20 day of OCT, 2021 at or near The State of Washington including, but not limited to, all liability for contribution and/or indemnity. AS A FURTHER CONSIDERATION FOR THE MAKING OF SAID SETTLEMENT AND PAYMENT, IT IS EXPRESSLY WARRANTED AND AGREED: (1) That I/we understand fully that this is a final settlement and disposition of the disputes both as to the legal liability for said accident, casualty, or event and as to the nature and extent of the property damage which I/we have sustained and I/we understand that liability is denied by Carol Hull, Releasee(s), and it is covenanted and agreed between the Releasor(s) and Releasee(s) herein that this release and settlement is not to be construed as consent or an admission of liability on the part of said Releasee(s); that this release and settlement agreement shall not be used by said Releasor(s) or any one on his behalf as a defense or estoppels in any action which is now pending or may be brought hereafter by said Releasee(s) against said Releasor(s) or his agents and servants, and any claim of whatever kind or nature the Releasee(s) might have or hereafter have other than property damage arising from said accident is expressly reserved to them. (2) That I/we do hereby for myself/ourselves, my/our heirs, executors, administrators, successors, assigns and next of kin covenant to indemnify and save harmless the Releassee(s) from any and every claim or demand of every kind or character for property damage arising from said accident which may ever be asserted. (3) That no promise, agreement, statement --or representation not herein expressed has been made to or relied upon by me/us and this release contains the entire agreement between both parties. IN WITNESS WHEREOF, I/we have hereunto set my/our hand and seal this of 20_ a:� THIS ISA (SEAL) RELEASE At.VIIA& I I OF PROPERTY DAMAGE ONLY OF We certify that this release was signed in our presence by the above who acknowledged that he/they understood it fully. WITNESS ADDRE S S WITNESS ADDRE S S STATE OFIrl COUNTY OF ss. `"� � � �jb � 'sOn this I day of a/, 20 before me personally appeared � QLA o me known to be the person(s) named in and who executed the above release and acknowledged that executed the same as .-I , ,� /N A own free act and deed. . ie n Title) For your protection, ' Oregon law requires the following to appear on this form: It is owingly provide false, incomplete, or misleading information to an insurance company -for t �oseoo • g company. imprisonment,udin the com an . Penalties include fines and denial of insurance be fits+ a of ® �*" •• . ®• .14ENMR INSURANCE CRIME PREVENTION INSTITUTE mo= Wor—C4,0 a 4. '146a aft • 4OP4 42 1`sOrZz 4 Y, JA, L%%%%� �r141111111i �` . Sensitivity: General/Internal