HomeMy WebLinkAboutLW09-314 - Original - Nicomedes Tubar III - Release of All Claims & Hold Harmless Agreement - 08/03/2009 ',and
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''.i CONTRACT COVER SHEET
This is to be completed by the Contract Manager prior to submission
to City Clerks Office. All portions are to be completed.
If you have questions, please contact City Clerk's Office.
Vendor Name:
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Vendor Number:
ID Edwards Number
Contract Number: z lud �- S
This Is assigned by City Clerk's Office
Project Name: ff� V. of �L E
Description: ❑ Interlocal greement Changp Order ❑ Amendment ❑ Contract
�I Other: CUI t6tU6S
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Contract Effective Date:TJLLA Termination Date:
Contract Renewal Notice (Days): I'[
Number of days required notice for termination or renewal or amendment
Contract Manager:fid f� f (,Department: (AA)
Detail: (i.e. address, location, parcel number, tax id, etc.):
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5'Publlc\RecordsManagement\Forms\ContractCover\adcc7832 1 11/08
RELEASE OF ALL CLAIMS AND
HOLD HARMLESS AGREEMENT
KNOW ALL BY THESE PRESENTS
That the Undersigned, as an individual Plaintiff(in Nicomedes Tubar, III, Plaintiff, v.
Jason Cliff; and The City of Kent, Washington, a municipal corporation, Defendants, U.S
District Cause No. C05-11541CC, Western District of Washington at Seattle), being of lawful
age, for the sole consideration of Four Hundred Thousand Dollars and 001100 cents
($400,000.00) to the undersigned paid, as indicated below and receipt of which is hereby
acknowledged, does hereby and for my heirs, executors, administrators, successors and assigns
release, acquit and forever discharge Jason Cl[ft, The City of Kent, Washington and Washington
Cities Insurance Authority, and their agents, servants, successors, heirs, executors, administrators
and all other persons, firms, corporations, associations or partnerships of and from any and all
claims, actions, expenses and compensation whatsoever, including but not limited to all claims
for punitive damages and all claims of any nature for attorney's fees and costs, 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 or
death and property damage and the consequences thereof resulting or to result from the accident,
casualty, event which occurred on or about: June 26, 2003, at or near the parking lot adjacent to
plaintiff's apartment building in Kent, Washington, as more fully set forth in the Complaint filed
under Nicomedes Tubar, 111, Plaintiff, v. Jason Cliff, and The City of Kent, Washington, a
municipal corporation, Defendants, U.S. Distnct Cause No C05-1154JCC, Western District of
Washington at Seattle It is understood and agreed that this settlement is the compromise of a
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 releasees deny liability therefor and
intend merely to avoid litigation and buy their peace
The undersigned hereby declares 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, that the 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.
In consideration of payment of the above sum, the undersigned represents, warrants and
agrees that helshe or hislher legal representative will satisfy any and all lien claims against the
above sum, or any settlement or recovery arising out of the incident, casualty or events which
occurred as above-described. In further consideration of the payment of the above sum, the
undersigned agrees to indemnify all Defendants named in the above-referenced action, their
attorneys of record, and their respective liability insurance carriers, and agrees to hold the same
harmless against any claim, suit, action or demand asserting a lien against said sum, settlement or
recovery
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The undersigned further declares and represents 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&.is Release are contractual
and not a mere recital.
THE UNDERSIGNED HAS READ THE FOREGOING RELEASE AND FULLY
UNDERSTANDS IT.
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Signed, sealed and delivered this 3r day of•Akly; 2009.
CAUTION' READ BEFORE SIGNING BELOW
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Wi ss Nicomedes Tubar, III
STATE OF WASHINGTON )
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County Of King )
On this 3r-A day of-J*7, 2009, before me personally appeared Nicomedes Tubar, III, to
me known to be the person named herein and who executed the foregoing Release and he
acknowledged to me that he voluntarily executed the same.
A ivi.
vaP�' f' Md6ry Public in and for the State of Washington,
residing at t7es (11o,nes
++n�`�fl My commission expires { 2[ f u� ZUa 9
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