HomeMy WebLinkAboutA020 - Release of All Claims - $1,500 B01262-31
KW
RELEASE OF ALL CLAIMS
FOR AND IN CONSIDERATION of the payment to me/us at this time of the sum of
One thousand five hundred and 00/100 — — — — — — — — — — — — Dollars ($ 1500.00
the receipt of which is hereby acknowledged, I/we, being of lawful age, do hereby release,acquit and forever discharge
Con—Struct, Inc., 1710 E. Main St., Marshalltown IA and 111 SE 16th, Ames IA
Fran A Rnziker, FYank W "Rill" Allan Gemld F &ith and item 3-loaty 0arpuW
and the HERITAGE MUTUAL INSURANCE COMPANY, Sheboygan, Wisconsin, their heirs, executors, administrators,
agents and assigns, and all other persons, firms or corporations who are or might be liable, of and from any and all
actions, causes of action, claims, demands, damages, costs, loss of services, expenses and compensation, on account of,
or in any way growing,out of, any and all known and unknown bodily injuries and property damage resulting or to
result from an accident'that.occurred on or about the 15th day of December 1987
at or near ' Sewer systems in Ames, IA
I/we hereby declare and represent that the injuries sustained 'are permanent and progressive and that recovery
therefrom is uncertain and indefinite, and in making this release and agreement it is understood and agreed that I/we
rely wholly upon my/our own judgment, belief and.knowledge of the nature, extent and duration of said injuries, and
that 1/we have not been influenced to any extent whatever in making this release by any representations or statements
regarding.said injuries, or regarding any other matters, made by the persons, firms or corporations who are hereby
released, or by any, person or persons representing him or them, or by any physician or surgeon by him or them
employed.
It is understood and agreed that this settlement is a compromise of a doubtful and disputed claim, that the pay-
ment is not to be construed as an admission of liability, and that liability is expressly,denied by the party or parties.
released.
It is further understood and agreed that this release and payment pursuant thereto is not to be construed as a
waiver by or estoppel of any party released to prosecute a claim or action against the undersigned for any damages
sustained.
This. release contains the ENTIRE AGREEMENT between the parties hereto, and the terms of this release are con-
tractual and not a mere recital.
1/WE FURTHER STATE THAT 1/WE HAVE CAREFULLY' READ THE FOREGOING RELEASE AND KNOW THE CON.
TENTS THEREOF, AND I/WE SIGN THE SAME AS MY/OUR OWN FREE ACT.
WITNESS X hand and seal this X day of X 19 90
SIGNED IN THE PRESENCE OF
X r 1 i UTION I REAJ 6EF E SIGNING
Attest by : 1 ,'
X — (SEAL)
Nancy Dionigi , City Clerk
B Larry R. Curti] Mayor (SEAL)
(SEAL)
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