HomeMy WebLinkAboutResolution No. 6014RESOLUTION NO. 6014
A RESOLUTION AUTHORIZING THE SIGNING
OF A LEASE OR AGREEMENT
THE CITY COUNCIL OF THE CITY OF SAN RAFAEL HEREBY RESOLVES as follows:
The MAYOR and CITY CLERK are authorized to execute, on behalf
of the City of San Rafael a lease or agreement with
CALIFORNIA STATE AUTOMBILE ASSOCIATION (Release of all Claims,as a
result of an accident which occurred on or about the 25th of November, 1975,
against Charles P. or Patricia A. Kaiser.)
A copy of which is hereby attached and by this reference made a part
hereof.
I, MARION A. GRADY, City Clerk of the City of San Rafael, hereby
certify that the foregoing resolution was duly and regularly introduced
and adopted at a regular meeting of the City Council of said
City held on Monday the 22nd _ day of March
19 76 , by the following vote, to wit:
AYES: COUNCILMEN: Jensen, Miskimen, Mulryan, Nixon and Mayor Bettini
NOES: COUNCILMEN: None
ABSENT: COUNCILMEN: None
MARION A. GRADY - City Cler
0-RICINA[
RELEASE OF ALL CLAIMS
To be executed by -------
C. PAUL B>r°I' IlVI.:.. I9ayor:...in behalf..of .the ..Cit.. -of--
.-S .............. ..... ...-.............
The undersigned do(es) hereby acknowledge receipt of Draft No.. I..-lt;�.1.11.].�..:.µ t.+� .�li------ ----
z� hundrec ,.I, 1 ----------------=_Dollar ($-.17-21.01....------- )
for..4`' - ---- �...T:...;.Tl#Y--tyJ .. �nS1..�:f��.(1�?---- - -- s
Payable to..0-itY-.Qf...; )lr a_�T'Aa te:------------ ••-- -- ----- --•------
--------------- -- ------ --------------- ..................................... .......... -............................................... .
which draft is accepted in full compromise settlement and satisfaction of, and as sole consideration ori e.
final release and discharge of, all actions, claims and demands whatsoever, that now exist, or may hereafter
accrue, against... ---Ch.' _FC_isP.x..-•-- .. ........ --.........-....... --------
•---•-•-----•---...----•--------- ----------------------------•-••--------------------------------------.............- .......... -................ ------------------------ ------------------
and any other person, corporation, association or partnership responsible in any manner or degree for injuries
to the person and property of the undersigned, and the treatment thereof, and the consequences flowing
therefrom, as a result of an accident, casualty or event which occurred on or about the ...... kh..........................
day of-_iinto:tzthur........... -...... -.......... 19('.5....at or nearLiricala..and
............................... -----...... ------................ ..................................................... ..
--------------- ---
and for which the undersigned claims the above named persons or parties are leqally liable in damages
which legal liability and damages are disputed and denied, and; ,
The undersigned warrants, that no promise or inducement has been offered except as herein set forth;
that this release is executed without reliance upon any statement or representation by the person or parties
released, or their representatives, or physicians, concerning the nature and extent of the injuries and conse-
quential damages, if any, and of legal liability therefor, if any; that the undersigned is of legal age, legally
competent to execute this release and accepts full responsibility therefor, and;
The undersigned agrees, as a further consideration and inducement for this compromise settlement, that
it shall apply to all unknown and unanticipated injuries and damages resulting from said accident, casualty
or event, as well as to those now disclosed.
The undersigned hereby expressly waives the provisions of Se
ctior( 1542 of the Civil Code of the State of
California, which reads as follows:
"A general release does not extend to claims which the creditor does not knout 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."
And ..............do declare that...-- -------•----- ---• ---------------- -.
Signedat---------------------------------------------------------------------------- this.
CITY STATIC
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WITNESS TO SIGNATURE
.............................................
ADDRESS
7. ------------.--..----.- .... ... _..-. .. ._...
WITNESS TO SIGNATURE
..........................................................................
ADDRESS
-day of. .............. -------- -----...... ------------- 19. -
C.AUTloN: READ `E 0111. SIGNIT1c,
... .... ...... . ......................
SIGNATURE
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SIGNATURE
For your protection California law requires the following to appear on this form. 556. It is unlawful to: (a) Present or cause to be presented any
false or fraudulent claim for the payment of a loss under a contract of insurance. lb) Prepare, make, or subscribe any writing. with intent to present
or use the same, or to allow it to be presented or used in support of any such claim. Every person who violates any provision of this section is pun-
ishable by imprisonment in the State prison not exceeding three years, or by fine not exceeding one thousand dollars, or by both.
(OVER)
F 14130 (REV. 5-55)