HomeMy WebLinkAboutPALMETTO SITE ASPHALT KELSEY HENDERSON
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Hull Storey
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GENERAL RELEASE
KNOW ALL BY THESE PRESENT: That the undersigned, for PALMETTO SITE &
ASPHALT, for the sole consideration of FIVE HUNDRED EIGHTY THREE DOLLARS AND
28/100 ($583.28), to us in hand paid, receipt whereof is hereby acknowledged,
have remised, released, and forever discharged, and for our heirs, release and
forever discharge KELSEY HENDERSON, individually and as an employee of Augusta-
Richmond County Commission, Augusta, Georgia, their successors and assigns,
heirs,
executors,
administrators,
and
all
other persons,
firms
and
corporations, of and from any and all claims, demands, rights and causes of
action of whatsoever kind and nature arising from, and by reason of any and
all known and unknown, foreseen and unforeseen bodily and personal injuries,
loss of consortium
and services,
damage to property, depreciation
of
property, rental and the consequences thereof, resulting and to result from a
certain incident which happened at the intersection of Wheeler Road and Medical
Center Drive, on or about the 21sT day of AUGUST 2007, for which I/we have
claimed AUGUSTA, GEORGIA, AUGUSTA-RICHMOND COUNTY COMMISSION, to be legally
liable, which liability is hereby expressly denied.
THIS RELEASE DOES NOT
CONSTITUTE A WAIVER OF SOVEREIGN IMMUNITY BY AUGUSTA, GEORGIA OR THE AUGUSTA-
RICHMOND COUNTY COMMISSION.
In further consideration, the undersigned(s) promises to bind themselves
and indemnify and hold harmless the parties released herein any sum of
money, that the party herein released shall be herein compelled to pay
to the undersigned or any other party, including but not limited to
medical, hospital and physician claims and/or liens, as a result of the
above stated incident.
IN WITNESS WHEREOF, we have hereunto set our hands and seals this ~~~
day of ~~ ' 2007.
THIS IS A RELEASE!
READ BEFORE SIGNING
Sealed and delivered
In the presence of
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ITNE S S GNATURE
~
ASPHALT