HomeMy WebLinkAboutRELEASE FOR PROPERTY DAMAGES ONLY BETWEEN AUGUSTA, GA AND TED COLLINS, MARY LEWIS COLLINS Release
(Property Damage Only)
11-921F-584
For the Sole consideration of:
$50,000 dollars,the rpt and sufficiency:of which is hereby acknowledged,the undersigned hereby and forever
discharges Mary Lewis Collins,Ted Collins,their heirs,executors, administrators,agents and assigns and all other
persons,firms or corporations liable,or who may be claimed to be liable, none of whom admit liability to the
undersigned,but all expressly deny any liability,from any and all claims,demands or suits of any kind on account of
and resulting frrr damage to property caused by an accident which occurred on or about the 12th day of July,
(year)2016,at or near Center Lane Of Highway 56 Near Augusta Road,Augusta, GA.
Undersigned hereby declares that the terms of this settlement have been completely read and are fully understood
and voluntarily accepted for the purpose of making a full and final compromise adjustment and settlement of any
and all claims,disputed or:otherwise,on account of the damages above mentioned,and;for the express purpose of
precluding forever any further or additional claims relating to property damage arising out of the aforesaid accident.
Undersigned hereby accepts draft or drafts as final payment of the consideration set forth above.
This release expressly reserves all rights of the parties released to pursue their legal remedies, if any,against the
undersigned,agents and assigns.
In Witness Whereofhave hereunto set hand(s)and seals)this q-14L/ day
of pac6, c9 D I (year).
In the presenceof
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Signed X
Wiin A Har.ze Davis, Jr. ,. ayor
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Signed_X
Witness Releasor Signature
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Approved as to Form:
An ew G. MacKenzie, General Counsel