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SIMONSON, KEITH MICHAEL
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SIMONSON, KEITH MICHAEL
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Last modified
9/20/2024 2:57:08 PM
Creation date
9/20/2024 2:57:04 PM
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Contracts
Company Name
SIMONSON, KEITH MICHAEL
Contract #
N-2024-320
Agency
City Attorney's Office
Expiration Date
11/4/2025
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N-2024-320 <br />SEP 2 0 2024 PROPERTY DAMAGE <br />1l RELEASE IN FULL SETTLEMENT AND COMPROMISE <br />Claire No.: 22-8740152 <br />jOriRMCkn—1tyY�eur-s}( Kv> Cross -Complainant: City of Santa Ana <br />Whereas we claim to have sustained damage and consequential damage to our property by reason of an occurrence <br />happening on or about November 4, 2022 , near the intersection of Bristol and Fifth Street, in the city of Santa Ana, <br />County of Orange, State of California. Whereas we claim that KEITH MICHAEL SIMONSON and all others legally <br />responsible for his acts and omissions, if any (hereinafter called Releasees) are legally liable therefore. Whereas <br />Releasees deny said liability. <br />Whereas the nature, extent and results of the property damages sustained by us are not now all known or unanticipated, <br />but we nevertheless desire to settle and compromise said claim(s) in full. <br />Therefore, in consideration of the payment to be received to us of TEN THOUSAND And Nell00 Dollars ($10,000.00), of <br />which we acknowledge receipt and sufficiency, WE HEREBY RELEASE, DISCHARGE AND ACKNOWLEDGE AS FULLY <br />PAID AND COMPROMISED, ALL CLAIMS, DEMANDS AND CAUSES OF ACTION which we may now have or may <br />hereafter have against the Releasees, their legal representatives or successors, to recover for damage, including the total <br />loss of or the loss of use of, our property and including consequential damage thereto. <br />WE UNDERSTAND THAT NO PAYMENT OR CONSIDERATION OTHER THAN THE ABOVE HAS BEEN PROMISED <br />US OR WILL BE PAID TO US. <br />WE UNDERSTAND THAT THIS PAYMENT CONSTITUTES THE FULL PAYMENT AND COMPLETE SATISFACTION <br />OF ANY CLAIM WHICH WE NOW HAVE OR MAY HEREAFTER HAVE FOR DAMAGE TO OUR PROPERTY. <br />WE ARE ON NOTICE THAT THE STATUTE OF LIMITATIONS FOR FILING A CLAIM FOR DAMAGES OTHER THAN <br />DAMAGES TO OUR PROPERTY WILL EXPIRE ON November 4, 2025. <br />1 have carefully read and understand the foregoing release. <br />Executed this 1 7th <br />day of September 2024, at Santa A0a <br />READ CAREFULLY BEFORE SIGNING <br />Print Name: � O V l SDI Y1Gi l d e r Sig <br />Print Name:Si <br />WITNESS: Add <br />NOTE: For your protection the law requires the following to appear on this form: Any person who knowingly presents a false <br />or fraudulent clairn for the payment of a loss and with the intent to injure, defraud or deceive any insurance <br />company, or files a statement of claim containing any false, incomplete, or misleading information, is guilty of a <br />
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