HomeMy WebLinkAboutANA MANJARREZ V. CITY OF SANTA ANAA-2020-046
dSURANCE NOT REQUIRED
WORK MAY PROCEED
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FULL RELEASE OF ALL CLAIMS AND DEMANDS
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v It is hereby agreed that in consideration of the sum of Sixteen Thousand Two Hundred Fifty
Dollars and 00/100 ($16,250.00), and for REPUBLIC INDEMNITY COMPANY OF
e� CALIFORNIA and for its executors, administrators and assigns, do hereby remise, release and
No forever discharge CITYOF SANTA ANA (hereinafter collectively referred to as "Settling Party")
and their respective successors, assigns, agents, employees, principals, partners, joint venturers,
officers, directors, predecessors, successors, insurers and all other related persons or entities, from
any and all claims and demands of any and every kind, name, nature or description, and from any
and all damages, liens, suits, actions or causes of action for reimbursement of workers'
compensation benefits conferred on ANA MANJARREZ either at law or in equity, which
REPUBLIC INDEMNITY COMPANY OF CALIFORNIA now has or in the future may have
against them, or any of them, including any and all claims or demands for wages, maintenance,
cure, medial expenses compensation, rehabilitation, reimbursement, transportation, sustenance, or
expense, whether or not the same be now existent or known to it or whether it later develops or
becomes existent or known to it in the future, by reason of or arising out of the claims involving a
April 16, 2018 trip and fall accident as set forth in Orange County Superior Court Case No: 30-
2019-01060879-CU-PO-CJC .
REPUBLIC INDEMNITY COMPANY OF CALIFORNIA does hereby affirm and
acknowledge that it has read the foregoing Release or had it fully explained to it and fully
understands and appreciates the foregoing words, terms and their effect, and that this is a full, final
compromise, release and settlement by it of all of its claims, demands, liens, suits, actions or causes
of action known or unknown, suspected or unsuspected, only with respect to Settling Party and, as a
further consideration and inducement for this compromise settlement, the provisions of Section
1542 of the Civil Code for the State of California, which reads as follows:
"A general release does not extend to claims that the creditor or
releasing party does not know or suspect to exist in his or her favor at
the time of executing the release and that, if known by him or her,
would have materially affected his or her settlement with the debtor
or released party."
This provision of Section 1542 of the Civil Code is expressly waived only as to Settling Party by the
undersigned who does hereby expressly agree that this Release executed only for the benefit of
Settling Party shall extend and apply to all unknown, unsuspected and unanticipated damages,
claims, liens, suits, actions or causes of action only in regards to this subject accident only as to
Settling Party and the undersigned hereby affirms that it has affixed its signature hereto voluntarily
and of its own free will and accord.
It is understood and agreed that any consideration recited herein is being transferred in
settlement of a claim which is expressly disputed and is not an admission of any liability or
responsibility of the released party for the occurrence described, that said consideration is the sole
Release of Claims
Page 2 of 2
and only consideration for the agreement and that no representations, promises or inducements have
been made by the released party or their representatives other than as appear in this instrument.
REPUBLIC INDEMNITY COMPANY OF CALIFORNIA AND BEHAVIOR
FUNCTIONS, INC. reserves all of its rights against ANA MANJARREZ in the defense of the
underlying workers' compensation case, including REPUBLIC INDEMNITY COMPANY OF
CALIFORNIA AND BEHAVIOR FUNCTIONS, INC. reserving its right to petition for credit
before the Workers' Compensation Appeals Board or any net recovery made by ANA
MANJARREZ in the third party case should ANA MANJARREZ request future workers'
compensation benefits, including vocational rehabilitation. This paragraph has no effect on
REPUBLIC INDEMNITY COMPANY OF CALIFORNIA'S full release and discharge of THE
CITY OF SANTA ANA.
A copy of this signature page is deemed the same as an original signature on this Full
Release of all Claims and Demands.
The person signing on behalf of Republic Indemnity Company of California represents
and warrants that she/he has the right, power, legal capacity and authority to bind Republic
Indemnity Company of California to the terms of this Release and that no further approval or
consent of any person or entity is required for Republic Indemnity Company of California.
I HAVE READ THIS RELEASE AND UNDERSTAND IT
DATED: 3
SETTLING PARTY:
Authorized Representative of
REPUBLIC INDEMNITY COMPANY OF
CALIFORNIA
Dated: CITY OF SANTA ANA, a charter law city and
municipal corporation, duly organized and existing
under the constitution and laws of the State of
California
Kristine Ridge, City N ages
SIGNATURES CONTINUE ON THE NEXT PAGE
ATTEST:
AFROVED AS TO FORM:
Dated:
3- 9- zo
Dated:
Documents/RICGCityOBontaAnn/Release
CITY OF SANTA ANA, a charter law city and
municipal corporation, duly organized and ex
io
under the Constitution and laws of the State o
California
By.
aisy Gomez, Clerk of the Council
LAW OFFICES OF ROBERT M. TUCKER
Ro6&t M. T sq.
Authorized Representative of Republic
Indemnity Company of California
SONIA R CARVALHO
CITY A j
VL
Senior Assistant City Attorney
Attorneys for Defendant
City of Santa Ana