Representative Claims

FULL RELEASE OF ALL CLAIMS AND INDEMNITY AGREEMENT

R VA 100F 06/2011

Claim number: 19-4954390

IT IS UNDERSTOOD AND AGREED THAT I, Bryan R Harris, in consideration of the payment of ninety thousand and 00/100 dollars ($90,000.00), the receipt and sufficiency of which is acknowledged, release Melissa A Howard and Martha Barnes for myself, my heirs, executors, administrators, successors, and assigns, and all other persons, firms, employers, corporations, associations, and partnerships from all obligations, suits, claims, demands of any kind or nature whatsoever, damages, loss of income, expenses, hospital and medical expenses which the undersigned may now have or which may accrue on account of or in any way aris- ing out of all known and unknown personal injuries which have resulted from or may in the future develop from an accident that oc- curred on or about August 9, 2019, at or near Airport Drive, Henrico County, Virginia. The undersigned warrants that all medical and hospital bills have been paid, or will be paid immediately upon receipt of the settlement proceeds, and that no other person or entity has asserted or is able to assert any lien, claim, or entitlement to any portion of the consid- eration being paid for this release. The undersigned agrees to indemnify and hold harmless the released parties and their insurers or representatives from any such liens or claims which may be asserted at any time by any such person or entity. In consideration of the above payment, the undersigned agrees to indemnify the released parties and their insurers or representatives and save them harmless from all further liability arising because of any injuries and damages sustained by the undersigned, and, if necessary, in order to save them so harmless, to satisfy on their behalf any judgment against them arising in any way out of the acci- dent.

It is understood and agreed that this settlement is in full compromise of a disputed claim as to both questions of liability and the nature and extent of the injuries and damages, and that neither this release nor the payment made shall be construed as an admission of liabil- ity.

The undersigned declares that no representation by the party or parties released, or their representatives, regarding their legal liability or financial responsibility, or about the nature and extent of the injuries, disabilities, or damages has induced the undersigned to make this agreement; that in determining the amount of the payment indicated above, the undersigned has considered not only the known injuries, disabilities, and damages, but also the possibility that there may be unknown injuries, disabilities, and damages, and that inju- ries sustained may be permanent and progressive and recovery uncertain and indefinite, so that unforeseen consequences may occur. The undersigned further declares and represents that no promise, inducement, or agreement not herein expressed has been made to the undersigned; this release contains the entire agreement between the parties hereto; and the terms of this release are contractual and not a mere recital.

I have read this release and understand it.

Pursuant to Virginia law, if you execute this release within thirty (30) days of the incident giving rise to your claim or action for personal injuries, you have a right of rescission until midnight of the third business day after the day on which you execute this release, provided: (1) you are not represented by counsel when you execute this release; (2) you make the rescission in writing to the person or persons being released, their representative, or insurance carrier; and (3) you return to the person or persons being released, their representative, or insurance carrier all drafts or settlement proceeds you received prior to the rescission.

It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose of defrauding the company. Penalties include imprisonment, fines and denial of insurance benefits. Signature Date Witness Signature Date

Signature Date Witness Signature Date

Electronically Signed 2020-11-16 17:51:49 UTC - 73.147.66.130 AssureSign® cc72e077-abd8-4f0a-97af-ac75011a335f

2020-11-16 12:51:55 (UTC-05:00)

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