HomeMy WebLinkAboutContract 51747 g1v ,
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N t\( S R��P�� o� CAUSE NO. 2017-006190-2
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!yd at " NAVA, BY AND THROUGH IN THE COUNTY COURT
S''SUBROGEE, THE CITY OF FORT
WORTH, TEXAS AND THE CITY OF
FORT WORTH, TEXAS, IN ITS
INDIVIDUAL CAPACITY, COUNTY COURT AT LAW NO. 2
Plaintiff(s),
vs. TARRANT COUNTY, TEXAS
ROBERT JAMES JONES,
Defendant(s).
SUBROGATION PROPERTY DAMAGE RELEASE
The undersigned, THE CITY OF FORT WORTH, TEXAS, (hereinafter known as
RELEASOR) acknowledges the receipt of $5,500.00 in consideration for the release for its
subrogation property damage claim, and RELEASES and forever discharges ROBERT JAMES
JONES, ALLSTATE PROPERTY & CASUALTY INSURANCE COMPANY, his spouses,
heirs, executors, assigns, agents, servants, employees, insurance carriers, insurance adjusters and
attorneys (hereinafter know as RELEASED PARTIES) for subrogation property damage claims
paid by REALEASOR to its insured in consequence of an incident that occurred on or about
October 09, 2015 at or near the 2400 block of University Drive in Fort Worth, Tarrant County,
Texas which gave rise to RELEASOR'S subrogation property damage claim.
As further consideration for full and final payment, RELEASOR warrants that
RELEASOR has made no assignment of RELEASOR'S subrogation property damage claims, or
any part of them, to any other person, firm, or corporation other than RELEASOR'S attorneys.
RELEASOR covenants and warrants that RELEASOR is more than 18 years of age and
competent to execute this release; that no promise or agreement which is not expressed here has
been made to RELEASOR; that in executing this release, RELEASOR is no0
Nava,et al.vs.Jones
SUBROGATION RELEASE 1l1JORTFi
Our File Number: 0390855740.1 FT. r TX
statement or representation of RELEASED PARTIES, but relying upon RELEASOR'S own
judgment and the advice of RELEASOR'S attorney or attorneys; that RELEASOR fully
understands that THIS IS A FULL AND FINAL SETTLEMENT of all subrogation property
damage claims paid for by RELEASOR and arising from the alleged occurrence.
As further consideration of payment, RELEASOR agrees to no longer prosecute a
subrogation property damage claim based on the event made the basis of this subrogation
property damage claim.
RELEASOR contracts that this subrogation property damage release is a compromise of
disputed claims, and not an admission of liability of any sort on the part of RELEASED
PARTIES. RELEASOR represents that through RELEASOR'S attorneys, RELEASOR has been
informed of the contents and effects of this instrument and that the instrument is executed as
RELEASOR'S act and deed.
WITNESS MY HAND this day of Deumtka, 2018.
ZRE RESENTATIVE OF THE CITY OF
Wald P. Gonzaks,Asst 000 q c T WORTH, TEXAS
Z ..
OFFICIAL RECORD
CITY SECRETARY
Nava, al.vs.Jones FT 1NORTI�AW
SUBROGATION RELEASE
Our File Number: 0390855740.1
Y
STATE OF TEXAS §
COUNTY OF §
SUBSCRIBED AND SWORN TO before me on the OL k-3
day of
2018, to certify which witness my hand official seal.
Notary Public State of Texas
Notary's Printed Name:
LA Im 4k YVA M f Ir
My Commission Expires:
LINDA M.HIRRLINGER
My Notary ID 0124144746
Expires February 2,202-2
OF,
OFFICIAL RECORD
CITY SECRETARY
Nava,et al.vs.Jones . WORTI$,GT7C
SUBROGATION RELEASE
Our File Number: 0390855740.1
Y
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7
Assistant City Attor /Signature
rm and
Approved as to f legality
Contract Compliance Manager:
By signing I acknowledge that I am the person responsible
for the monitoring and administration of this contract, including
ensuring all performance and reporting requirements.
Name of Employee/Signature
Title
This form is N/A as No City Funds are associated with this Contract
A�- —4
Printed Name Signature
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH TX