HomeMy WebLinkAboutContract 57495 CITY SECRETARY
M14TRACT NO. 574 9'J`'
CAUSE NO.067-323889-21
ARTEMIO GARZA-MORALES; § IN THE DISTRICT COURT OF
AND BERTA WALLE DE GARZA; §
Plaintiffs, §
VS. § TARRANT COUNTY,TEXA, S
CITY OF FORT WORTH; §
Defendant. § 67TH JUDICIAL DISTRICT
PLAINTIFF BERTA WALLE DE GARZA'S COMPROMISE SETTLEMENT
AGREEMENT AND RELEASE OF ALL CLAIMS
I.RECITALS
WHEREAS, Berta Walle De Garza, Plaintiff in the above-entitled and numbered cause,
alleges that on or about August 28,2019, she received personal injuries in an automobile accident
when her vehicle collided with a City of Fort Worth vehicle;
WHEREAS,Plaintiff further alleges that the negligence of the City of Fort Worth("City"
or"Defendant"),by way of its employee Armando Reyna,proximately caused the above-descried
accident;
WHEREAS, as a result of such accident, injuries and damages allegedly suffered by
Plaintiff,suit was filed against the City in the above-entitled and numbered cause,reference b 'ng
made to the pleadings on file in said cause for a more full and complete description of Plainti s
claims and cause of action;
WHEREAS,Plaintiff has offered to compromise and settle all claims and causes of action
of any kind which she may have against the City, its agents, employees, workers 6d
representatives,and all others connected with or in privity with the City,arising out of or connected
in any way with the above-described accident in consideration of payment by the City to Plaintiff
Berta Walle De Garza,and her attorneys John C.Nohinek and Shelly Greco,of the Witherite Law
Group, PLLC, the sum of One Hundred Twenty Thousand and Nol100 Dollars ($120,000.00 in
full and final settlement of all claims against the City, its agents, employees, workers or
representatives, arising out of Plaintiff's alleged injuries; and
WHEREAS,even though the City denies any liability of any kind on account of the alleged
incident made the subject of Plaintiff's suit, the City has agreed to the paym7OFFICIALRECORD
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above in compromise and settlement of the disputed claims and in order to avoid further time-
consuming and costly litigation.
II.TERMS
NOW,THEREFORE,in consideration of the recitals set forth above,the mutual probes
and agreements made herein,and other valuable consideration,the receipt and sufficiency of which
is acknowledged,the City and Plaintiff agree that:
1. Berta Walle De Garza, Plaintiff herein,for and in consideration of payment by the
City to Plaintiff Berta Walle De Garza, and her attorneys John C. Nohinek and Shelly Greco, of
the Witherite Law Group,PLLC,the sum of One Hundred Twenty Thousand and No/100 Dollars
($120,000.00) in full and final settlement of all claims against the City, its agents, employees,
workers or representatives,arising out of Plaintiff's alleged injuries,and the receipt and sufficie cy
of such consideration being hereby acknowledged and confessed by Plaintiff,does for herself,her
representatives, successors and assigns, unconditionally release, acquit and forever discharge the
City of Fort Worth, and its agents, employees, workers and representatives, and all others
connected with or in privity with the City of Fort Worth, of and from any and all claims of every
kind,character or nature which said Plaintiff might assert by reason of the above described incident
together with all claims heretofore asserted in Cause No. 067-323889-21, in the Judicial District
Court,67th District Court,Tarrant County,Texas,including claims for physical pain and stifletj-)
(past and future), medical expenses (past and future), physical impairment (past and fut ,
property damage,lost wages (past and future), loss of earning capacity (past and future) and �y
other kind, character or nature of damage which could or might be the subject of a claim by er
arising from the incident herein above described.
2. In consideration of the respective payment described above, Plaintiff agrees to indemnify
and forever hold harmless and defend the City of Fort Worth, and all agents,employees,workers
and representatives of the City of Fort Worth, and all others connected with or in privity with the
City of Fort Worth, its heirs, representatives, successors and assigns, from any and all claims or
causes of action,including any costs or expenses in connection therewith,which may hereafter be
brought by Plaintiff,or by anyone on her behalf, arising out of the above-described incident.
3. For the same consideration, Plaintiff declares and warrants that all medical,
hospital,and/or other expenses of any and every nature and character whatsoever incurred by t
or on her behalf, or in any way pertaining to or arising out of the injury that allegedly occurre
or about August 28, 2019, made the basis of this litigation, have been or will be paid or
compromised by Plaintiff, and Plaintiff hereby agrees to defend, indemnify and hold harmless
Defendant,City of Fort Worth and any other person,corporation,association,partnership,or entity
in privity with or connected with them,as well as any person,corporation,association,partnership,
or entity they are or may be required to defend,indemnify,or hold harmless from and against any
claims for medical, hospital, and/or other claims and expenses of any and every nature, including
but not limited to, claims which may hereafter be made under the authority of the Texas Hospital
Lien Law or any other state or federal statute,rule, or regulation.
4. Taxes. The Parties will report,as may be required by law,their respective paym nts
and receipt of the amounts described herein. Plaintiff and her attorneys acknowledge and a;ee
Compromise Settlement Agreement And Release Of
All Claims—Berta Walle De Garza—Cause No.067-323889-21 Page 2
that: (1)the City and its counsel have made no representations to Plaintiff or her counsel regarding
the tax consequences of the payments made to her or to her attorneys under this Agreement; d
(2) Plaintiff and her attorneys are ultimately responsible for determining the taxability of anyrof
the payments made to Plaintiff and her attorneys in this Agreement, and for paying taxes(federal,
state,or otherwise),if any,which any taxing authority determines or claims are owed with respect
to such payments.
PLAINTIFF REPRESENTS THAT NONE OF THE MEDICAL BILLS OF BERTA
WALLE DE GARZA HAVE BEEN PAID BY MEDICARE OR BY ANY OTHER
GOVERNMENTAL OR QUASI-GOVERNMENTAL AGENCY. IF PLAINTIFF IS
MISTAKEN IN THIS REGARD AND MEDICARE OR SOME OTHER
GOVERNMENTAL OR QUASI-GOVERNMENTAL AGENCY HAS PAID ANY BILLS,
WHATSOEVER,PLAINTIFF WILL FULLY SATISFY ANY CLAIM EVER ASSERTED
BY MEDICARE OR OTHER GOVERNMENTAL OR QUASI-GOVERNMENTAL
AGENCY FOR REIMBURSEMENT AND WILL DEFEND, INDEMNIFY AND HOLD
HARMLESS THE CITY OF FORT WORTH AND ANY OTHER PERSON,
CORPORATION,ASSOCIATION,PARTNERSHIP OR ENTITY IN PRIVITY WITH OR
CONNECTED WITH IT AGAINST ANY SUCH CLAIM.
PLAINTIFF ALSO REPRESENTS THAT SHE WILL FULLY SATISFY A L
LEGAL BILLS INCURRED BY HER WITH ANY OTHER LAW FIRM OR ATTO;=
WHO MAY BE OWED FEES RELATED TO THIS MATTER.
5. The release of claims contained herein is given with full knowledge of all parties
to the referenced suit that there is a dispute on the part of the City regarding whether or not it is
liable for any damages alleged in the above-entitled and numbered cause.It is also understood and
agreed that this settlement is in compromise of disputed claims and that the payment made
hereunder is not to be construed as an admission of liability on the part of the City of Fort Wo th,
and, in fact, City denies liability for the above-described accident, if any, and intends, bys
settlement,merely to buy its peace.
6. Plaintiff agrees to dismiss the cause of action in the above-entitled and numbered
matter, with prejudice, and hereby authorizes and directs her attorneys, John C. Nohinek and
Shelly Greco, to prepare and file the appropriate Motion and Order of Dismissal, with prejudice,
with respect to Plaintiff's claims and causes of action in the above-entitled and numbered case
against the City.And,in this connection,Plaintiff and her attorneys agree to expeditiously pro 'de
any information the Court may require, and/or to attend any hearings the Court may require, in
connection with the dismissal of said lawsuit.
7. It is understood and agreed that all taxable court costs will be paid by the party
incurring same.
8. This Compromise Settlement Agreement and Release of All Claims may be
executed in a number of identical counterparts, each of which shall be deemed an original for all
purposes.The Parties agree that this Agreement contains the entire agreement between the Parties
and supersedes any and all prior agreements, arrangements, or undertakings between the Parties
Compromise Settlement Agreement And Release Of
All Claims—Berta Walle De Garza—Cause No.067-323889-21 Page 3
relating to the subject matter. No oral understandings, statements, promises, or inducemcnrs
contrary to the terms of this Agreement exist. This Agreement cannot be changed orally, and apy
changes or amendments must be signed by all Parties affected by the change or amendment.
9. Plaintiff, Berta Walle De Garza, represents and acknowledges that t 1is
Compromise Settlement Agreement and Release of All Claims has been read in its entirety be re
signing and that it has been fully explained,in detail,to each of them by her attorney and that it is
fully understood.
10. By her signature hereto, Berta Walle De Garza, Plaintiff represents and declares
that she is more than eighteen(18)years of age and fully competent to enter into this Compromise
Settlement Agreement and Release of All Claims, that the representations, declarations and
agreements herein are accurate, binding, and are contractual in nature and that no representation
or agreement not herein expressed has been made to her as inducement to enter into this
Compromise Settlement Agreement and Release of All Claims.
11. It is understood and agreed that this Agreement shall be governed by and constr ed
and enforced in accordance with, and subject to, the laws of the State of Texas, to the extent not
preempted by federal law.
12. This Agreement is the product of arm's-length negotiations between the Parties, rid
no Party shall be deemed to be the drafter of any provision or the entire Agreement, The wording
in this Agreement was reviewed and accepted by all Parties after reasonable time to review with
legal counsel, and no Party shall be entitled to have any wording of this Agreement constr4ed
against the other Party as the drafter of the Agreement in the event of any dispute in connection
with this Agreement.
This agreement should be effective as of the date the last party signature is affixed hereto
as indicated by the dates set forth below.
BERTA WALLE DE GARZA Plaint] f��
Date: Q
OFFICIAL RECOR
CITY SECRETARY
Compromise Settlement Agreement And Release Of FT. WORTHS TX
All Claims—Berta Walle De Garza—Cause No. 067-323889-21 Page 4
STATE OF TEXAS §
COUNTY OF ij[l §
BEFORE ME, the undersigned authority, on this day personally appeared BERTA
WALLE DE GARZA,known to me to be the person whose name is subscribed to the foregoing
instrument, and acknowledged to me that she executed the same as her free act and deed for
purposes and consideration therein expressed.
GIVEN UNDER MY HAND AND SEAL OF OFFICE this day of
2022.
Not ublic in and for the State of�Q $_
CATHERINE VICTORIA CHAVEZ
a , Notary Public,State of Texas
9. � Comm,Expires 08-06-2022
�`` Notary ID 131670896
OFFICIAL ]ECORDCITY SEC FT.WOR
Compromise Settlement Agreement And Release Of
All Claims—Berta Walle De Garza—Cause No.067-323889-21 Page 5
APPROVED AS TO SUBSTANCE AND FORM:
Date: 4/14/2022
JOHN,,6.NOHINEK
State Bar 00794379
John.Nohinek(@ewlawyers.co
SHELLY GRECO
State Bar No. 24008168
shelly.greco(@withelitelaw.com
WITHERITE LAW GROUP
901 W Vickery Blvd., Suite 900
Fort Worth,TX 76104
817/263-4466
817/263-4477 (fax)
ATTORNEYS FOR PLAINTIFF
CITY OF FORT WORTH:
APPROVED:
Date: S/Z/2,;ZZ
Assistant City Manager
CITY OF FORT WORTH
APPROVED AS TO FORM:
Date:
Siang L. S RT
Assistant ity Attorney 7
ATTEST:
Date:
Uity Secretary
Compromise Settlement Agreement And Release Of
All Claims—Berta Walle De Garza—Cause No. 067-323889-21 Page'6
MEDICAL POWER OF ATTORNEY
AND HIPAA RELEASE AUTHORIZATION
OF
BERTA WALLE DE GARZA
Prepared by:
THE HALE LAW FIRM P.C.
417 W. Main Street
Waxahachie,Texas 75165
214446-5080
214446-5081 (facsimile)
STATE OF TEXAS )
COUNTY OF TARRANT )
This instrument was acknowledged before me on 0%11,W , 2021, by
ARTEMIO GARZA.
rERIN?"Ar�fi;E
y�tsry 'ub`iC: S'3==:� Notary Public, State of Texas j /
Comm�fy
pife C4-t 9.2G'`.- f My commission expires: 4ll#[2y 4
i
D !299'i3174F�
STATE OF TEXAS }
COUNTY OF TARRANT )
This instrument was acknowledged before me on t Yh4 if 1� , 2021, y
BERTA W.GARZA by and through her attorney-in-fact,Artemio Garza.
GItJ it jiME.
t ' Notary Public State of Texas
My commission expires: glt4ltdL {
AFTER RECORDING RETURN TO:
THE HALE LAW FIRM,P.C. -
417 W.Main Street
Waxahachie,TX 75165
MEDICAL POWER OF ATTORNEY
AND HIPAA RELEASE AUTHORIZATION
OF
BERTA WALLE DE GARZA
I,BERTA WALLE DE GARZA,appoint:
Name: ARTEM10 M. GARZA-MORALES
Address: 3617 N. Little John Ave
Fort Worth,Texas 76105
Phone:
as my agent to make any and all health care decisions for me, except to the extent I state
otherwise in this document. This medical power of attorney takes effect if I become unable to
make my own health care decisions and this fact is certified in writing by my physician.
DESIGNATION OF ALTERNATE AGENT
If ARTEMIO M. GARZA-MORALES is unable or unwilling to make health c4re
decisions for me, I designate the following person to serve as my agent to make health care
decisions for me as authorized by this document:
Name: RUMALDO GARZA
Address: 107 B Philo Rd West
Elmira,New York 14903
Phone: 817 915 6936
HIPAA RELEASE AUTHORITY
I intend for my agent to be treated as I would be treated with respect to my n4lits
regarding the use and disclosure of my individually identifiable health information and other
medical records. This release authority applies to any information governed by the Heoth
Insurance Portability and Accountability Act of 1996 ("HIPAA"), 42 USC 1320d and 45 CVR
160-164.This release authority is effective immediately.
Accordingly, I hereby authorize any doctor, physician, medical specialist, psychiatrist,
chiropractor, health-care professional, dentist, optometrist, health plan, hospital, hospice, clinic,
laboratory, pharmacy or pharmacy benefit manager, medical facility, pathologist, or other
provider of medical or mental health me, as well as any insurance company and the Medical
Information Bureau Inc. or other health-care clearinghouse that has paid for or is seeking
payment from me for such services (referred to herein as a "covered entity"), to give, disclose
and release to my agent who is named herein, without restriction, all of my individually
identifiable health information and medical records regarding any past, present or future med�cal
or mental health condition, including all information relating to the diagnosis and treatment of
COPIES
The following individuals or institutions have copies of the signed originals:
Name: RUMALDO GARZA
Address: 107 B Philo Rd West, Elmira,New York 14903
Name- THE HALE LAW FIRM
Address- 417 W. Main Street,Waxahachie,Texas 75165
DURATION
I understand that this power of attorney exists indefinitely from the date I execute this
document unless I establish a shorter time or revoke the power of attorney, If I am unable to
make health care decisions for myself when this power of attorney expires, the authority I have
granted my agent continues to exist until the time I become able to make health care decisions
for myself. I do not wish to have this power of attorney end on a specified date.
PRIOR DESIGNATIONS REVOKED
I revoke any prior durable power of attorney for health care and any prior medical power
of attorney.
DISCLOSURE STATEMENT
THIS MEDICAL POWER OF ATTORNEY IS AN IMPORTANT LEGAL
DOCUMENT. BEFORE SIGNING THIS DOCUMENT, YOU SHOULD KNOW THESE
IMPORTANT FACTS:
Except to the extent you state otherwise, this document gives the person you name as
your agent the authority to make any and all health care decisions for you in accordance with
your wishes, including your religious and moral beliefs, when you are unable to make the
decisions for yourself. Because "health care" means any treatment, service, or procedure to
maintain, diagnose, or treat your physical or mental condition,your agent has the power to make
a broad range of health care decisions for you. Your agent may consent refuse to consent, or
withdraw consent to medical treatment and may make decisions about withdrawing or
withholding life-sustaining treatment. Your agent may not consent to voluntary inpatient mental
health services, convulsive treatment,psychosurgery, or abortion. A physician must comply with
your agents instructions or allow you to be transferred to another physician.
Your agent's authority is effective when your doctor certifies that you lack the
competence to make health care decisions.
3
General Warranty Deed with Reservation of Enhanced Life Estate
(Lady Bird Deed)
Date: 4t.11%OW tO 2021
Grantor: ARTEMIO GARZA and spouse, BERTA W. GARZA, by and through her
attorney-in-fact,Artemio Garza
Grantor's Mailing Address:
3 617 N.Little John Ave.
Fort Worth,Texas 76150
Grantee: RUMALDO GARZA
Grantee's Mailing Address:
107 B.Philo Road West
Elmira,New York, 14903
Consideration:
Cash and other good and valuable consideration,the receipt and sufficiency of which are
hereby acknowledged.
Property(including any improvements):
TRACT 1:
Being all of Lot 4, save and except the North 50 feet thereof, Block 8, Sunshine Hill
Addition to the City of Fort Worth, Tarrant County, Texas, according to plat recorded in
Vol. 309,Page 69,Deed Records,Tarrant County,Texas
TRACT
Lot 3, Block 8, Sunshine Hill Addition to the City of Fort Worth, Tarrant County, Tqe
according to plat recorded in Vol. 309, Page 69, Deed Records, Tarrant County, Tex
save and except the North 50 feet of said Lot 3 conveyed to Clayton B. Bellow and ' e
Doris E. Bellow, by deed dated March 30, 1951, recorded in Volume 2305, Page 1,
Deed Records,Tarrant County,Texas.
Reservations from Conveyance:
For Grantor and Grantor's assigns, a reservation of a life estate without any liability for
waste, with full power and authority to sell, convey, mortgage, lease, and otherwise dispose of
the Property in fee simple, with or without consideration, without joinder by the rernaindermen.
Form W-9 Request for Taxpayer Give Form to the
(Rev.October2018) Identification Number and Certification regiteart Do not
DepatrtrentoflheTreasuy send to the IRS.
Internal Reventte3ervice ►Go to www.1rs.gov1ForrnW9 for instructions and the latest Information.
1 Name(as shown on your income tax return).Name is required on this line;do not leave this line blank.
WITHERITE LAW GROUP PLLC
2 Business name/dlsregarded entity name,if different from above
m 3 Check appropriate box for federal tax classification of the person whose name Is entered on One 1.Check only one of the 4 Exemptions(codes apply orgy to
p following seven boxes. certain entitles,not Individuals;see
n. instructions on page 3):
o ❑ Individual/sole proprietor or ❑ C Corporation ❑S Corporation ❑ Partnership ❑Trust/estate
single-member LLC Exempt payee code(H any)
u ❑✓ Umited liability company.Enter the tax classification(C-C corporation,S=S corporation,P-Partnership)► S
`o Note:Check the appropriate box In the line above for the tax classification of the single-member owner. Do not check Exemption from FATCA,reporting
m LLC if the LLC is classified as a single-member LLC that Is disregarded from the owner unless the owner of the LLC is
aQ u another LLC that Is not disregarded from the owner for U.S,federal tax purposes.Otherwise,a single-member LLC that code(if any)
Is disregarded from the owner should check the appropriate box for the tax classification of Its owner.
[a Other(see instructions)► (Ar>a"fu" Wit" kd •°..Nds tlr us.)
to 5 Address(number,street,and apt.or suite no.)See instructions. Requester's name and address(optional)
10440 N CENTRAL EXPY SUITE 400
6 City,state,and ZIP code
DALLAS TX 75231
7 Ust account number(s)here(optional)
Taxpayer Identification Number(TiN)
Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid J Social security number m�
backup withholding.For individuals,this Is generally your social security number .However,for a —M
resident alien,sole proprietor,or disregarded entity,see the Instructions for Part I,,later.
r,For other
entities,it is your employer identification number(EIN).If you do not have a number,see Now to get a
TIN,later. or
Note:If the account is In more than one name,see the instructions for line 1.Also see What Name and I Employer identification number
Number To Give the Requester for guidelines on whose number to enter,
M75 - 2 9 5 1 3 6 7 3
certification
Under penalties of perjury,I certify that:
1.The number shown on this forth is my correct taxpayer Identification number(or I am waiting for a number to be issued to me);and
2.1 am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue
Service(IRS)that I am subject to backup withholding as a result of a failure to report all Interest or dividends,or(c)the IRS has notified me that I am
no longer subject to backup withholding;and
3.1 am a U.S.citizen or other U.S.person(defined below);and
4.The FATCA code(s)entered on this form(if any)indicating that I am exempt from FATCA reporting is correct
Certification instructions.You must cross out item 2 above If you have been notified by the IRS that you are currentty subject to backup withholding because
you have failed to report all interest and dividends on your tax return.For real estate transactions,item 2 does not apply.For mortgage interest paid,
acquisition or abandonment of secured property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and generally,payments
other than interest and dividends,you not required sign the certification,but you must provide your correct TiN.See the instructions for Part 11,later.
Sign Signature of
Here U.S.person► Date► S Z�1 Z Z_
General Instructions •Form 1099-DN(dividend,Including those from stocks or mutual
fuss)
Section references are to the Internal Revenue Code unless otherwise •Form 1099-MISC(various types of income,prizes,awards,or gross
noted.
proceeds)
Future developments.For the latest information about developments •Form 1099-B(stock or mutual fund sales and certain other
related to Form W-9 and its Instructions,such as legislation enacted transactions by brokers)
after they were published,go to www.Jrs.gov1FormW9.
•Form 1099-S(proceeds from real estate transactlorts)
Purpose of Form •Form 1099-K(merchant card and third party network transactions)
An Individual or entity(Form W-9 requester)who Is required to file an •Form 1098(home mortgage Interest),1098-E(student loan interest),
Information return with the IRS must obtain your correct taxpayer 109B-T(tuition)
Identification number(TIN which may be your social security number •Form 1099-C(canceled debt)
(SSN),Individual taxpayer identification number(ITIN),adoption
taxpayer Identification number(ATIN),or employer Identification number •Form 1099-A(acquisition or abandonment of secured property)
(EIN),to report on an information return the amount paid to you,or other Use Form W-9 only If you are a U.S.person(including a resident
amount reportable on an information return.Examples of Information alien),to provide your correct TIN.
returns inciude,but are not limited to,the following. lfyou do not return Form W-9 to the requester with a Tlhl,you might
•Form 1099-INT(interest earned or pall) be subject to backup withholding.See What is backup withholding,
later.
CaL No.10231X Form W-9(Rev.10-2019)