Disability Settlement Agreement

DISABILITY SETTLEMENT AGREEMENT

This Disability Settlement Agreement ("Agreement") is entered into as of Effective Date: by and between Claimant Name: whose address is and Respondent Name: whose address is .

RECITALS

WHEREAS, Claimant initiated or threatened claims against Respondent arising out of alleged disability discrimination, failure to accommodate, or related employment actions, and certain administrative or judicial proceedings may be pending or contemplated; and

WHEREAS, Respondent expressly denies any wrongdoing or liability but desires to compromise and settle all disputes and to avoid the expense, burden, and uncertainty of litigation; and

WHEREAS, the parties have negotiated terms they deem fair and mutually acceptable and wish to memorialize their agreement as set forth below.

NOW, THEREFORE, in consideration of the mutual promises and covenants contained herein and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties agree as follows:

1. DEFINITIONS

For purposes of this Agreement, the following terms have the meanings set forth below:

(a) "Claimant" means the individual identified above and any heirs, executors, administrators, assigns, agents and attorneys acting on the individual's behalf.

(b) "Respondent" means the employer, its predecessors, successors, representatives, insurers, attorneys, parents, subsidiaries, affiliates and agents identified above.

2. SETTLEMENT CONSIDERATION

Respondent agrees to pay Claimant a total gross settlement amount of (the "Settlement Amount"), subject to the terms of this Agreement. Payment will be made as follows:

The Settlement Amount is intended to fully compensate Claimant for the matters being released in Section 3 below, except as otherwise expressly provided. Any agreed attorney's fees or liens will be satisfied in accordance with the terms provided in writing by Claimant's counsel and shall be disbursed from the Settlement Amount as specified below.

3. RELEASES

(a) In consideration of the Settlement Amount, Claimant, on behalf of Claimant and Claimant's heirs, executors, administrators, agents, attorneys, successors and assigns, hereby fully and finally releases and discharges Respondent and its past and present parents, subsidiaries, affiliates, insurers, officers, directors, employees, agents, attorneys, successors and assigns (collectively, the "Released Parties") from any and all claims, causes of action, demands, liabilities, damages, costs, and expenses of any kind, whether known or unknown, asserted or unasserted, including but not limited to claims arising out of or related to disability discrimination, failure to accommodate, retaliation, wrongful termination, and all statutory and common law claims that existed up to the Effective Date.

(b) Notwithstanding the foregoing, the release does not apply to: (i) claims that by law cannot be waived; (ii) rights to workers' compensation benefits or claims for unemployment compensation unless expressly settled in a separate writing; (iii) any vested pension or retirement benefits except as expressly set forth in writing; or (iv) any obligations to make payments required by law, including tax withholdings, or to third-party lienholders which are expressly reserved in this Agreement.

4. CONFIDENTIALITY

The parties agree that the terms and amount of this Agreement are confidential and shall not be disclosed by either party to any third party except as required by law, as necessary to enforce this Agreement, to the parties' legal or tax advisors, or to a purchaser of a party's business who agrees to maintain confidentiality. Any permitted disclosure shall be limited to the minimum information necessary.

5. NO ADMISSION OF LIABILITY

The parties agree that this Agreement is a compromise of disputed claims and that neither the payment of any consideration nor anything contained in this Agreement shall be construed as an admission of liability or unlawful conduct by Respondent, which expressly denies any such liability.

6. TAXES

Each party shall be responsible for its own tax reporting and liabilities arising from the Settlement Amount. Claimant acknowledges sole responsibility for any personal tax obligations arising from payments received under this Agreement and agrees to indemnify Respondent for any tax-related claims attributable to Claimant's failure to pay amounts properly owed by Claimant.

7. COOPERATION

Each party shall execute and deliver such further documents and take such further actions as may be reasonably necessary to effectuate the intent of this Agreement, including but not limited to documentation required to effect payment and satisfaction of liens, subject to any legal restrictions or confidentiality obligations.

8. REPRESENTATIONS AND WARRANTIES

Claimant represents and warrants that Claimant has read this Agreement, has had the opportunity to consult with counsel, is fully authorized to enter into this Agreement, has not assigned any right or claim released herein, and that no other person or entity has any interest in the claims released by Claimant except as disclosed in writing to Respondent.

9. NOTICES

All notices required or permitted under this Agreement must be in writing and delivered to the addresses below by hand, certified mail (return receipt requested), or courier service. Notice is effective upon receipt.

10. AMENDMENT; WAIVER; COUNTERPARTS

This Agreement may not be amended or modified except by a writing signed by both parties. No waiver of any term shall be effective unless in writing signed by the waiving party. This Agreement may be executed in counterparts, each of which shall be deemed an original and all of which together shall constitute one and the same instrument.

11. ENTIRE AGREEMENT; SEVERABILITY; GOVERNING LAW

This Agreement contains the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, understandings, negotiations and communications, whether oral or written. If any provision of this Agreement is held invalid or unenforceable, the remaining provisions shall remain in full force and effect. This Agreement shall be governed by and construed in accordance with the laws of the State selected by the parties below, without regard to conflict of law principles.

12. MISCELLANEOUS

(a) Headings used in this Agreement are for convenience only and shall not affect the interpretation of this Agreement. (b) The parties acknowledge that each has read and fully understands this Agreement and that it is executed voluntarily and without duress. (c) Each party represents that the person signing below on its behalf has full authority to bind that party.

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