Legal Traffic Incident Agreement

Legal Traffic Incident Agreement

This Legal Traffic Incident Agreement (the "Agreement") is made and entered into as of by and between Driver A Name: whose address is (hereinafter "Party A"), and Driver B Name: whose address is (hereinafter "Party B").

Recitals

WHEREAS, on or about the parties were involved in a motor vehicle incident at or near (the "Incident");

WHEREAS, the parties seek to resolve, without admission of liability, all claims, demands, causes of action and damages arising out of or related to the Incident;

WHEREAS, the parties desire to set forth the terms and conditions upon which the Incident shall be finally resolved and to avoid the expense, uncertainty and delay of litigation.

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

1. Definitions

1.1 "Claim" means any and all demands, actions, causes of action, suits, liabilities, losses, costs, expenses and damages of any kind whatsoever, whether known or unknown, arising out of or related to the Incident.

2. Incident Description

2.1 The parties acknowledge the material facts relating to the Incident as follows. Each party shall describe the relevant facts, observations and contributions to the Incident in the fields below.

3. Settlement and Release

3.1 In full and final settlement of all Claims arising out of or related to the Incident, Party agrees to pay to Party the sum of $ (the "Settlement Amount") subject to the terms below.

3.2 Payment of the Settlement Amount shall be made by and shall be delivered to on or before .

3.3 Upon receipt in cleared funds of the Settlement Amount, the receiving party shall execute and deliver to the settling party a full release in form and substance consistent with this Agreement and confirming the release of all Claims arising from the Incident.

3.4 Except as expressly provided otherwise in this Agreement, the parties acknowledge that this settlement is a compromise of disputed claims and is not an admission of liability by any party.

4. Allocation of Liability

4.1 The parties acknowledge that allocation of fault for the Incident is expressly set forth in the statements above and/or in the police report identified below. The allocation of liability for purposes of insurance or subrogation shall be as stated in the parties' factual narratives and any attached exhibits.

Yes No

5. Insurance and Claims Cooperation

5.1 Each party shall promptly notify its insurer of the Incident and shall cooperate fully and in good faith with the other party, their insurers and any third party investigating or adjusting claims, including providing copies of written statements, photographs, repair estimates, invoices, medical records, and the police report upon request.

5.2 No party shall take any action or make any representation to any insurer, adjuster, investigator or third party that is inconsistent with the substance of this Agreement or that is intended to prejudice the rights of the other party to receive the benefit of the bargain herein.

6. Indemnification

6.1 Each party agrees to indemnify, defend and hold harmless the other party and its officers, agents and employees from and against any and all claims, liabilities, losses, damages, costs and expenses (including reasonable attorneys' fees) arising out of that party's breach of this Agreement, willful misconduct, or material misrepresentation in connection with the Incident.

7. Confidentiality

7.1 The parties agree that the terms, amount and conditions of this Agreement shall be confidential and shall not be disclosed to any third party, except as required by law, to a party's attorney, insurer, tax advisor, or as necessary to effectuate the terms of this Agreement.

8. Representations and Warranties

8.1 Each party represents and warrants that it has the full power and authority to enter into this Agreement, that it has not assigned any rights or Claims released herein, and that it enters this Agreement voluntarily and with a full understanding of its terms.

9. Notices

9.1 Any notice, demand or communication required or permitted under this Agreement shall be in writing and delivered personally, by certified mail (return receipt requested), or by a nationally recognized overnight courier to the addresses set forth below or to such other address as a party may designate by written notice to the other party.

10. Governing Law

10.1 This Agreement shall be governed by and construed in accordance with the laws of the state of , without regard to its conflict of laws principles.

11. Entire Agreement

11.1 This Agreement constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous negotiations, understandings and agreements, whether written or oral, relating thereto.

12. Severability

12.1 If any provision of this Agreement is held to be illegal, invalid or unenforceable in whole or in part by a court of competent jurisdiction, such provision shall be severed and the remaining provisions shall continue in full force and effect.

13. Amendments; Waiver

13.1 No amendment, modification or waiver of any provision of this Agreement will be effective unless in writing and signed by both parties. The failure of any party to enforce any provision shall not constitute a waiver of that provision or any other provision.

14. Counterparts; Execution

14.1 This Agreement may be executed in counterparts, each of which shall be an original and all of which together shall constitute one instrument. Signatures transmitted by electronic means shall be deemed original signatures for all purposes.

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