Settlement Agreement and Release

Settlement Agreement and Release (Lawsuit not Filed)

This Settlement Agreement and Release (the Settlement Agreement) is made and entered into this (date) by and between

of

, hereinafter called Releasor, and

of

, hereinafter called Releasee.

Whereas, on (date), Releasor and Releasee were involved in a automobile accident at while Releasor was driving a and Releasee was driving a ; and

Whereas, as a result of said accident, Releasor sustained damages to said automobile, incurred medical expenses, missed worked and suffered other damages related to said accident; and

Whereas, the parties desire to enter into this Settlement Agreement in order to provide for certain payments in full settlement and discharge of all claims which are, or might have been made, brought by Releasor against Releasee for negligence or any other wrongful act of Releasor which was the proximate cause of any damages sustained by Releasee as a result of said accident.

Now, therefore, for and in consideration of the mutual covenants contained in this agreement, and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the parties agree as follows:

1. In consideration of the payment of $ , Releasor hereby completely releases and forever discharges Releasee from any and all past, present or future claims, demands, obligations, actions, causes of action, wrongful death claims, rights, damages, costs, losses of service, expenses and compensation of any nature whatsoever, whether based on a tort, contract or other theory of recovery, which the Releasee now has, or which may hereafter accrue or otherwise be acquired, on account of, or may in any way grow out of said accident, including, without limitation, any and all known or unknown claims for physical and other injuries to Releasee, or any future wrongful death claim of Releasee's representatives or heirs, which have resulted or may result from the alleged acts or omissions of the Releasor.

2. This release and discharge shall also apply to Releasor's past, present, and future officers, directors, stockholders, attorneys, attorneys-in-fact, agents, servants, representatives, employees, subsidiaries, affiliates, member companies, partners, insurers, predecessors and successors in interest, and assigns and all other persons, firms or

corporations with whom any of the former have been, are now, or may hereafter be affiliated.

3. This release, on the part of the Releasee, shall be a fully binding and complete settlement among the Releasee, the Releasor, and their heirs, assigns and successors.

4. The Releasee acknowledges and agrees that the release and discharge set forth above is a general release. Releasee expressly waives and assumes the risk of any and all claims for damages which exist as of this date, but of which the Releasee does not know or suspect to exist, whether through ignorance, oversight, error, negligence, or otherwise, and which, if known, would materially affect Releasee's decision to enter into this Settlement Agreement. The Releasee further agrees that Releasee has accepted payment of the sums specified herein as a complete settlement and compromise of matters involving disputed issues of law and fact. Releasee assumes the risk that the facts or law may be other than Releasee believes. It is understood and agreed to by the parties that this settlement is a compromise of a doubtful and disputed claim, and payment of said sum is not to be construed as an admission of liability on the part of Releasee, by whom liability is expressly denied.

5. In entering into this Settlement Agreement, the Releasee represents that Releasee has relied upon the advice of his attorney, who is the attorneys of his own choice, concerning the legal and income tax consequences of this Settlement Agreement; that the terms of this Settlement Agreement have been completely read and explained to Releasee by his attorney; and the terms of this Settlement Agreement are fully understood and voluntarily accepted by Releasee.

6. Releasee represents and warrants that no other person or entity has, or has had, any interest in the claims, demands, obligations, or causes of action referred to in this Settlement Agreement, except as otherwise set forth herein; that Releasee has the sole right and exclusive authority to execute this Settlement Agreement and receive the sums specified in it; and that Releasee has not sold, assigned, transferred, conveyed or otherwise disposed of any of the claims, demands, obligations or causes of action referred to in this Settlement Agreement.

7. This Settlement Agreement shall be construed and interpreted in accordance with the laws of the State of California.

8. Releasee agrees that the terms of this Settlement Agreement shall be kept completely confidential and shall not be disclosed to anyone not herein excepted, unless required to be disclosed pursuant to legal process and/or subpoena, become the subject of examination by any duly constituted federal or state taxing agency or its representatives, or are otherwise required to be disclosed by operation of law. Releasee may discuss the circumstances giving rise to this Settlement agreement as well as the negotiations and/or terms of this Settlement Agreement with his attorney, tax advisor and immediate family members, provided that prior to such disclosure the person is informed that the information is confidential and may not be disclosed and is agreed to be kept confidential. If Releasee, or any person authorized to have knowledge of the circumstances of the negotiations and/or terms of this Settlement Agreement, is asked about the same he/she shall indicate only that

the matter is resolved. This confidentiality provision is a material term of this Settlement Agreement.

9. Releasee agrees to defend, indemnify and hold harmless Releasor from any and all known claims, demands, causes of action, expenses, losses, liabilities and damage of any kind or character, including attorney's fees and court costs arising out of, or in any way connected with said accident, or proceedings brought by, or prosecuted by or for the benefit of, or on the initiative of Releasee based upon the subject matter of this Settlement Agreement. It is further agreed that this hold harmless provision shall be deemed breached and a cause of action accrued thereon immediately upon the commencement of any action contrary to this Settlement Agreement, and in any such action, this Settlement Agreement may be pleaded by Releasor as a defense or asserted by way of cross-complaint, counter claim or cross claim.

10. All parties agree to cooperate fully and execute any and all supplementary documents and to take all additional actions, which may be necessary or appropriate to give full force and effect to the basic terms and intent of this Settlement Agreement.

11. This Settlement Agreement contains the entire agreement between Releasee and the Releasor with regard to the matters set forth in it and shall be binding upon and inure to the benefit of the executors, administrators, personal representatives, heirs, successors and assigns of each.

12. This Settlement Agreement shall become effective immediately following execution by each of the parties.

WITNESS our signatures as of the day and date first above stated.

State of California

County of

On (date), before me, , personally appeared

who proved to me on the basis of satisfactory evidence to be the persons whose names are subscribed to the within instrument and acknowledged to me that they executed the same in their authorized capacities, and that by their signatures on the instrument, to be the persons whom executed the instrument.

I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct.

WITNESS my hand and official seal.