HomeMy WebLinkAboutAgreement_General_9/10/2020_JSP Solution LLCClaim # 58158 MWR
RELEASE OF ALL CLAIMS
That the Undersigned, being of lawful age, for sole consideration of Eighty Three Thousand Nine Hundred Ninety One and
I I/100 Dollars ($83,991.11) to the undersigned in hand paid, receipt whereof is hereby acknowledged, do/does hereby and
for my/our/its heirs, executors, administrators, successors and assigns release, acquit and forever discharge JSP Solutions
LLC and those Certain Underwriters at Lloyd's, London, who subscribe severally and not jointly to policy number
CIBFL0050924 and Chubb Group of Insurance Companies, Mas Tee Network Solutions, Mas Tee Inc., Mas Tee North
America, Ace American Insurance Company, MCI, ESIS Inc., Verizon, JMP Power, Standard Optic General Services
Corp., Fiber 1 Communications Inc. and his, her, their, or its agents, servants, successors, heirs, executors, administrators
and all other persons, firms, corporations, associations or partnerships of and from any and all claims, actions, causes of
action, demands, rights, damages, costs, loss of service, expenses and compensation whatsoever, which the undersigned
now has/have or which may hereafter accrue on account of or in any way growing out of any and all known and unknown,
foreseen and property damage and the consequences thereof resulting or to result from the accident, casualty or event which
occurred on or about the 25"' day of in the year of 2020 at or near the roadway intersection of US Route I and Tequesta
Drive in the Village of Tequesta Florida.
It is understood and agreed that this settlement is the compromise of a doubtful and disputed claim, and that the payment
made is not to be construed as an admission of liability on the part of the party or parties hereby released, and that said
released parties deny liability and intend merely to avoid litigation and buy their peace.
The undersigned hereby declare(s) and represent (s) that the injuries sustained are or may be permanent and progressive and
that recovery there from is uncertain and indefinite and in making this Release it is understood and agreed, that the
undersigned rely(ies) wholly upon the undersigned's judgment, belief and knowledge of the nature, extent, effect and
duration of said injuries and liability therefor and is made without reliance upon any statement or representation of the party
or parties hereby released or their representatives.
The undersigned further declare(s) and represent(s) that no promise, inducement or agreement not herein expressed has been
made to the undersigned, and that this Release contains the entire agreement between the parties hereto, and that terms of
this Release are contractual and not a mere recital.
70REGOING RELEASE AND FULLY UNDERSTANDS IT.
��=E n ME ", I'll
Signed, sealed and delivered this I— day of in the year of _2C 1LO
CAUTION: READ BEFORE SIGNING BELOW
NOTARY:
State of [Sva1Ei`, County of 2�,,�((�/�
On this_l!� day of in the year ofbefore me appeared
1Va4,1 •.Aa,�
who is known to be theterson(s) nameoerein and who voluntarily executed this release.
Notary Signature �/1/l Date Commission Expires 0 tz
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Commission 0 GG 132666
^�'•` Expires August 8, 2021
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August 6, 2020
Village of Tequesta Utilities
345 Tequesta Drive
Tequesta, FL 33469-0000
Attention: Matthew Hammond, PE
RE: Insured
Date of Loss
Claimant
Loss Location
Policy No.
Policy Period
Our File No.
Dear Mr. Hammond:
VIA EMAIL AND FIRST CLASS MAIL
mhammond@tequesta.org
JSP Solution LLC
February 5, 2020
Village of Tequesta Utilities
250 US-1 South & Bridge Road
Tequesta, FL 33469
CIBFL0050924
July 18, 2019 - July 18, 2020
58158 MWR
We are Third Party Administrators for Certain Underwriters at Lloyd's, London, who
provide insurance coverage to JSP Solution LLC.
Enclosed is a Release of All Claims in the amount of $83,991.11. When the signed and
notarized Release is returned to our office, we will request a funds transfer, and a check
will be issued and forwarded to you.
Please return the Release of All Claims to:
BLAIR & COMPANY
28025 Smyth Drive
Valencia, CA 91355
Enclosed is a self-addressed envelope for your convenience. If you have any questions,
please do not hesitate to contact us.
Western R4onal (3tfrce • 28025 Smyth D.rive..Suite 1 1 • Veien;dia • CA 91355
Eastern Regitfral Df e - 3111 Sprirxjtsank Lam. SUite G • Charlotte NC 2K26
Telephone 00, 87..1263 • claims a(�.blairandco.net - Facsimile 866-487.0476
Village of Tequesta Utilities — Page 2
Insured: JSP Solution LLC
Our File No.: 58158 MWR
August 6, 2020
Very truly yours,
*44444 "ab-t—
Michael Walker
Blair & Company
Eastern Regional Office
800.487.1263, ext. 203
michael.walker@blairandco.net
MWR:eh
Enclosures: 1. Release of All Claims
2. Blair & Company return envelope
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