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EXHIBIT "A" <br />STATEMENT AND WAIVER OF ADDITIONAL CLAIMS <br />OF <br />LITTLE CANADA CAR WASH <br />Business: Little Canada Car Wash <br />Displaced From: 2600 Rice Street <br />Little Canada, MN 55113 <br />The subject property that my business will be displaced from has been acquired by the City of <br />Little Canada. I understand that the City of Little Canada has taken steps to contact me to assist <br />me in making certain relocation assistance claims. I have had the opportunity to consult with an <br />attorney and I understand the rights and benefits provided to me under the Uniform Relocation <br />Assistance and Real Property Acquisition Policies Act of 1970 (Uniform Act). In addition, I <br />have received and reviewed any and all necessary documentation relative to my rights under the <br />Uniform Act. <br />The claim I have made as of this date and in the amount of $20,000 is my final claim for <br />relocation assistance and I shall make no further claims to the City of Little Canada involving my <br />move from the subject property. I expressly declare and agree that all claims, past, present and <br />future have been settled. I will indemnify and hold harmless the City of Little Canada against <br />loss, including attorney fees, from any and every claim that may arise relating to my move. This <br />waiver shall bind myself, my heirs, my next of kin, my successors and /or my assigns. I have had <br />the opportunity to discuss my business's claim for relocation benefits with any advisors I have <br />wished to consult, and I freely execute this document under no threat or duress. <br />LITTLE CANADA CAR WASH <br />By: Date: <br />Its: President <br />By: Date: <br />Its: Secretary <br />Page 11 of 11 <br />