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<br />. <br /> <br />. <br /> <br />. <br /> <br />PROPERTY DAMAGE RELEASE <br /> <br />In consideration of the sum of One Hundred Finy dollars ($150.00), receipt whereof <br />is hereby acknowledged. 1 Dennis Hammcs, do hereby release and forever discharge the <br />City of Mounds View and any other person, tirm or corporation charged or chargeable with <br />responsibility or liability. their heirs, representatives and assigns, ii'om any and all claims <br />and causes or action lor property damagc. loss of use and depreciation sustained or that may <br />be sustained as a result of an accident that occurred on or about the 20th day January of , <br />2003. at or near 5511 Quincy Street. Mounds View, MN 55112. <br /> <br />It is understood that upon receipt of the above-referenced monies, this document <br />shall be a full and final release of all property damage claims and shall release all such <br />claims whether knmvn or unknown. <br /> <br />I understand the parties hereby rcleased admit to no liability for said accident and <br />that said payment is made solely to compromise a disputed and contested claim. <br /> <br />Signed and sealed this <br /> <br />/ <br /> <br />I <br /> <br />day of 0:1 <br /> <br />. 20 C) 3 <br /> <br />(CAUTION: READ ALL OF THE ABOVE BEFORE SIGNING) <br /> <br />Witnessed: <br /> <br />~ d <br />. , <br /> <br />1 . . <br />"'4~_7, ~. <br />C: annant <br /> <br />Witness <br /> <br />Witness <br /> <br />Claimant <br /> <br />Subscribed and s\lorn to betixe me this <br />/ day of &c'-:-/chc.;'''--- , 20Qj <br /> <br />---L~ , ~~t.i -- <br />.~ ;) <br />City of Mounds Vie\\" ~ <br />240 1 Highwav 10 <br />.... - <br />Mounds View. MN 55112 <br /> <br />