FORM FOR MEDIATION SETTLEMENT BY JUDGE STAN BILLINGSLEY

FORM FOR MEDIATION SETTLEMENT

Prepared By Judge Stan Billingsley

Settlement Agreement 

This settlement of a civil action, is executed this (date)  ________, by and between the Plaintiff(s) and Defendant(s), hereinafter identified,  in a certain civil action #13-CI-00203 pending in the Grant Circuit Court WHEREAS Plaintiff’s  _______________holds claims or may hold claims against Defendant __________________. which are more particularly described in the aforementioned Civil Action,

NOW THEREFORE the parties hereto acknowledge that they have entered into an agreement settling all issues between the parties arising out of said civil action.

The Plaintiff does hereby agrees to release, cancel, forgive and forever discharge the Defendant(s)_ Defendant ________________________________from all actions, claims, demands, damages, obligations, liabilities, controversies and executions, of any kind or nature whatsoever, whether known or unknown, whether suspected or not, which have arisen, or may have arisen, or shall arise by reason of the incident described in the pleadings of the above mentioned civil action, does specifically agree to waive any claim or right to assert any cause of action or alleged case of action or claim or demand which has, through oversight or error intentionally or unintentionally or through a mutual mistake, been omitted from this Release.

The Defendant(s) hereby release, cancel, forgive and forever discharge the Plaintiff, from all actions, claims, demands, damages, obligations, liabilities, controversies and executions, of any kind or nature whatsoever, whether known or unknown, whether suspected or not, which have arisen, or may have arisen, or shall arise by reason of the incident described above does specifically waive any claim or right to assert any cause of action or alleged case of action or claim or demand which has, through oversight or error intentionally or unintentionally or through a mutual mistake, been omitted from this Release.

In addition, to said mutual release of all claims, the Defendant(s) agree to pay to the Plaintiff, the sum of $______________,  Said sum shall be paid within ______________days of the date of this settlement agreement.

Additional terms (if any): ____________________________________________________________________________________________________________________________________________________________

The Plaintiff shall cause the pending civil action to be dismissed forthwith upon payment of the settlement amount.  Each party hereto shall be responsible for their own attorney fees and court costs.

In the event there is a subrogation claim by any third party arising out of the aforementioned civil action or for any services or treatment incurred by Plaintiff, the Plaintiff shall hold the Defendant(s) harmless from the entirety of said claim.

It is mutually agreed by all parties hereto, this settlement agreement shall be confidential, and shall not be disclosed to any parties other than the parties hereto and their officers and authorized agents.  Said officers and agents shall be bound by this obligation of confidentiality. The terms of any settlement shall not be made a part of the court record, and shall not be disclosed to any court personnel, unless ordered by the court, and in any action to enforce the terms of this settlement agreement.

The undersigned parties hereby acknowledge that they have read the foregoing settlement agreement, and have decided to utilize this form, and waive any claims against the mediator. It is understood that the parties prior to acceptance of this settlement agreement may negotiate amendments, changes, additions hereto, if all parties agree, and evidence said agreement by signing below.  All parties hereto have the right to prepare and submit their own settlement form and are not required to use this settlement form.

The provisions of this Agreement must be read as a whole and are not severable and/or separately enforceable by either party hereto.

IN WITNESS WHEREOF, the undersigned have executed this Release in duplicate originals as of the date first set forth above.

Party Authorized to make this Settlement in behalf of the Plaintiff  _________

____________________________________

Signature Date:

 

Party Authorized to make this settlement in behalf of the Defendant __________________

__________________________________________________________                            Signature

Date

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