EFTA00787679
EFTA00787681 DataSet-9
EFTA00787682

EFTA00787681.pdf

DataSet-9 1 page 354 words document
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POLICYHOLDER'S RELEASE (For Individuals or Corporations) McLarens File H008.021055.00 MG Claim #:610421 CLAIM NUMBER PCG POLICY NUMBER IN CONSIDERATION of One million dollars and no cents 1,000,000.00 and other good and valuable considerations to me paid, the receipt whereof is hereby acknowledged, I, JEFFREY EPSTEIN (being of lawful age) do hereby release and forever discharge AIG Property Casualty Company, Insurance Office Central Ohio and McLarens and their respective successors and assigns, from any and all action, causes of action, claims and demands whatsoever for, upon, or by reason of any damage, loss or injury and all consequential damage, which heretofore have been or which hereafter may be sustained by me in consequence of damage and loss to fine art and jewelry insured under Policy No. PCG 0021940015 caused by Hurricane Maria and Hurricane Irma in or about September 2017 IT BEING FURTHER AGREED AND UNDERSTOOD, that the payment of said amount is not to be construed as an admission of liability, but is a compromise of a disputed claim and that this release is executed in full settlement and satisfaction of rights of the undersigned under Policy No. PCG 0021940015 arising out of Damage and loss above referred to. said WITNESS my/our signature and seal this day of , 20 CAUTION: READ BEFORE SIGNING (SEAL) Witness (SEAL) Witness Officer ACKNOWLEDGMENT FOR INDIVIDUALS FOR CORPORATIONS State of State of 0 SS.: County of County of On the day of , 20 On the day of , 20 before me before me came came to me known to be the individual described in, and who to me known, who, being by me duly sworn, did depose and say executed, the foregoing instrument, and acknowledged that that Executed the same. s/he resides in ; that s/he is the Notary of , the corporation described in, and which executed, the foregoing instrument; that s/he knows the seal of said corporation; that the seal affixed to said instrument is such corporate seal; that It was so affixed by order of the Board of Directors of said corporation; and that s/he signed her/his name thereto by like order. Notary EFTA00787681
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EFTA00787681
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DataSet-9
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document
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1
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