Small Business Sustainability Program - Tier I Waiver And Release Form printable pdf download

You have the Option to Have Your Attorney Review this Before You Sign

Small Business Sustainability Program

Tier I Waiver and Release Form

I __________________________________, on behalf of myself and my business

____________________________________________________ (the “Business”), in exchange

for participating in the Santa Clara Valley Transportation Authority (“VTA”) Small Business Sustainability

Program (“SBSP”) and for receiving any payment thereunder including the Tier I payment of $1,000, hereby

compromise, settle, release, waive, discharge, and relinquish any and all past and present claims, demands,

losses, damages, rights, remedies, or causes of action for personal injury, compensatory damages, property

damages, business interruption and disruption damages, any and all other damages, losses, costs, and

expenses, including attorneys’ and experts’ fees, whether based on tort, inverse condemnation, contract,

California’s Government Code, or other theories of recovery, against VTA, the City of San José, and their

respective board members, council members, officers, employees, consultants, administrators, agents,

attorneys, predecessors, and successors in interest, and their respective heirs, and assigns from same,

arising from or in any way related to VTA’s Alum Rock-Santa Clara Bus Rapid Transit Project (the “Waiver

and Release”).

If I believe that I have suffered damages in excess of $1,000, I may still participate in SBSP Tier II if my

business qualifies, but I understand that any payment my business receives will not exceed an additional

$49,000 and may be less than the amount I request, and that by signing this Waiver and Release, I will

accept without qualification the Special Administrator’s final decision regarding my Tier II application.

This Waiver and Release does not apply to claims that arise after the date that I sign this Waiver and

Release or the date any payment under Tier II is mailed or delivered to Business, whichever is later.

However, to the extent the Business receives any payment from the SBSP, the Business agrees that the first

one thousand dollars ($1,000) of any payment will operate as a credit toward any potential future claims.

I represent and warrant that I have authority to bind the Business with respect to this Waiver and Release.

Signature:

__________________________________

Printed Name:

__________________________________

Title:

__________________________________

Business Name:

__________________________________

Date:

__________________________________

 You Must Sign this Waiver and Release to Receive Your $1,000 Under Tier I,

Even if You Will Also be Seeking a Tier II Payment.

 You Do Not Have to Sign this Waiver and Release if You Want to Participate in Tier II Only

11-11-15

Small Business Sustainability Program - Tier I Waiver And Release Form