Draft - Separation Agreement And General Release (Page 2 of 4) in pdf

Whistleblowers Act, (11) the Americans With Disabilities Act, (12) Veterans' Reemployment

Rights Act, as amended (USERRA) (13) the Florida Civil Rights Act, and (14) any other federal

or state statutory or common law theory of liability or damages.

Employee’s signature below certifies that Employee has not assigned or transferred or

purported to assign or transfer any claim or matter released by and through this Agreement.

The release of claims in this paragraph shall be effective to release all of Employee’s

claims against the Releasees, individually and collectively, including claims that are known or

unknown, suspected or unsuspected provided; however, this Release shall not apply to any rights

or claims that may arise after the date of this Agreement or that by federal or state statute cannot

be waived.

FOURTH:

As consideration for the release of claims by Employee in this Agreement,

Employer will:

(1) Pay to Employee a Severance Benefit equal to one (1) week’s pay for each full Year of

Service and a pro rata amount of one (1) week’s pay for each partial year of service

completed by Employee with Employer as of the Termination Date, less applicable

federal, state and local taxes. For example, if Employee completed six and one-half

years of service as of the Termination Date, the severance benefit would equal six and

one-half week’s pay; and

(2) Payment to Employee a Severance Benefit equal to the balance of the current pay period

plus an additional two weeks pay, less applicable federal, state and local taxes and

(3) Payment of the premiums for employee-only COBRA continuation coverage for

Employer’s group health and/or dental plan(s) in which Employee was participating on

the Termination Date for a period of three (3) months, beginning with the date the

Employee otherwise loses coverage under such plan(s) as a result of the termination of

employment (provided that the Participant otherwise remains eligible for COBRA

coverage during such period)

If the Employee elects family coverage under the Employer’s group health and or dental

plan(s) in which the employee was participating at the time of his termination of

employment, the Employee must pay the difference in the COBRA premium for such

coverage in the time and manner explained in the COBRA notice and election form.

If the Employee elects COBRA continuation coverage, the subsidy described above will

not be paid directly to the Employee, but rather to the Board of Sumter County

Commissioners Group Health Plan.

(4) Pay to Employee twenty-five percent (25%) of the value of accrued, but unused, sick

leave as of the Termination Date, less applicable federal, state and local taxes.

Draft - Separation Agreement And General Release Page 2