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The Insured warrants and represents that the claim in connection with which this <br /> Release is given has not been assigned in whole or in part, and the Insured further warrants <br /> that the Insured has made a full and complete disclosure of all the facts which were required <br /> to evaluate and process the claim for which this Release is given . <br /> This Release shall be binding upon the Insured , jointly and severally, and its <br /> administrators and assigns . <br /> IN WITNESS WHEREOF, the parties hereto have executed this Release on the date <br /> indicated below . <br /> ATTEST: Jeffrey K . Barton , BOARD OF COUNTY COMMISSIONERS <br /> Clerk of Courts OF INDIAN RIVER COUNTY <br /> uusaannno <br /> COMMIst4A <br /> B H <br /> � �� `. o ``�' • ' � ry � /� /�/ 0��! �-tom✓ <br /> y ' `� Ga heeler, Chairman <br /> eputy ClerkI go <br /> ry <br /> � . <br /> • Vpproved by BCC : i, 7 L , 2012 <br /> age . ? ? 0 ��Q'� <br /> Approved : <br /> COUN�y, <br /> Approved as to Form and Legal Sufficiency : <br /> l SIG <br /> oseph . Baird , County Administrator Alan S. Polackwich , Sr . , County Attorney <br /> STATE OF FLORIDA <br /> INDIAN RIVER COUNTY <br /> 5 <br /> THIS IS TO CERTI.FY THAT THIS IS �v • • ' is >,y <br /> A TRUE AND CORRECT COPY OF <br /> THE ORIGINA N FILE I THI <br /> OFFICE <br /> J F K . BAR N , E <br /> D . C . <br /> DATE Ca o2 Jam ' I a` .' ,+ 00 4 <br /> /ND <br /> ZAN RINAP <br /> �n. Mu .JJ1 ,1i. <br />