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<br />FXIIIBlT A
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<br />RELEASE
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<br />BACKGROUND: By virtue of a settlement, Brown & Brown, Inc, ("Brown") has paid a
<br />sum of money for the benefit of its Florida governmental entity policyholder clients to resolve the
<br />investigation conducted jointly by the Florida Department of Financial Services ("Department"), the
<br />Florida Department of Legal Affairs, Office of the Attorney General, and the Office of Insurance
<br />Regulation regarding undisclosed compensation allegedly received by Brown from insurers on
<br />accounts such as yours. Brown has admitted no wrongdoing or liability in the settlement. Please be
<br />advised that only those Florida governmental entity policyholder clients who execute this Release are
<br />entitled to receive payments under the settlement.
<br />
<br />'RELEASE: For and in consideration of the approximate sum of $27,960.13, and other
<br />good and valuable consideration in hand paid by Brown to the Department for distribution to the
<br />Releasor, the Releasor, by executing this Release for itself and its respective divisions, subdivisions,
<br />officials, officers, executors, attorneys, administrators, agents, successors, and assigns, hereby
<br />waives, releases, remises, forgives, acquits, and forever discharges Brown, including any parent,
<br />subsidiary, or affiliated company of Brown (expressly including, but not limited to Program
<br />Management Services, Inc. ["PMSI"]), and their respective predecessors, successors, assigns,
<br />fonner and current officers, directors, agents, representatives, officials, attorneys, and employees of
<br />and from all manner of actions, cause and causes of action, suits, damages, whether compensatory,
<br />consequential or punitive, awards, claims, demands, and judgments whatsoever, whether sounding
<br />in contract, quasi-contract or tort, in law or in equity, or any right of participation in any class
<br />action, which Releasor now has against Brown or which it ever had, or which Releasor's successors
<br />or assigns hereafter can, shall or may have regarding Brown's receipt of undisclosed compensation
<br />from insurers through the date of the execution of this Release. Releasor acknowledges that, in
<br />making this release, Brown does not admit any liability to Releasor.
<br />
<br />IN WITNESS WHEREOF,
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<br />the undersigned has caused this RELEASE to be executed
<br />,2007.
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<br />RELEASOR:
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<br />Public Entity:
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<br />City of Sunny Isles Beach
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<br />Tax ID#:
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<br />650 78 4647
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<br />Mailing Address: 18070 Collins Avenue, Sunny Isles Beach, Fl 33160
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<br />Title:
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<br />Assistant City Manager - Finance
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<br />Signature:
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<br />..4 Wll~.,
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<br />Print Name:
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<br />Douglas M. Haag
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<br />Nolo<y Publlc Slole 01 Florida
<br />Priscilla Tyler Walker
<br />My Commission DD54a519
<br />Expires 07l14/2Q10
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