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In consideration of the agreements set forth below, [name of employee] (Employee), of [name of company] (Company), [address, city], Michigan [zip code], for [himself / herself] and [his / her] heirs and personal representatives, fully and forever releases and discharges Company, its agents, employees, officers, directors, shareholders, representatives, subsidiaries, affiliated companies, parent companies, successors, predecessors, and assigns, both past and present (collectively referred to as “Employer”), from any and all claims, demands, actions, and causes of action of every kind, nature, or description, whether known or unknown, which Employee may have had, may now have, or may have hereafter arising before the date of this Settlement Agreement [Note: if the Older Workers Benefit Protection Act of 1990 (OWBPA) applies, add “, including any claim under the Age Discrimination in Employment Act of 1967,”] by reason of any matter, cause, act, or omission arising out of or in connection with [his / her] employment or termination of employment with Employer, including but not limited to all charges and claims asserted, or which could have been asserted, in the case of [name of case], Civil Action No [number], now pending in the [name of court].
1. [Use the following paragraph if there is a lawsuit:][Case name and number] shall immediately be dismissed with prejudice and without the payment of costs, interest, or attorney fees by any party, and Employee authorizes [his / her] attorney to immediately execute a stipulated order for the dismissal of this action.
2. In consideration for signing this Settlement Agreement and General Release (Release) and the fulfillment of the promises herein, Employer agrees to pay Employee the total sum of ($[amount]). This payment includes all claims for attorney fees and expenses. The payment shall be made in the following disbursements within [number] business days after receipt of a fully executed original of this Release and signed Stipulated Order of Dismissal [If OWBPA compliance is necessary, add “and after the revocation period specified in Paragraph ______below.”]: [Use only applicable paragraphs.]
a. Employer agrees to pay Employee, as payment for claims for lost wages, the sum of ($[amount]), less all applicable withholding taxes and payroll deductions.
b. Employer agrees to pay Employee, as payment for Employee’s claims of compensatory damages (including emotional distress), the sum of ($[amount]).
c. Employer agrees to pay Employee the sum of $[amount] in a check made payable to Employee’s attorney, [name]. Employee agrees to provide the attorney’s completed IRS Form W-9 before receipt of this payment.
The above payment(s) includes all claims for attorney fees and expenses. The appropriate IRS form(s) shall be issued reflecting the payment(s).
[Plaintiff’s optional provision]
The parties agree that $[amount] represents reimbursement of monies actually expended by Plaintiff for nontaxable medical and health care. No taxes shall be deducted, and no Form W-2 or Form 1099 shall issue for this amount.
[Insert the following language in Paragraph 2 if there is a WDCA claim being redeemed.]
d. Employer agrees to pay Employee the additional sum of $[amount] to redeem Employee’s pending Worker’s Disability Compensation Act of 1969 (WDCA) suit. The WDCA suit [Employee v Employer] shall be redeemed. Employee agrees to execute settlement documents satisfactory to Employer for the redemption of this claim, and all parties and their attorneys agree to use their best efforts to redeem this claim immediately in accordance with the terms of this Agreement. Employee understands and agrees that if the WDCA suit cannot be redeemed for the amount set out above, Employer, in its sole discretion, may enforce only that portion of this Agreement that pertains to the settlement of the court action; declare this entire Agreement null and void; or reallocate the settlement amounts set forth in paragraph 1 to provide sufficient consideration to ensure approval of the WDCA redemption.
3. Employee and [his / her] attorney, [name], understand and agree that the terms of this Release, including the fact that any payment was made to Employee or the amount of the payment, shall be confidential and shall not be divulged to any third party other than Employee’s spouse, attorney, or tax preparer without the prior written consent of Employer. The parties agree that only if somebody asks about this case may Employee state that the matter has been resolved but that [he / she] does not want to discuss the matter.
4. Employee agrees that should [he / she] breach the preceding confidentiality agreement, it will not be necessary for Employer to prove actual damages as a result of [his / her] breach. Rather, the parties agree that Employee will pay liquidated damages to Employer in the amount of $[amount] for breach of the confidentiality agreement if Employer demonstrates, by a preponderance of the evidence, that Employee caused or permitted the activity prohibited in paragraph 3 to occur. Employee will also pay actual damages as well as reasonable costs and reasonable attorney fees incurred by Employer as a result of the litigation.
5. Employee agrees that [he / she] will not file a lawsuit or claim of any type in any forum against Employer that has been waived in connection with this Settlement Agreement and Release and that if [he / she] does, the lawsuit or claim will be immediately dismissed; and, notwithstanding the fact that the terms of this Agreement shall otherwise remain in full force and effect, [he / she] will return to Employer all of the money received from Employer as a result of this Settlement Agreement and Release, and Employee will pay to Employer all of the costs, expenses, and attorney fees incurred by Employer in defending against such a lawsuit or claim. [If OWBPA compliance applies, add the following: However, nothing in this Settlement Agreement and Release shall prevent Employee from filing suit to challenge this Agreement, to enforce the terms of this Agreement, or, notwithstanding that this Agreement waives Employee’s rights to file suit under the Age Discrimination in Employment Act, to assert a timely claim in accordance with the Age Discrimination in Employment Act, if Employee believes this release does not comply with the requirements of the Age Discrimination in Employment Act as amended by the Older Workers Benefit Protection Act and, if such a suit is filed, the provisions regarding returning the consideration provided in exchange for this Agreement and providing that Employee shall pay Employer’s attorney fees and costs shall not apply.]
6. Nothing in this Agreement shall interfere with Employee’s right to file a charge, cooperate with, or participate in an investigation or proceeding conducted by the Equal Employment Opportunity Commission [and/or state Fair Employment Practices Agency] or any other federal or state regulatory or law enforcement agency. However, the consideration provided to Employee in this Agreement shall be the sole relief provided to Employee for the claims that are released by Employee in this Agreement, and Employee will not be entitled to recover and agrees to waive any monetary benefits or recovery against Employer in connection with any such claim, charge, or proceeding without regard to who has brought the complaint or charge.
7. Employee understands and agrees that [he / she] waives all rights to current and future employment with Employer and that [he / she] will not seek employment from Employer in the future and that if [he / she] does, this Settlement Agreement and Release will constitute a legitimate nondiscriminatory reason for denying such employment.
8. Employee agrees that [he / she] will not in any way disparage, demean, make negative comments about, or take negative action against Employer or assist in any way any other individual or entity attempting to make or making a claim of any type against Employer. Employer recognizes that Employee must testify if issued a subpoena, but Employee agrees that if [he / she] receives a subpoena related in any way to Employer, [he / she] will immediately advise Employer’s senior legal counsel and director of labor relations of this fact in writing and fully cooperate with Employer if it takes any action regarding the subpoena, including but not limited to moving to quash the subpoena.
9. Employee agrees to put forth a good-faith effort to assist Employer, if needed, to provide testimony regarding any matter or claim made by or against Employer about which [he / she] has personal knowledge or any claim made against Employer in which [his / her] testimony would aid Employer’s defense.
10. The above commitments by Employer are undertaken solely to avoid the inconvenience and cost of defending against claims by Employee and for no other reason. Employee accordingly acknowledges and agrees that the consideration stated above is made and accepted in settlement and compromise of disputed claims and shall not be, and shall not be construed to be, an admission of liability by Employer, by whom any liability to Employee is expressly denied.
11. It is further understood and acknowledged that the terms of this Release are contractual and not a mere recital and that there are no agreements, understandings, or representations made by Employer, except as expressly stated.
12. This Agreement contains the entire agreement and understanding between Employee and Employer with respect to any and all disputes or claims that Employee has, or could have had, against Employer as of the date this Agreement is executed, and supersedes all other agreements between Employee and Employer with regard to such disputes or claims except [Describe any Employer agreements, such as a noncompete or nonsolicitation agreement, that Employer wishes to remain in place following execution of this Agreement.]. This Agreement shall not be changed unless such change is made in writing and is signed by both Employee and Employer.
13. The invalidity or unenforceability of any provision of this Agreement shall not affect or impair any other provisions, which shall remain in full force and effect. If any portion of this Agreement is found invalid, the parties agree to enter into a full and general Release by Employee that is not invalid.
14. Employee acknowledges that before signing this Release, [he / she] has read it, fully understands its terms, content, and effect, has had the benefit of advice from an attorney of [his / her] own choosing, and has relied fully and completely on [his / her] own judgment and the advice of [his / her] attorney in executing this Release.
[Use the following substitute Paragraph 14 for OWBPA compliance, if necessary (single-employee decision).]
14. Employee acknowledges that [he / she] was advised to and did consult with an attorney before executing this Settlement Agreement and Release. Employee further acknowledges that [he / she] was given a period of 21 days within which to consider this Settlement Agreement and Release before signing this document. Finally, Employee understands that during the 7-day period following [his / her] signature on this Settlement Agreement and Release that [he / she] may revoke this Agreement and that this Agreement will not become effective or enforceable until the 7-day revocation period has expired and [he / she] has signed the Statement of Nonrevocation.
15. This Agreement may be signed in counterparts, and a scanned or photocopied signature shall have the same force and effect as an original signature.
Employee has executed this Settlement Agreement and Release and has acknowledged that [he / she] executed it as [his / her] own free act and deed.
______Employee
STATE OF MICHIGAN
______COUNTY / )
)
Acknowledged before me in [county] County, Michigan, on [date] by [name of person acknowledged].
/s/______[Notary public’s name, as it appears on application for commission]
Notary public, State of Michigan, County of [county].
My commission expires [date].
[If acting in county other than county of commission: Acting in the County of [county].]
Statement of Nonrevocation
Employee acknowledges that [he / she] signed the Employment Termination Agreement and Release with Employer on [date], that 7 days have passed since [he / she] signed the Employment Termination Agreement and Release, and that [he / she] does not want to revoke the Employment Termination Agreement and Release that [he / she] previously signed.
Dated: ______/ /s/______[Typed name]
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