Code:
Parcel:
Page: / 2 of
STATE OF : / Project: / PROJECT #
COUNTY OF : / Code: / CODE
Special Agreement / Parcel: / PARCEL #
Revised 07/2014 / Page / 1 of 4
SPECIAL AGREEMENT
Indiana Department of Transportation
WHEREAS the Indiana Department of Transportation, hereinafter referred to as "INDOT," on or about acquired a parcel of real estate and/or interests therein from GRANTOR(S), hereinafter referred to as "Owner", which real estate is located in COUNTY County, Indiana. The acquisition is further identified and described in Parcel Number PARCEL #, under Project PROJECT #, in the Real Estate Divisionof the Indiana Department of Transportation; and
WHEREAS, INDOThas subsequently determined that the initial acquisition failed to compensate the Owner for <explain damages>; and
WHEREAS, the Owner has petitioned INDOT for additional compensationfor cost to cure the above mentioned damages; and
WHEREAS, INDOThas agreed to pay the sum of DOLLARS ($0.00) as additional compensation to the Owner as reimbursementfor cost to cure the <explain damages>; and
Project:Code:
Special Agreement / Parcel:
Page: / of
Project: / PROJECT #
Code: / CODE
Special Agreement / Parcel: / PARCEL #
Revised 07/2014 / Page / 2 of 3
WHEREAS, the Owner for , heirs, and assigns, agree(s) to accept said sum as full, complete and adequate compensation for any and all claims, damages, and recompense due the Owner, <choose one> heirs, and assigns, caused by or arising out of or in any way related to Project PROJECT #; and
WHEREAS, the Owner, <choose one> heirs, and assigns, covenant that in accepting said sum and conditions, forever relinquishes all future claims and legal rights it may have in regard to and arising out of or in any way related to Project PROJECT #and agrees to save and hold harmless INDOT from same; and
WHEREAS, this agreement shall inure to the benefit of the Indiana Department of Transportation, and is binding upon the Owner, <choose one> heirs, legal representatives, assigns, and successors in interest.
NOW THEREFORE, for the consideration above stated, the payment of same being hereby acknowledged, the Owner herein sets <choose one> hand and seal to this agreement hereby agreeing to, and in all ways accepting and binding <choose one> to the terms and conditions set forth hereinabove and hereby so aver.
< insert jurat(s) here - otherwise delete >
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Special Agreement / Parcel:
Page: / of
Project:
Code:
Special Agreement / Parcel:
Page: / of
Project: / PROJECT #
Code: / CODE
Special Agreement / Parcel: / PARCEL #
Revised 07/2014 / Page / 3 of 3
COMPANY NAME
(Seal) / (Seal)Signature / Signature
NAME, TITLE, IF APPLICABLE (or delete) / NAME, TITLE, IF APPLICABLE (or delete)
Printed Name / Printed Name
(Seal) / (Seal)
Signature / Signature
NAME, TITLE, IF APPLICABLE (or delete) / NAME, TITLE, IF APPLICABLE (or delete)
Printed Name / Printed Name
STATE OF:______:
SS:
COUNTY OF______:
Before me, a Notary Public in and for said State and County, personally appeared
______
who acknowledged the truth of the statements in the foregoing agreement on this ______day of ______, ______.
Signature
Printed Name ______
My Commission expires ______
I am a resident of ______County.