R25-316 RESOLUTION NO. R25-316
1 A RESOLUTION OF THE CITY COMMISSION OF THE CITY OF BOYNTON
2 BEACH, FLORIDA, APPROVING THE CONDITIONAL SETTLEMENT AND
3 RELEASE OF CLAIM IN THE MATTER OF CHRISTINA SORTORE V. CITY
4 OF BOYNTON BEACH, TOTALING $100,000; AND FOR ALL OTHER
5 PURPOSES.
6
7
8 WHEREAS, the Code of Ordinances of the City of Boynton Beach, Florida, provides that
9 the authority for settlement of all claims in excess of $50,000 shall require approval of the City
10 Commission by formal resolution; and
i WHEREAS, Christina Sortore ("Claimant") brought a claim stemming from an alleged
12 incident that occurred on or about December 13, 2019; and
13 WHEREAS, a Settlement and Release of Claim was reached with the Claimant for $100,000
14 in exchange for a general release of all claims, which resolves all claims for damages between the
15 Claimant and the City of Boynton Beach, as well as attorney's fees and costs, if any; and
16 WHEREAS, the City Commission, upon the recommendation of staff, has deemed it in the
17 best interests of the city's citizens and residents to approve the Contingent Settlement Agreement
18 and Release in the matter of Christina Sortore and the City of Boynton Beach, totaling $100,000.
19 NOW, THEREFORE, BE IT RESOLVED BY THE CITY COMMISSION OF THE CITY OF BOYNTON
20 BEACH, FLORIDA, THAT:
21 SECTION 1. The foregoing "Whereas" clauses are hereby ratified and confirmed as
22 being true and correct and are hereby made a specific part of this Resolution upon adoption.
23 SECTION 2. The City Commission of the City of Boynton Beach, Florida, does hereby
24 approve the Contingent Settlement Agreement and Release in the matter of Christina Sortore and
25 the City of Boynton Beach totaling $100,000, in form and substance similar to that attached as
26 Exhibit A.
27 SECTION 3. This Resolution shall take effect in accordance with the law.
28
29 [SIGNATURES ON THE FOLLOWING PAGE]
30
31
RESOLUTION NO. R25-316
32
33 PASSED AND ADOPTED this d5 day of Q.0 t.M Q_,C , 2025.
34 CITY OF BOYNTON BEACH, FLORIDA
35 YES NO
36 Mayor— Rebecca Shelton ✓
37
38 Vice Mayor—Woodrow L. Hay ✓
39
40 Commissioner—Angela Cruz
41
42 Commissioner—Thomas Turkin
43
44 Commissioner—Aimee Kelley ✓
45
46 VOTE 5-0
47 ATTEST:
48
49 ( .,
50 / j1aylee De J us, MPA, R ecca Shelton
5IV City Clerk Mayor
52
53 APPROVED AS TO FORM:
54 (Corporate Seal)
55n� G�
56
57 Shawna G. Lamb
58 City Attorney
CONTINGENT SETTLEMENT AGREEMENT AND RELEASE
Employee/Claimant: OJCC Case No. 24-015353TAH
Christina Sortore
11622 Hackberry St
West Palm Beach, FL 33410
Employer:
City of Boynton Beach Claim No. 06330021
100 East Ocean Avenue
Boynton Beach, FL 33435
Carrier/Servicing Agent:
Commercial Risk Management, Inc. Date of Accident: 12/13/2019
P.O. Box 18366
Tampa, FL 33679
THIS AGREEMENT, subject to the terms and conditions as set forth below, is
intended to be a complete, entire and final release and waiver of any and all rights, to any
and all benefits, past, present and future, that the Employee/Claimant, Christina Sortore,
is, or may be, entitled to under Chapter 440, Florida Statutes, (as more fully set forth
below), and any other actions, claims, demands, or causes of actions, whatsoever, that
the Employee/Claimant may have against the Employer, City of Boynton Beach, and the
Carrier/Servicing Agent, Commercial Risk Management; Inc., hereinafter,
Employer/Carrier/Servicing Agent.
I. TERMS OF WORKERS' COMPENSATION SETTLEMENT AGREEMENT AND
RELEASE PURSUANT TO 440.20(11)(c)(d) & (e) (2013):
A. TOTAL SETTLEMENT AMOUNT:
The Employer/Carrier/Servicing Agent will pay to the Employee/Claimant,
in a lump sum, the amount of $100,000.00 ($100.00 of which is payable to the
Employee/Claimant as consideration for an ADA/General employer release) less the
OJCC#: 24-015353TAH
Page 1 of 13
$2,000.00 that the Employer/Carrier/Servicing Agent has paid to the Employee/Claimant
as an advance, payment of which will be issued within thirty (30) days from the date of
Certificate of Service on the Order approving the Motion for Approval of Attorney's Fee
and Allocation of Child Support Arrearage for Settlement under Section 440.20(11)(c)(d)
& (e). It is understood and agreed by the parties that the terms of this agreement are
binding and fully enforceable.
B. ALL BENEFITS RESOLVED:
Payment of the aforementioned lump sum is in full satisfaction of the
obligation or liability of the Employer/Carrier/Servicing Agent to pay any benefits of
whatever kind or classification available under the Florida Workers' Compensation Law,
including, but not limited to, temporary total and temporary partial disability benefits,
impairment benefits, permanent total disability benefits, permanent total supplemental
benefits, supplemental benefits, wage loss benefits, rehabilitative temporary total
disability benefits, vocational benefits, required to be provided by the Employer, death
benefits, attorney's fees, past, present and future medical benefits, attendant care,
prescriptions, orthotics, prosthetics, transportation, or any other benefits contemplated
under Florida Statute 440 relating to the alleged injury or occupational disease arising on
account of or in connection with an accident, occurrence, incident, exposure, or event
which took place on or about 12/13/2019.
The Employee/Claimant acknowledges by her signature below, that upon
payment of the consideration referenced in paragraph I.A. herein, she waives all
entitlement to any and all further Workers' Compensation benefits and that the
Employer/Carrier/Servicing Agent will be fully and forever discharged and released from
the obligation or liability to pay any and all benefits of whatever kind or classification
payable under the Florida Workers' Compensation Law.
The Employee/Claimant stipulates, and the parties agree, that this
Settlement Agreement and Release shall constitute an election of remedies by the
Employee/Claimant with respect to the Employer/Carrier/Servicing Agent herein. As a
result of accepting the above referenced sum, the Employee/Claimant relinquishes all
rights for recovery for negligence, intentional torts, employer liability under workers'
compensation law, bodily injury and any other potential claims arising under the workers'
compensation law and employers' liability policy (including, but not limited, Part
II/Coverage B) in effect for the 12/13/2019 date of accident.
OJCC#: 24-015353TAH
Page 2 of 13
The undersigned Employee/Claimant accepts and assumes all risk,
chance, or hazard that said injuries, damages, manifestations or losses are now or may
become greater, more numerous or more extensive than is now know, anticipated or
expected; and the undersigned Employee/Claimant agrees that this release applies to all
injuries, damages, manifestations or losses of every kind and character which have
arisen, or which may hereafter arise, even though now unknown, unanticipated or
unexpected. The undersigned Employee/Claimant hereby acknowledges full
responsibility for all future medical benefits.
C. ATTORNEYS FEES:
1. FEES/COSTS PAID BY THE EMPLOYEE/CLAIMANT:
The Employee/Claimant will pay her attorney, Vincent Leuzzi, Esq., the sum
of$24,972.00 out of the above settlement. Additionally, the Employee/Claimant shall pay
the sum of$28.00 as costs. The fee and costs shall be paid from the settlement proceeds,
thereby making the net settlement amount $75,000.00 ($100.00 of which is payable to
the Employee/Claimant as consideration for an ADA/General employer release).
2. PRIOR REPRESENTATION:
The Employee/Claimant will be responsible for any and all attorney's fee
liens filed or held by any prior attorney, for representation of the Employee/Claimant. The
Employee/Claimant agrees to indemnify and hold the Employer/Carrier/Servicing Agent
harmless as to any attorney fee liens.
D. CHILD SUPPORT ARREARAGE:
The Employee/Claimant agrees that, if there is any outstanding child
support, it shall be deducted from the Employee/Claimant's net settlement proceeds
pursuant to the Motion for Attorney Fee Approval and Child Support Allocation. Any
payments to child support shall be made by the Claimant's Counsel from the
Employee/Claimant's net settlement proceeds. The Employer/Carrier/Servicing Agent
shall in no way be responsible for any child support owed by the Employee/Claimant. The
Employee/Claimant also stipulates and agrees that the Employer/Carrier/Servicing Agent
shall be indemnified and held harmless against any action brought by any third party for
payment of child support arrearage.
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Page 3 of 13
E. THIRD PARTY LIENS
The Employer/Carrier/Servicing Agent does not waive any lien rights
pursuant to Florida Statute 440.39 and the lump sum benefits paid herein shall be
included in the amount thereof. The Employee/Claimant agrees to give written notification
to the Employer/Carrier/Servicing Agent or their attorney as to the filing of any suit against
third parties arising out of the accident or injuries giving rise to this claim and to advise as
to any recovery received from third parties arising out of the accident or injuries which are
the subject matter of this claim. The Employee/Claimant further agrees that no proceeds
from any third-party claim shall be disbursed prior to satisfaction of the
Employer/Carrier/Servicing Agent's lien.
II. STIPULATED FACTS:
A. MEDICAL CARE:
The Employee/Claimant understands and acknowledges that any and all
entitlement to authorized treatment ceased effective the date of settlement as outlined in
the parties' November 4, 2025 Memorandum of Contingent Settlement, which is hereby
incorporated by reference.
B. INDEMNITY BENEFITS:
The Employee/Claimant acknowledges that effective the date of settlement,
as outlined in the parties' November 4, 2025 Memorandum of Contingent Settlement, she
is no longer eligible nor entitled to any past, present, or future indemnity benefits.
III. SPECIFIC WAIVERS AND REPRESENTATIONS:
A. WAIVER OF RIGHT TO HAVE CASE HEARD BY JUDGE OF
COMPENSATION CLAIMS AND RIGHT TO BRING PETITION FOR
MODIFICATION:
The Employee/Claimant understands that she does hereby relinquish the
right to have any unresolved conflicts or disputes involving the right to monetary
compensation benefits, impairment benefits, death benefits, attorney's fees, past due
medical benefits, future medical benefits, and rehabilitation benefits heard and decided
by the Judge of Compensation Claims. The Employee/Claimant also understands that
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Page 4 of 13
this Settlement Agreement and Release shall not be reviewed by the Judge of
Compensation Claims in accordance with Florida Statute section 440.20(11)(c). In
addition, the Employee/Claimant also understands that the Order approving the Motion
for Approval of Attorney's Fee and Allocation of Child Support Arrearage for Settlement
under Section 440.20(11)(c)(d) & (e) is not an award under the Florida Workers'
Compensation Act and is not subject to modification or review.
B. WAIVER OF PENALTIES AND INTEREST:
The Employee/Claimant does hereby waive any right she may have to any
and all penalties and/or interest on account of the alleged accident or occupational
disease referenced herein.
C. RIGHT TO FUTURE MEDICAL CARE CLOSED:
As provided under Florida Statutes section 440.20(11)(c), the lump sum
payable herein will fully discharge and satisfy the Employer/Carrier/Servicing Agent's
liability to provide future remedial and palliative medical care under Florida Statute section
440.13 and 440.134, including, but not limited to, follow up examinations, pain medication,
diagnostic testing, attendant care, and surgery. The Employer/Carrier/Servicing Agent
shall no longer be liable for any medical benefits resulting from the alleged accident or
occupational disease referenced herein. Any further/future medical expenses will be the
sole responsibility of the Employee/claimant. The Employee/Claimant agrees to notify his
treating physicians' that she is now alone fully financially responsible for any and all
medical care and treatment.
The Employee/Claimant has considered or had the opportunity to consider
any and all reports submitted by medical providers and rehabilitation providers. In
addition, the Employee/Claimant has consulted with or had the opportunity to consult with
medical providers and rehabilitation providers. The Employee/Claimant stipulates and
agrees that she has determined that the amount of money being proposed to settle
medical care and treatment is reasonable and adequate to meet the Employee/Claimant's
future medical needs, in connection with the accident, occurrence, incident, exposure or
event, which took place on or about 12/13/2019.
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D. ALL CLAIMS RELATED TO THE EMPLOYEE/CLAIMANT'S EMPLOYMENT
WITHDRAWN AND/OR ACTIONS WAIVED:
All pending Claims/Petitions for Benefits are hereby voluntarily withdrawn
and dismissed, with prejudice. This settlement represents a settlement of any and all
claims or actions that may arise from the accident referenced herein and any claims or
actions that may have arisen out of the Employee/Claimant's employment with City of
Boynton Beach, whether known or unknown, reported or unreported.
As part of this settlement, the Employee/Claimant further specifically agrees
to release and discharge the Employer, City of Boynton Beach, its officers, agents,
servants, employees, directors, successors, assigns, and any other person or entity so
connected to the Employer, of any and all claims relating to retaliatory discharge under
section 440.205, Florida statutes.
In addition, as further consideration for such payment, the
Employee/Claimant agrees and does hereby release, discharge, and surrender any and
all claims, whether or not asserted, against the Employer, City of Boynton Beach, or its
Servicing Agent, or any of their officers, agents, servants, employees, directors,
successors, assigns, and any other person or entity so connected to the Employer and/or
Servicing Agent, of any nature whatsoever, without limitations thereof.
E. EMPLOYER/CARRIER/SERVICING AGENT'S PAYMENT OF PAST
MEDICAL BILLS:
The Employer/Carrier/Servicing Agent agrees to pay, in accordance with
the Workers' Compensation Fee Schedule, any bills for treatment causally related to the
work accident or occupational disease, from authorized health care providers/facilities,
for dates of service prior to the date of settlement. The Employer/Carrier/Servicing Agent
will pay for such services upon receipt of the authorized treating physician's bills,
submitted upon proper form.
The Employer/Carrier/Servicing Agent does not agree to pay any bills from
unauthorized health care providers/facilities and the Employee/Claimant stipulates and
agrees that she is solely responsible for resolving and satisfying any liens or attachments
filed by any such health care provider/facility that was not authorized by the
Employer/Carrier/Servicing Agent. The Employee/Claimant also stipulates and agrees
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that she is not aware of any liens or attachments, filed by any health care provider/facility
not authorized by the Employer/Carrier/Servicing Agent. Moreover, the
Employee/Claimant stipulates and agrees that the Employer/Carrier/Servicing Agent shall
be indemnified and held harmless, against any action brought by any third party for
payment of past medical bills for medical treatment not authorized by the
Employer/Carrier/Servicing Agent.
The Employee/Claimant stipulates and agrees that she is not aware of any
liens or attachments, filed by any health care provider/facility or Medicare, including
Medicare Advantage Organizations, its assignees, and/or its subcontractors, or Medicaid
not authorized by the Employer/Carrier/Servicing Agent. Moreover, the
Employee/Claimant stipulates and agrees that the Employer/Carrier/Servicing Agent shall
be indemnified and held harmless against any action brought by any third party for
payment of past medical bills for medical treatment not authorized by the
Employer/Carrier/Servicing Agent. The Employee/Claimant shall be responsible for any
Medicare, including Medicare Advantage Organizations, its assignees, and/ or its
subcontractors, or Medicaid liens.
F. FULL AND COMPLETE KNOWLEDGE:
The Employee/Claimant acknowledges that she has full and complete
knowledge of all pertinent and material facts in the instant claim and it is her desire to
settle this claim, fully and finally, consistent with and under the provisions of Section
440.20 of the Florida Statutes. The Employee/Claimant has entered into this agreement
after full discussion and consideration of the matter and with full knowledge of the reports
and opinions of the Employee/Claimant's treating physicians and rehabilitation
counselors, as well as the Employee/Claimant's own estimate of her physical condition.
The Employee/Claimant further represents that her rights under the Florida Workers'
Compensation Law have been explained to her satisfaction and that she made
independent inquiry concerning the reasonableness of the settlement and medical and
disability status or has waived the opportunity to do so.
The Employee/Claimant understands that if this case were not settled, the
Employee/Claimant would have a period of time following the date of last payment of
compensation or furnishing of medical care in which to make a further claim against the
Employer/Carrier/Servicing Agent herein because of injuries suffered in this accident. The
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Employee/Claimant feels it is advantageous and in her best interest to terminate this
litigation and accept the settlement agreed to hereunder in full and final adjudication and
settlement of this claim to compensation and medical benefits. The Employee/Claimant
understands that the Employer/Carrier/Servicing Agent also waives substantial rights in
settling this claim. The Employee/Claimant also understands that if she initiates legal
proceedings pertaining to this Settlement Agreement and Release, after the Judge of
Compensation Claims approves that Motion for Approval of Attorney's Fees and
Allocation of Child Support Arrearage for settlement under Section 440.20(11)(c)(d) & (e),
the Employee/Claimant shall be liable to the Employer/Carrier/Servicing Agent for all its'
expenses, including reasonable attorney's fees incurred during the proceeding.
As a further consideration and inducement for this compromise settlement,
the undersigned Employee/Claimant agrees to indemnify, protect, and hold harmless all
the parties named in this Settlement Agreement and Release and all other persons, firms,
and corporations whomsoever, from all judgments, costs, attorney's fees and expenses
whatsoever arising on account of any action, claim or demand including but not limited to
the following: all claims for subrogation, workers' compensation liens, bills and any and
all claims under any Federal, State or local income disability act; any claim under the
Americans with Disabilities Act; any other public programs providing medical expenses,
disability payments or other similar benefits; any and all claims under Medicaid, Medicare,
including Medicare Advantage Organizations, its assignees, and/ or its subcontractors;
any and ail claims for reimbursement or subrogation under any group medical policy,
individual medical policy or any health maintenance organization; any and all claims for
reimbursement or subrogation under any health, sickness, or income disability insurance,
automobile accident insurance, and any other similar insurance that provides health
benefits or income disability coverage; any and all claims for reimbursement or
subrogation under any contract or agreement with any group, organization, partnership
or corporation which provides for the payment or reimbursement of medical expenses or
wages during the period of disability; and any and all actions, claims, demands
whatsoever of any type or nature which may hereafter be brought or asserted against the
parties named in this Settlement Agreement and Release, on account of any injury, loss
or damage resulting from the accident, occurrence, incident or event aforesaid.
The undersigned Employee/Claimant warrants that no promise or
inducement not herein expressed has been made; that in executing this Release the
undersigned Employee/Claimant is not relying upon any statement or representation
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made by any person, firm or corporation hereby released or any agent, physician or doctor
or other person representing them or any of them concerning the nature, extent or
duration of the injuries, losses or damages here involved or the legal liability therefore, or
concerning any other thing or matter; that the payment of the above-mentioned sum is in
compromise and in full satisfaction of the aforesaid actions, claims and demands
whatsoever; that the undersigned Employee/Claimant is over the age of twenty-one (21)
years and legally competent to execute this Settlement Agreement and Release and that
the undersigned Employee/Claimant is fully informed of the contents of this Settlement
Agreement and Release and signs it with full knowledge of its meaning.
G. AGREEMENT NOT TO RE-APPLY
The Employee/Claimant previously separated from her employment and will
not seek re-employment or volunteer opportunities with the City of Boynton Beach. The
agreement to voluntarily separate and not seek re-employment is not being entered into
due to any disabilities the Employee/Claimant may allege and is not the sole
consideration for settlement of the claim referenced herein.
H. VOLUNTARY SETTLEMENT:
The parties agree and acknowledge that they attended a private mediation
conference on November 4, 2025, which resulted in a contingent settlement agreement.
The terms of the parties' Memorandum of Contingent Settlement are incorporated by
reference. The Employee/Claimant understands that she, like the
Employer/Carrier/Servicing Agent, does not have to settle and is doing so freely,
voluntarily and with no duress or coercion from anyone. The Employee/Claimant also
affirms that she is mentally competent and understands all of the terms of this agreement
and the consequences therefrom and further has had advice of counsel, with whom the
Employee/Claimant is satisfied. The Employee/Claimant further understands that she has
the right to take any claims/petition for any Workers' Compensation benefits to a hearing
to have said claim/petition heard by a Judge of Compensation Claims and that by settling,
gives up that right permanently. The Employee/Claimant represents that she has read
this Settlement Agreement and Release and hereby acknowledges that she understands
and accepts all of the terms and conditions herein and that she has done so with the
advice of counsel.
OJCC#: 24-015353TAH
Page 9 of 13
I. MEDICARE CONSIDERATIONS:
Pursuant to Federal Regulations, and in accordance with internal guidelines
issued by the Centers for Medicare and Medicaid Services (''CMS''), Medicare's interests
must be considered in a workers' compensation settlement where a claimant is already a
Medicare beneficiary and the total settlement amount is greater than $25,000.00; or in
such cases wherein there is a reasonable expectation that the claimant will be eligible to
receive Medicare benefits within thirty (30) months of the settlement date and the
anticipated total settlement amount is expected to be $250,000.00 or greater. In the
present matter, there is no reasonable evidence that the Employee/Claimant is currently
a Medicare beneficiary or will become a Medicare beneficiary, including a beneficiary of
a Medicare Advantage Plan, prior to the effective date of this Settlement Agreement and
Release. Specifically, the Employee/Claimant affirms and states that the
Employee/Claimant is not current receiving any Medicare benefits. including benefits
under a Medicare Advantage Plan, will not become a Medicare beneficiary prior to the
effective date of this Settlement Agreement and Release, and the settlement is under
$250,000.00. In addition, the Employer/Carrier/Servicing Agent have received no notice
from Medicare, including Medicare Advantage Organizations ("MAOs"), their assignees,
and/ or their subcontractors, CMS or any other third party that the Employee/Claimant is
a Medicare beneficiary, including a beneficiary of Medicare Advantage Plan, or will
become a Medicare beneficiary prior to the effective date of this Settlement Agreement
and Release.
The parties have not considered the receipt of any Medicare, including
MAOs, their assignees, and/ or their subcontractors, or Medicaid assistance for the
purpose of an alternative means of medical recovery pursuant to negotiations. The
settlement reached herein has been based upon the full anticipated value of future
workers' compensation indemnity and medical benefits exposure offset by future
uncertainty as to the nature and extent of the Employee/Claimant's entitlement to these
benefits, and available statutory defenses.
In the event of Medicare, including MAOs, their assignees, and/ or their
subcontractors, or CMS make a claim for past or future Medicare benefits. Medicare
Advantage Plan benefits, Medicaid asserts a lien, or there are any child support liens,
arrearages, orders. obligations or claims, on any part of this settlement, the
Employee/Claimant agrees to fully and completely indemnify, defend and hold harmless
OJCC#. 24-015353TAH
Page 10 of 13
the Employer/Carrier/Servicing Agent against any resulting obligation, claim, penalty,
fine, or lien. The Employee/Claimant expressly agrees to accept full liability for any prior
attorney liens for representation or benefits acquired for the Employee/Claimant in
relation to the industrial accident(s) and the Employee/Claimant's counsel agrees to hold
settlement proceeds in trust until any prior attorney lien, if any, is resolved.
The Employee/Claimant acknowledges that the Employee/Claimant has not
relied on any representations, advice or counsel of the Employer/Carrier/Servicing Agent,
their attorneys, agents or adjusters regarding the Employee/Claimant's entitlement to
Social Security, Medicare, Medicare Advantage Plan, or Medicaid benefits or the impact
the terms of this Settlement Agreement and Release may have on such benefits. The
Employee/Claimant further acknowledges that any decision regarding entitlement to
Social Security, Medicare, Medicare Advantage Plan, or Medicaid benefits, including the
amount and duration of payments and offset or reimbursement for prior or future
payments is exclusively within the jurisdiction of the Social Security Administration, The
United States Government, and the United States Federal courts and is determined by
Federal Law. As such, the United States Government is not bound by all the terms of this
agreement. The Employee/Claimant has been advised of her right to seek assistance
from legal counsel of her choosing or directly from the Social Security Administration or
other governmental agencies regarding the impact this agreement may have on the
Employee/Claimant's present or future entitlement to Social Security, Medicare, Medicare
Advantage Plan, Medicaid, or other governmental benefits. Notwithstanding the
foregoing, the Employee/Claimant desires to enter into the terms of this Agreement and
release of claims.
[Remainder of Page Intentionally Left Blank. Signature Pages Follow.]
OJCC#: 24-015353TAH
Page 11 of 13
This Settlement Agreement and Release was signed by the
Employee/Claimant on this / 9— day of ^Iv✓e n-1 r 20.a6
and by the attorney for the Employee/Claimant on this 18th day of November
2025 , and by the attorney for the Employer/Carrier/Servicing Agent on
this 18th day of November 20 25
Christina Sortore, Claimant Vincent Leuzzi, Esquire
Attorney for Employee/Claimant
Mr. Vincent Leuzzi
Bichler & Longo
541 South Orlando Avenue, Suite 310
Maitland, FL 32751
1-407-599-3777
/o/ a&caa4n J. scn4
Alison J. Schefer, Esquire
Attorneys for Employer/Carrier/Servicing Agent
SCHEFER PETRIC & SIMPSON
1645 Palm Beach Lakes Blvd Suite 350
West Palm Beach, FL 33401
561-537-8040
OJCC#: 24-015353TAH
Page 12 of 13
STATE OF FLORIDA
COUNTY OF ?al-vi -Rd
The foregoing instrument was acknowledged before me by means oft -Ohysical
presence or 0 online notarization, this /a- day of /(6/4-4e,/' , 2025 by Christina
Sortore, f J who is personally known to me or [ J who has produced
FG- OZ-- as identification
SWORN TO AND SUBSCRIBED before me, by means of L hysical presence or
❑ online notarization, this 0. day of 46ve,34(, 2025 .
Christina Sortore
Oion,-) 64,___ _.c -6,--vt--.C=2114 &
NOTARY PUBLIC, State of Florida
My Commission Expires: 324 9?
4 -of) tc)/..c4cY)-aii-L5
(Print, Type or Stamp Commissioned Name of
Notary Public)
—/
��� + °°A KERRIAN WISDOM•CATNOTT
o Notary Public,State of Florida
„�,, ” Commission#HH 576401 ?
1"-"" My comm.expires July 29,2028 1
OJCC No: 24-015353TAH
Page 13 of 13
STATE OF FLORIDA
DIVISION OF ADMINISTRATIVE HEARINGS
OFFICE OF THE JUDGE OF COMPENSATION CLAIMS
EMPLOYEE/CLAIMANT: ATTORNEY FOR EMPLOYEE/CLAIMANT:
Christina Sortore Vincent Leuzzi, Esquire
11622 Hackberry St 541 South Orlando Avenue
West Palm Beach, FL 33410 Maitland, FL 32751
EMPLOYER:
City of Boynton Beach ATTORNEY FOR EMPLOYER/CARRIER:
100 East Ocean Avenue Alison J. Schefer, Esquire
Boynton Beach. FL 33435 Attorney for Employer/Carrier/Servicing Agent
1645 Palm Beach Lakes BLVD
STE 350
West Palm Beach, FL 33401
CARRIER/SERVICING AGENT:
Commercial Risk Management; Inc. OJCC NO.: 24-015353TAH
P.O. Box 18366
Tampa, FL 33679 D/A: 12/13/2019
JUDGE: Thomas Hedler
MEDICARE AFFIDAVIT
State of Florida f
County of ��o.f m gi cJ
Before me, the undersigned authority, personally appeared, Christina Sortore, who,
and after being sworn by me, states as follows:
1. My name is Christina Sortore, and I am the Employee/Claimant in the above
captioned workers' compensation matter.
2, I represent that no services, medicine, medical appliances, or X-rays of any
kind were received by me from any Veteran's Hospital, Naval or Military Hospital, or any
other medical institution maintained by the United States Government, as a result of the
accident and injuries described herein.
Page 1 of 4
3. I further represent that no medical bills or services have been paid to me or
on my behalf by Medicare, including Medicare Advantage Organizations, its assignees,
and/ or its subcontractors, as a result of any injuries arising out of and during the course
and scope of my employment with the above Employer.
If conditional payments were made by Medicare, including Medicare Advantage
Organizations, its assignees, and/or their subcontractors, for authorized medical treatment
related to my industrial accident, that the Employer/Carrier would have otherwise rendered
as authorized medical treatment to me, I understand that the Employer/Carrier would accept
responsibility for reimbursement to Medicare, including Medicare Advantage Organizations,
their assignees, and/or their subcontractors, of those authorized visits.
If conditional payments were made by Medicare, including Medicare Advantage
Organizations ("MAOs"), their assignees, and/ or their subcontractors, for unauthorized
medical treatment sought by me related to my industrial accident of 12/13/2019, and
Medicare, including MAOs, their assignees. and/ or their subcontractors, request
reimbursement for same, I understand I would be fully responsible for reimbursement of
those conditional payments to Medicare, including MAOs, their assignees, and! or their
subcontractors, out of the proceeds of my net settlement funds.
4. I have considered that many common medical expenses are not paid or
reimbursable under certain group health policies or the Federal Medicare Program. I also
understand that I may, in the future, be entitled to Medicare benefits. I understand that it is
not the intent of this settlement to shift the responsibility for my future medical care to the
Federal Government.
5. As of the date of the signing of this Affidavit, I have NOT been issued a
Medicare or Medicaid benefits card, therefore, it is my understanding that I am not eligible,
nor have I been eligible since the date of my workers' compensation injury for Medicare or
Medicaid benefits.
6. Additionally, as of the date of the signing of this Affidavit, I do not belong to
a Medicare Advantage Plan (separate from regular Medicare), therefore, it is my
understanding that I am not eligible, nor have I been eligible since the date of my workers'
compensation injury for benefits under Medicare Advantage Plan.
Page 2 of 4
7. I have carefully read this Affidavit. I understand the contents thereof and its
importance. This Affidavit shall be interpreted in accordance with and governed in all
respects by the Laws of the State of Florida.
8. I have signed this Affidavit freely and voluntarily with my own act, and
without any promise of any benefits other than those which are specifically set forth in the
attached settlement agreement. I represent that at the time I sign this Affidavit, I am mentally
competent, and not under the influence of any medications or substances, either legal or
illegal, that my affect my ability to make an informed and competent decision.
FURTHER AFFIANT SAYETH NAUGHT.
Dated this /9- day of No yen b-e ; 20 25—at / gPOCG�/
County, Florida.
Christina Sortore
STATE OF FLORIDA )
COUNTY OF palm Q ad)
The foregoing instrument was acknowledged before me by means of Er-physical
presence or 0 online notarization, this 12 day of MVeyyt4Pi, 205 by Christina Sortore,
[ ] who is personally known to me or [ t fwho has produced Fe- Q L as
identification
SWORN TO AND SUBSCRIBED before me, by means of hysical presence or ❑
online notarization, this 12 day of*8,44'20 .
Personally known ; Driver's license FG _- b L ;
Other (describe)
WITNESS my hand and official seal in the County and State last aforesaid this
of /Ubverw`'� , 20
Page 3 of 4
even cc--0/ate,^ L .
-».-1w- NOTARY PUBLIC
y _i'e [1".".."--"--m*Notary
Lary
NSDOMATNOT7 Pubc,State at Forida576401
mm.expires July 29,2028 /(�, iQn dc,/ e �rG�
� � Printed NOTARY signature
My commission expires: 9-j�1�'
7
Page 4 of 4
STATE OF FLORIDA
DIVISION OF ADMINISTRATIVE HEARINGS
OFFICE OF THE JUDGE OF COMPENSATION CLAIMS
Christina Sortore, OJCC Case No.: 24-015353TAH
Claimant, DIA: 12/13/2019
v.
Judge: Thomas Hedler
City of Boynton Beach\
Commercial Risk Management, Inc.
Venue: Palm Beach
Employer/Carrier/Servicing Agent
Vincent Leuzzi, Esquire, Bichler & Longo, Attorney for Employee/Claimant, 541 South Orlando
Avenue Suite 310, Maitland, FL 32751
Alison J. Schefer, Esquire, Schefer Petric & Simpson, Attorney for Employer/Carrier. 1645 Palm
Beach Lakes Blvd, Suite 350, West Palm Beach, FL 33401
AFFIDAVIT RELATING TO SETTLEMENT AND WAIVER OF ALL CLAIMS PURSUANT TO
SECTION 440.20(11)(C)AND (D), FLORIDA STATUTES
I, Christina Sortore, certify that the Settlement and Waiver of all Claims Pursuant to Section
440.20(11)(c) and (d), Florida Statutes, was either read by me or read to me, and that the
agreement was explained to me by my attorney, Vincent Leuzzi, Esquire, and that 1 am satisfied
with the explanation given. I also certify that I was not acting under duress or coercion when I
signed this agreement. Moreover, at the time of signing the Settlement Agreement and Release
Pursuant to Section 440.20(11)(c) and (d), Florida Statutes, I was competent to handle my own
affairs and was not under the influence of alcohol or drugs to the extent that my judgment was
impaired. I agree to settle my claim on the terms outlined in the Settlement and Waiver of all
OJCC#: 24-015353TAH
Affidavit Relating to Settlement and Waiver of All Claims
Page 1 of 3
Claims Pursuant to Section 440.20(11)(c) and (d), Florida Statutes. The decision to enter into the
agreement, which I understand is final and cannot be changed, was done voluntarily of my own
will.
FURTHER AFFIANT SAYETH NAUGHT.
Dated this / ' day of Ivo✓emiQV, 20 .J at PJM &QC(c 4 County, Florida.
fea_t_In
Christina Sortore
OJCC#: 24-015353TAH
Affidavit Relating to Settlement and Waiver of All Claims
Page 2of3
STATE OF FLORIDA
COUNTY OF Wa)-i
The foregoing instrument was acknowledged before me by means ofQhysical presence
or ❑ online notarization, this lob day of AMyM , 2025 by Christina Sortore, [ 1 who
is personally known to me or[ ✓who has produced FL as identification
SWORN TO AND SUBSCRIBED before me, by means ofE'physical presence or❑ online
notarization, this f day of/L6Venk 20 25
Christina Sortore,
K ✓z-� — 1L1g -,,---a,<- (
NOTARY PUBLIC, State of Florida
My Commission Expires: �� 29 902e-
KERRIAN WISDOM-CATNOTT
x�A pude Notary Public,Slate of Florida
,,•-•., Commission#HH 676401
/ My comm.expires July 29,2028
(Print, Type or Stamp Commissioned
Name of Notary Public)
OJCC#: 24-015353TAH
Affidavit Relating to Settlement and Waiver of All Claims
Page 3 of 3
CONFIDENTIAL GENERAL RELEASE
This Confidential General Release("Agreement")is entered into by and between Christina Sortore
("EMPLOYEE") and City of Boynton Beach (the"EMPLOYER").
WHEREAS,EMPLOYEE was previously employed by the EMPLOYER as a firefighter;
WHEREAS,EMPLOYEE previously resigned her employment with the EMPLOYER;
WHEREAS, the parties wish to enter into a confidential agreement releasing claims as
outlined herein.
NOW, THEREFORE, in consideration of their mutual promises and other good and
valuable consideration, EMPLOYEE and the EMPLOYER, intending to be legally bound, agree
to the following:
1. Full and General Waiver of All Rights and Claims. EMPLOYEE hereby
knowingly and voluntarily releases, waives, and forever discharges any and all claims, rights,
demands, actions, or causes of actions, of any kind whatsoever, known or unknown, foreseen or
unforeseen, foreseeable or unforeseeable, and any consequences thereof, which EMPLOYEE has
or may have against the EMPLOYER (including but not limited to, its current and former
members, shareholders, partners, attorneys, employees, agents, affiliates, successors and assigns)
from the beginning of the world until the date of execution of this Agreement, including, but not
limited to, any claim(s)under:
• Title VII of the Civil Rights Act of 1964;
• The Civil Rights Act of 1991;
• The Florida Civil Rights Act of 1992;
• Sections 1981 through 1988 of Title 42 of the United States Code;
• The Constitutions of the United States and the State of Florida;
• The Age Discrimination in Employment Act;
• The Older Workers Benefit Protection Act;
• Florida Wage and Hour laws;
• Florida and federal whistle-blower laws, including § 112.3187,Florida Statutes;
• The Internal Revenue Code;
• The Rehabilitation Act;
• The Consolidated Omnibus Budget Reconciliation Act;
• The Immigration Reform and Control Act of 1986;
• The Americans with Disabilities Act of 1990;
• The Fair Labor Standards Act;
• The Equal Pay Act of 1963;
• The Family and Medical Leave Act of 1993; or
• The Families First Coronavirus Response Act; or
• Any other federal, state, or local civil or human rights law or any other federal,
state, or local law, regulation, or ordinance.
Page 1 of 6
EMPLOYEE also acknowledges and agrees that this release and waiver bars any claim or
demand for unpaid wages, damages, costs, fees, or other expenses, including attorneys' fees,
incurred in connection with EMPLOYEF,'s employment with the EMPLOYER, EMPLOYEE's
resignation from that employment, or with any of the above-referenced claims. EMPLOYEE has
reported all hours worked for the EMPLOYER and stipulates that she has been paid for all hours
or other increments of time during her employment with the EMPLOYER. EMPLOYEE
understands and agrees that with respect to the claims EMPLOYEE is waiving in this Agreement,
EMPLOYEE is waiving not only the right to recover money or other relief in any action
EMPLOYEE might institute, but also that EMPLOYEE is waiving any right to recover money or
any other relief whatsoever in any action that might be brought on EMPLOYEE's behalf by any
other person or entity, including but not limited to, the United States Equal Employment
Opportunity Commission or any other federal, state or local government agency or department.
EMPLOYEE understands that the foregoing list of causes of action, which have been
waived, is meant to be illustrative rather than exhaustive, and understands and acknowledges that
EMPLOYEE is waiving and releasing the EMPLOYER from any and all causes of action of any
nature whatsoever. It is EMPLOYEE's intention to fully, finally and forever resolve and release
any and all disputes EMPLOYEE may have or believe to have against the EMPLOYER with
respect to any alleged acts occurring before the Effective Date of this Agreement, whether those
disputes presently are known or unknown, suspected or unsuspected.
2. Waiver of Employment and Agreement Not to Reapply for Employment
EMPLOYEE stipulates and agrees this agreement memorializes her separation from employment
with the City of Boynton Beach, which was for reasons unrelated to her pursuing workers
compensation benefits. Claimant hereby waives any right to reinstatement or reemployment and
agrees not to apply for, solicit, seek,or otherwise attempt to obtain employment with or volunteer
with the Employer or any of its related corporations and further agrees that said corporation is not
or will not be at any time under any obligation to employ her or allow her to volunteer.
EMPLOYEE further stipulates and agrees that she was properly paid for all hours that she worked
prior to her separation from the EMPLOYER.
3. Covenant Not to Sue. EMPLOYEE represents and agrees that EMPLOYEE will
not hereinafter pursue, initiate, or cause to be instituted any dispute released herein against the
EMPLOYER, and represents that EMPLOYEE has not heretofore assigned or transferred, or
purported to have assigned or transferred, to any entity or person, any dispute released by her
herein.
4. Consideration. In consideration for EMPLOYEE's signing this Agreement, the
EMPLOYER agrees to provide EMPLOYEE with = the amount of$100.00, which is being paid
upon the execution of this Agreement. The parties agree and acknowledge that the settlement
amount constitutes good,valuable, and sufficient consideration for EMPLOYEE's full waiver and
release of all claims, and EMPLOYEE's fulfilling all other promises as set forth herein.
EMPLOYEE acknowledges that without this Agreement EMPLOYEE would not otherwise be
entitled to the consideration EMPLOYEE is receiving pursuant to this Agreement.
Page 2 of 6
Consideration for this separate Confidential General Release shall be allocated from the
EMPLOYEE's net settlement proceeds from the accompanying workers' compensation
Settlement Agreement and Release.
5. Confidentiality. EMPLOYEE recognizes that, as a result of EMPLOYEE's
employment with the EMPLOYER, EMPLOYEE has had access to Confidential Information as
defined below, which is a valuable asset of the EMPLOYER and which, if disclosed or used
without authorization,could cause irreparable harm to the EMPLOYER. Therefore,EMPLOYEE
agrees that,except as required by a lawful order of a court of competent jurisdiction or to the extent
that EMPLOYEE has written authorization from the EMPLOYER, EMPLOYEE will not, at any
time or in any manner whatsoever, either directly or indirectly, reveal, divulge, disclose, or
communicate to any person, EMPLOYER, or corporation or use for EMPLOYEE's benefit or for
the benefit of others any Confidential Information.
For purposes of this Agreement,"Confidential Information"shall include,any confidential
proprietary information concerning any matters affecting or relating to the business of the
EMPLOYER, regardless of whether it constitutes a trade secret, including but not limited to: (a)
any information concerning the identity or needs of the EMPLOYER's clients or prospective
clients; (b) any information concerning the business of the EMPLOYER, its method of business,
manner of operation, its finances, plans, processes, products, techniques, marketing strategies,
computer programs or other data; (c)any information regarding the identity of the EMPLOYER's
vendors or their accounts; (d) any other information or documents which EMPLOYEE has been
told or reasonably ought to know that the EMPLOYER regards as confidential; or(e) information
constituting a trade secret under Florida law.
EMPLOYEE agrees she will not at any time, in any fashion,form or matter, either directly
or indirectly, divulge, disclose or communicate to any person, firm or corporation in any manner
whatsoever any information of any kind, nature or description concerning any matter affecting or
relating to EMPLOYER or business of EMPLOYER, including without limiting the generality of
the foregoing, the names and addresses of any EMPLOYER customers, patients, prices of goods
and services or any other information of, about or concerning the business of EMPLOYER, its
manner of operation, its plans, processes or other data of any kind, nature or description without
to whether any or all of the foregoing matters would be deemed confidential, or important, the
parties hereto stipulating that as between them,the matters are important,material and confidential
and gravely affect the effective and successful conduct of the business of EMPLOYER and its
goodwill.
EMPLOYEE also agrees to keep confidential and not disclose,either directly or indirectly,
the terms of this Agreement other than to EMPLOYEE's legal counsel, tax advisor and/or
members of EMPLOYEE's immediate family. In the event that EMPLOYEE discloses any
information about this Agreement to EMPLOYEE's legal counsel,tax advisor and/or members of
EMPLOYEE's immediate family, EMPLOYEE agrees to inform such persons of the confidential
nature of the Agreement and, to the extent of EMPLOYEE's control or force or application of law,
bind said persons to this provision.
Page 3 of 6
6. Non-Disparagement. EMPLOYEE agrees not to engage in any conduct or make
any statements(written or oral)that defame or otherwise disparage the EMPLOYER,its principals,
or its employees. EMPLOYEE will refrain from making any negative, disparaging, libelous,
defamatory or otherwise adverse statements or communications to any third party concerning any
EMPLOYER including all officers, directors, shareholders, owners and employees of
EMPLOYER.
7. No Pending Lawsuits, Claims or Charges and Covenant Not to Sue.
EMPLOYEE represents that she does not have any charges or claims pending against
EMPLOYER with any federal,state,or local agency,administrative body,or department,and does
not have pending before any court any dispute of any kind against EMPLOYER. EMPLOYEE
further represents and agrees that she will not hereinafter pursue, initiate, or cause to be instituted
any claim, charge or dispute with any federal, state, or local agency, administrative body, or
department against EMPLOYER, and represents that she has not heretofore assigned or
transferred, or purported to have assigned or transferred, to any entity or person, any such charge
or claim. If it is determined that EMPLOYEE has any lawsuit,charge or claim of any kind pending
against EMPLOYER,she agrees to dismiss all such charges,claims and/or lawsuits with prejudice,
immediately upon the effective date of this Agreement. EMPLOYEE expressly acknowledges that
the confidentiality provisions of this agreement as set forth above and the covenant not to assert
any charges or claims of any type with any state, federal or local regulatory authority are material
terms to this agreement; and that she will faithfully abide by her agreement to keep all aspects of
the business of EMPLOYER strictly confidential.
8. Effective Date. This Agreement will become effective upon the execution of this
Agreement by both the EMPLOYEE and the EMPLOYER.
9. Return of Property. EMPLOYEE agrees and understands that EMPLOYEE must
return any and all EMPLOYER property in EMPLOYEE's possession before the EMPLOYER
will provide EMPLOYEE with the settlement amount, and the parties acknowledge and agree that
the EMPLOYER will not be required to tender the settlement amount to EMPLOYEE until
EMPLOYEE does so. EMPLOYEE further agrees not to remove or copy any files, paperwork,
data, electronic data or other information of any kind that belongs to the EMPLOYER and/or that
EMPLOYEE created, used or received while employment by the EMPLOYER.
10. No Admission. Neither this Agreement nor any provision contained herein shall
constitute or otherwise be construed as an admission by the EMPLOYER of any liability,
wrongdoing, violation of law or unlawful conduct by the EMPLOYER against EMPLOYEE.
11. Governing Law and Severability. This Agreement shall be governed and
construed in accordance with the laws of the State of Florida, with venue of any dispute in the
Palm Beach County Circuit Court. If any provision of this Agreement is declared illegal or
unenforceable by any court of competent jurisdiction and if it cannot be modified to be enforceable,
such provision shall immediately become null and void, leaving the remainder of this Agreement
in full force and effect. The language of this Agreement shall be construed as a whole, according
to its fair meaning, and not strictly construed for or against either party. If the waiver language of
this Agreement is declared unenforceable because of actions taken by EMPLOYEE or on
Page 4 of 6
EMPLOYEE's behalf, EMPLOYEE shall return all monies paid to EMPLOYEE under this
Agreement and this Agreement shall immediately become null and void, and the EMPLOYER
will owe nothing further pursuant to that Agreement.
12. Breach of any portion of this Agreement. In the event EMPLOYEE breaches or
violates any of the terms of this Agreement, she agrees to immediately return the $100.00
consideration upon written demand. In the event of failure to return this consideration,
EMPLOYER may file suit against the EMPLOYEE to recover said funds in which case employee
waives all defenses and waives jury trial.
13. Entire Agreement. This Agreement sets forth the entire agreement between the
parties and shall supersede any and all prior agreements, understandings, whether written or oral,
between the parties, except the accompanying workers' compensation settlement agreement.
EMPLOYEE acknowledges that EMPLOYEE has not relied on any representations,promises, or
agreements of any kind made to EMPLOYEE in connection with EMPLOYEE's decision to sign
this Agreement except for those set forth in this Agreement.
14. Amendment. This Agreement may not be amended except by written agreement
signed by all parties.
15. Headings. Section headings are used herein for convenience of reference only and
shall not affect the meaning of any provisions of this Agreement.
16. Acknowledgment. EMPLOYEE acknowledges that EMPLOYEE has carefully
read and understands this Agreement consisting of Six (6) pages and agrees that the EMPLOYER
has not made any representations other than those contained herein. EMPLOYEE also
acknowledges that EMPLOYEE enters into this Agreement voluntarily, without any pressure or
coercion and with full knowledge of its significance, and this Agreement constitutes a full and
absolute settlement and bar as to any and all claims EMPLOYEE had, has, or may have against
the EMPLOYER.
THE PARTIES HAVE READ, UNDERSTOOD, AND FULLY CONSIDERED THIS
AGREEMENT AND ARE MUTUALLY DESIROUS OF ENTERING INTO THIS
AGREEMENT. THE TERMS OF THIS AGREEMENT ARE THE PRODUCT OF
COMPROMISE BETWEEN THE EMPLOYER AND EMPLOYEE. HAVING ELECTED TO
EXECUTE THIS AGREEMENT,TO FULFILL THE PROMISES SET FORTH HEREIN, AND
TO RECEIVE THE BENEFITS SET FORTH ABOVE, EMPLOYEE FREELY AND
KNOWINGLY, AND AFTER DUE CONSIDERATION, ENTERS INTO THIS AGREEMENT
INTENDING TO RELEASE, WAIVE, AND SETTLE ALL CLAIMS EMPLOYEE HAS OR
MIGHT NOW HAVE AGAINST THE EMPLOYER FROM THE BEGINNING OF TIME
UNTIL THE EFFECTIVE DATE OF THIS AGREEMENT.
IN WITNESS WHEREOF, the EMPLOYEE hereto knowingly and voluntarily executed
this Agreement as of the date set forth below.
Page 5 of 6
Le
Christina Sortore
EMPLOYEE
STATE OF FLORIDA )
COUNTY OF jelai
The foregoing instrument was acknowledged before me by means of E]-physical presence
or❑online notarization,this P- day of4 'r.-, by Christina Sortore, [ 1 who
is personally known to me or[ 1/1 who has produced FL- AL- as identification and who
has acknowledged to me that she has had the foregoing General Release read to her and that she
has executed the foregoing General Release freely and voluntarily for the uses and purposes therein
expressed.
SWORN TO AND SUBSCRIBED before me, by means of12'physical presence or ❑
online notarization,this 12- day of16V4'40025 .
My Commission Expires: J1.,414tt 91, 2b2g'
WITNESS my hand and official seal in the County and State last aforesaid
/�
this /2-- day of C/ ,20 25.
le/rian
------- NOTARY PUBLIC Signature
KERRinfd WISDO CATNOTT
It Notary Public,State of Florida
Commae 578401
0^1. Ay comm.mires July 29,2028 /eecrLGe-r / M.� s
NOTARY PUBLIC Printed
Page 6 of 6
OFFICE OF THE JUDGES OF COMPENSATION CLAIMS
CASE NO. : 24-015353TAH DATE OF ACCIDENT: 12/13/19
EMPLOYEE: CHRISTINA SORTORE REPRESENTED BY: VINCENT LEUZZI
EMPLOYER: CITY OF BOYNTON BEACH REPRESENTED BY: ALISON SCHEFER
CARRIER/SA: COMMERCIAL RISK MGMT. REPRESENTED BY: ALISON SCHEFER
MEDIATION REPORT
1. A private Mediation Conference was conducted by Rand Hoch on
November 4, 2025.
2. At the Mediation Conference, the parties agreed to a Lump Sum
Settlement, CONTINGENT UPON RATIFICATION BY THE BOYNTON BEACH CITY
COMMISSION NO LATER THAN JANUARY 6, 2026.
x 3. The Employee affirms that she is not presently under the influence
of any medication, drugs or alcohol which would impair the Employee 's
ability to knowingly enter into this agreement.
4. The parties have not completed a pretrial stipulation.
5. The DOAH web site reflects that a Petition for Benefits was filed on
6/21/24.
6. If the contingency is met, all claims in dispute shall be resolved and
none shall remain unresolved.
MEMORANDUM OF CONTINGENT SETTLEMENT
Pursuant to the Mediation Report, the parties have reached
agreement as set forth below:
x This is a CONTINGENT Washout Settlement or a
Settlement Agreement. The Employee has elected
workers ' compensation as the sole and exclusive
remedy. The settlement includes and covers all
dates of accidents -- reported or unreported --
with this Employer/Carrier/Servicing. Agent.
This is neither a Washout Settlement nor a
Settlement Agreement.
1 . THE AGREEMENT SET FORTH HEREIN IS CONTINGENT UPON RATIFICATION BY
THE BOYNTON BEACH CITY COMMISSION NO LATER THAN JANUARY 6, 2026. The
Page 1
attorney for the Employer/Carrier, the Risk Manager and the
adjuster all agree to recommend the settlement and they shall
notify the Employee' s attorney of the City Commission' s decision no
later than January 10, 2026.
x 2. If the contingency is met, The Employer/Carrier/Servicing Agent
the sum of $100,000. 00 in full settlement of all claims, medical
closed. Out of the settlement, the Employee shall pay attorney' s
fees of $25,000. 00 and no costs .
3. In accordance with the Rules of Procedure for Workers '
Compensation Adjudication, the Employee or the Employee' s attorney
shall file a copy of this report with the presiding judge.
I x 4 . While both parties were satisfied with the services rendered
by the mediator, his fees are to be paid by the Employer/Carrier/
Servicing Agent.
x 5. Special terms, if the contingency is met:
(A) All indemnity at Employer/Carrier/Servicing Agent' s
expense shall end on the date the attorney for the Employer/
Carrier/Servicing agent notifies the Employee' s attorney that
the City Commission has ratified the settlement. Any and all
medical benefits of any kind in any class at Employer/Carrier/
Servicing Agent' s expense shall also end on the afore-
referenced date.
(B) The Employer/Carrier/Servicing Agent remains
responsible for payment of all medical bills for the
Page 2
Employee' s care through the date the attorney for the
Employer/ Carrier/Servicing agent notifies the Employee' s
attorney that the City Commission has ratified the settlement;
however, this covers only that care from authorized
providers for conditions related to the industrial accident.
Payment in accordance with the fee schedule shall be timely
made after the bills have been submitted to the
Employer/Carrier/ Servicing Agent on the proper forms.
( C ) The Employee has retired and agrees to (1) tender
an Agreement Not to Seek Re-employment and/or Volunteer
effective the date the attorney for the Employer/Carrier/
Servicing agent notifies the Employee' s attorney that the City
Commission has ratified the settlement and (2) execute a
mutually agreeable General Release of all claims, including
Coverage B, against the Employer/Carrier/Servicing Agent and
all related entities. Nothing herein shall effect the
employee' s rights to vested benefits, including the right to
apply for re-employment compensation However, the Employer
has the right to defend/contest entitlement to any re-
employment insurance claim. Consideration for the general
release is included in the settlement amount.
(D) After payment of all attorney' s fees and costs, the
Employee shall net $75,000 . 00.
6. The parties agree to the terms as stated herein and
consent to their disclosure to -- and the submission of this
Report(via DOAH) to -- the Judge of Compensation Claims following
ratification by the City Commission.
Page 3
7 . The parties have considered Medicare ' s interests, if any,
and the Employee agrees to execute all documents, if any, which are
necessary to protect all parties and their counsel regarding
Medicare issues .
8 . If the contingency is met, the attorney for the
Employer/Carrier/Servicing Agent shall prepare all documents
necessary to effectuate this agreement (including a workers '
compensation release, if applicable) , and the parties and their
counsel agree to promptly submit same to the appropriate authority,
and to perform all their agreed upon acts. If this is a Settlement
Agreement, the documents shall indicate that the Employer/Carrier/
Servicing Agent shall have fourteen (14) days from the date the
Office of the Judges of Compensation Claims issues the Order
Approving Attorney' s Fees to pay the settlement proceeds.
9. The preceding Memorandum of CONTINGENT Settlement
contains only the key points in the settlement and it is not
comprehensive. It may be superceded by a more formal agreement.
Notwithstanding, if the contingency is met, the parties intend
x this mediation settlement agreement to be binding and specific-
ally enforceable. If the Mediator was asked to prepare the initial
draft of this Agreement, the parties acknowledge that they, and
their lawyers (if any) , reviewed it carefully and had all of the
changes and additions made which they wanted, and hold the mediator
harmless from all liability arising from his drafting. This
agreement shall survive the execution or non-execution of any
subsequent documents.
Page 4
10. Although the undersigned mediator is also a licensed
attorney, the services provided in this matter are solely third
party neutral services and the undersigned mediator has not acted
as an advocate for any party to this mediation. To the extent the
undersigned mediator has assisted in the preparation of this
settlement agreement, each party to the agreement has had (or has
been advised to have) this agreement independently reviewed by
counsel of that party' s choosing before executing the agreement.
11 . The undersigned mediator is not a legal advisor, tax
advisor or mental health counselor. Each party will look solely to
its attorney, accountant and/or mental health counselor for legal,
tax and mental health advice . The mediator will accept no liability
for the giving or the failure to give any legal, tax or mental
health advice.
12 . The mediation conference and any related post-conference
sessions held thereafter are subject to Florida' s Mediation and
Confidentiality Act. Communications made during this process are
confidential, regardless of whether the mediation conference is
court ordered. Violations by any mediation participant are subject
to punishment under Section 44.406, Florida Statutes. Moreover, the
undersigned mediator is entitled to immunity under Florida Statutes
Section 44 . 107 whether or not this mediation is court ordered.
13 . The parties and their counsel agree that, from this date
forward until the end of time, in no event shall Rand Hoch be
subpoenaed, be called to testify, be called to give a statement or
deposition, or be deposed, in any court or other forum in the
universe, to resolve any matter or to disclose any communication or
Page 5
conduct made during this mediation conference. That having been
said, in the event a party attempts to compel the mediator ' s
testimony in a court proceeding, that party shall be responsible
for and shall pay the mediator ' s fees and costs in defending such
an attempt, and shall pay for all time incurred by the mediator in
preparing for and participating in any court proceeding at the
standard hourly rate. All records , reports, documents and/or
communications received by the undersigned mediator will be
confidential and under no circumstances shall the undersigned
mediator be compelled to divulge records or testify about the
mediation conference .
By their signatures below, the parties and their counsel
represent that they have authority to enter into this Memorandum of
Settlement. The undersigned mediator attests the Employee has
authorized their attorney to sign this document on their behalf and
the undersigned mediator certifies that the Employee stipulated to
be bound by their attorney of record' s signature on this document,
pursuant to Rule 60Q-6 . 110 (5) , Fla. Admin. Code. Therefore, the
foregoing Memorandum of Settlement is stipulated and agreed to by
the undersigned parties (or their legal counsel) before Rand Hoch
on November 4 , 2025 .
/s/ Alison Schefer
EMPLOYEE CARRIER/SERVICING AGENT REPRESENTATIVE
/s/ Alison Schefer
ATTORNEY FOR THE EMPLOYEE EMPLOYER REPRESENTA VE
ATTORNEY OR E E/C A
This is to certify that a copy of this Media ' n Report ha b n furnished to
the parties and/or their attorneys . z�
HOCH,
CERTIFIED CIRCUIT CIVIL MEDIATOR
'.age 6