R25-315 RESOLUTION NO. R25-315
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 JOHN GUERRERO V. CITY OF
4 BOYNTON BEACH, TOTALING $200,000; AND FOR ALL OTHER
5 PURPOSES.
6
7 WHEREAS, the Code of Ordinances of the City of Boynton Beach, Florida, provides that
8 the authority for settlement of all claims in excess of $50,000 shall require approval of the City
9 Commission by formal resolution; and
10 WHEREAS, John Guerrero ("Plaintiff") brought a claim stemming from an alleged incident
I I that occurred on or about July 27, 2025; and
12 WHEREAS, a Settlement and Release of Claim was reached with the Plaintiff for $200,000
13 in exchange for a general release of all claims, which resolves all claims for damages between the
14 Plaintiff and the City of Boynton Beach, Jonathan Hickman, Tristar Risk Management, PGIT
15 Insurance Company, and their employees, as well as attorney's fees and costs, if any; and
It, 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 Settlement Agreement and Full
18 and Final General Release of Claim in the matter of John Guerrero and the City of Boynton Beach,
19 Jonathan Hickman, Tristar Risk Management, PGIT Insurance Company and their employees,
20 totaling $200,000.
21 NOW, THEREFORE, BE IT RESOLVED BY THE CITY COMMISSION OF THE CITY OF BOYNTON
22 BEACH, FLORIDA, THAT:
23 SECTION 1. The foregoing "Whereas" clauses are hereby ratified and confirmed as
24 being true and correct and are hereby made a specific part of this Resolution upon adoption.
25 SECTION 2. The City Commission of the City of Boynton Beach, Florida, does hereby
26 approve the Settlement Agreement and Full and Final General Release of Claim in the matter of
27 John Guerrero and the City of Boynton Beach, Jonathan Hickman, Tristar Risk Management, PGIT
28 Insurance Company, and their employees, totaling $200,000, in form and substance similar to that
29 attached as Exhibit A.
30 SECTION 3. This Resolution shall take effect in accordance with the law.
31
RESOLUTION NO. R25-315
32 PASSED AND ADOPTED this a day of\e_c_e_vse-' 3 Q' , 2025.
33 CITY OF BOYNTON BEACH, FLORIDA
34 YES NO
35 Mayor- Rebecca Shelton
36
37 Vice Mayor-Woodrow L. Hay ✓
38
39 Commissioner-Angela Cruz V
40
41 Commissioner-Thomas Turkin
42
43 Commissioner-Aimee Kelley ✓
44
45 VOTE 5 'c
46 ATTEST:
47
48
4*LMaylee De J sus, MPA, C 'ebecca Shelton
5( City Clerk
51 O• GORPNrO ..
F BOY � Mayor
52 f ' .
i V . �1�1
APPROVED AS TO FORM:
53 (Corporate Seal) $ : S� T��.D�•
54 S/N�ORp : n i
55 � 19��''qTF� =i %611‘)M• 2
56 1I Shawna G. Lamb
`N�ORI DA
57 = City Attorney
RELEASE
CLAIM#25000011456
I, John Guerrero ("RELEASOR"), for the sole consideration of$ 200,000.00 (Two
Hundred Thousand Dollars and NO/XX) ("Settlement Funds") to be paid in accordance with the
terms of this Release, do hereby for myself and for my heirs, executors, administrators,
successors and assigns release, acquit and forever discharge The City of Boynton Beach,
Jonathan Hickman,Tristar Risk Management, PGIT Insurance Company and their employees,
("RELEASEES"), of and from any and all claims, actions, causes of action, liens or conditional
payments, demands, rights, damages, costs, loss of service, expense and compensation
whatsoever of every name and nature, known or unknown, which the RELEASOR now has or
which may hereafter accrue on account of or in any way growing out of any and all known and
unknown, foreseen or unforeseen bodily and personal injuries, illnesses and property damage and
the consequences thereof resulting from or arising out of an accident or incident which occurred
on or about July 27, 2025 at or near N.E 1st Ave. and N. SR 5 in Boynton Beach, FL
("Incident"). The foregoing release and discharge is intended by RELEASOR to be as broad in
favor as RELEASEES can possibly create.
RELEASOR recognizes that the consideration referred to above is intended to effectuate
the compromise of a doubtful and disputed claim and is not to be construed as an admission of
liability on the part of any of the RELEASEES, each of whom expressly denies liability.
RELEASOR further recognizes that any injuries or illnesses sustained in the Incident are
or may be permanent and progressive and that the recovery from said injuries or illnesses is
uncertain and indefinite, and in entering this Release is not relying on any statement of any of the
RELEASEES with respect to the nature, extent,or duration of said injuries. RELEASOR further
declares and represents that no promise, inducement or agreement not herein expressed has been
made to RELEASOR. RELEASOR further stipulates that the terms of this Release are
contractual and not a mere recital and that the representations in this Release are material
representations upon which RELEASEES have relied in making this settlement.
RELEASOR stipulates and agrees that he/she is responsible for payment of all
outstanding and future bills relating to medical and prescription drug items or services associated
with injuries or illnesses arising from or relating to the Incident or forming the basis of the
claims asserted by RELEASOR("Medical Services").
RELEASOR further stipulates and agrees that he/she is solely responsible for satisfying
any conditional payment, lien or other obligation to reimburse the Centers for Medicare &
Medicaid Services("CMS")and/or its contractors,other governmental entities [or programs,]
insurers or [other sources of payment or benefits] for any Medical Services furnished to
RELEASOR. RELEASOR acknowledges and agrees that it is his/her responsibility, and not that
of RELEASEES, to satisfy all conditional payments, liens, subrogation and other claims
or demands for payment associated with Medical Services that may arise in any manner,
including without limitation under the Medicare Secondary Payer("MSP") statute(42 U.S.C. §
I395y(b)), contract, or other applicable state or federal law.
1. With respect to Medicare status (check relevant box):
V RELEASOR hereby represents and warrants that he/she (a) is not
currently entitled to Medicare benefits, (b)was not entitled to Medicare
benefits on or between the date of the Incident and execution of this
Release and (c) does not reasonably expect to qualify for Medicare
coverage within 30 months of executing this Release; or
RELEASOR hereby represents and warrants that he/she (a) currently
qualifies for Medicare coverage, (b)was entitled to Medicare benefits on
or between the date of the Incident and execution of this Release, or(c)
expects to so qualify within 30 months of executing this Release. In
further consideration for this Release, a Medicare Addendum dated
is attached hereto and incorporated herein by reference.
2. In order to give full effect to the intent expressed in this Release, RELEASOR stipulates
and agrees in consideration for the aforesaid payment, to fully indemnify and hold harmless
RELEASEES from any and all loss associated with any conditional payment, lien, subrogation
or other claim or demand asserted by CMS and/or its contractors, other governmental entities [or
programs], insurers or [other sources of payment or benefits] that may arise in any manner,
including without limitation under the MSP statute(42 U.S.C. § I395y(b)), contract, or other
applicable state or federal law relating to Medical Services or from RELEASOR's failure to
make the payments and satisfaction described in this Release. RELEASOR further agrees to
indemnify and hold harmless RELEASEES from all loss resulting from RELEASOR's failure to
provide accurate representations and warranties or to adhere to the representations and warranties
contained herein. This indemnification from loss includes all damages and costs incurred by
RELEASEES and/or their attorneys, including without limitation, any attorney's fees, fines and
penalties, interest, expenses,judgments, and multipliers.
BY SIGNATURE, RELEASOR AFFIRMS THAT HE/SHE HAS READ THE FOREGOING
RELEASE AND FULLY UNDERSTANDS IT.
SIGNATURE PAGE FOLLOWS NEX"I'
ICxeeuted ilm Beach n county. _ _�_-_� _this
__14th. cl2iy 4°'Y e••« Floridasati-,�
Novembpr 2025 /
Nam :John Guerrero
STATE OF FLORIDA ___
COUNTY OF BROWARD to wit:
i
On the 14th day of Novemver ,2025_before me personally appeared John Guerrero to
me known to be the person named in the foregoing Release,and who executed the foregoing
Release and acknowledged to me that he has read the Release and understands the contents
thereof12.e Volunt ; executed the same.
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