HomeMy WebLinkAboutSettlement Participation Form - TevaExhibit K
Subdivision and Special District Settlement Participation Form
Governmental Entity: Mason County State: WA
Authorized Signatory: /officialname_teva_allergan/
Address 1: /address1_teva_allergan/
Address 2: /address2_teva_allergan/
City, State, Zip: /cit_ta/ /state_ta/ /zi_ta/
Phone: /phone_teva_allergan/
Email: /email_teva_allergan/
The governmental entity identified above (“Governmental Entity”), in order to obtain and in
consideration for the benefits provided to the Governmental Entity pursuant to the Agreement
dated November 22, 2022 (“Teva Settlement”), and acting through the undersigned authorized
official, hereby elects to participate in the Teva Settlement, release all Released Claims against all
Released Entities, and agrees as follows.
1.The Governmental Entity is aware of and has reviewed the Teva Settlement, understands that
all terms in this Election and Release have the meanings defined therein, and agrees that by
this Election, the Governmental Entity elects to participate in the Teva Settlement as provided
therein.
2.Following the execution of this Settlement Participation Form, the Governmental Entity shall
comply with Section III.B of the Teva Settlement regarding Cessation of Litigation Activities.
3.The Governmental Entity shall, within 14 days of the Reference Date and prior to the filing of
the Consent Judgment, file a request to dismiss with prejudice any Released Claims that it has
filed. With respect to any Released Claims pending in In re National Prescription Opiate
Litigation, MDL No. 2804, the Governmental Entity authorizes the Plaintiffs’ Executive
Committee to execute and file on behalf of the Governmental Entity a Stipulation of Dismissal
With Prejudice substantially in the form found at https://nationalopioidsettlement.com.
4.The Governmental Entity agrees to the terms of the Teva Settlement pertaining to
Subdivisions as defined therein.
5.By agreeing to the terms of the Teva Settlement and becoming a Releasor, the Governmental
Entity is entitled to the benefits provided therein, including, if applicable, monetary payments
beginning after the Effective Date.
6.The Governmental Entity agrees to use any monies it receives through the Teva Settlement
solely for the purposes provided therein.
7.The Governmental Entity submits to the jurisdiction of the court in the Governmental Entity’s
state where the Consent Judgment is filed for purposes limited to that court’s role as provided
in, and for resolving disputes to the extent provided in, the Teva Settlement.
1
DocuSign Envelope ID: DA8D9ADD-8754-439D-BCCD-33A6405CAF11
360-427-9670
98584
411 N. 5th Street
Shelton Washington
Kevin Shutty
kshutty@masoncountywa.gov
8.The Governmental Entity has the right to enforce the Teva Settlement as provided therein.
9.The Governmental Entity, as a Participating Subdivision or Participating Special District,
hereby becomes a Releasor for all purposes in the Teva Settlement, including but not limited
to all provisions of Section V (Release), and along with all departments, agencies, divisions,
boards, commissions, districts, instrumentalities of any kind and attorneys, and any person in
their official capacity elected or appointed to serve any of the foregoing and any agency,
person, or other entity claiming by or through any of the foregoing, and any other entity
identified in the definition of Releasor, provides for a release to the fullest extent of its
authority. As a Releasor, the Governmental Entity hereby absolutely, unconditionally, and
irrevocably covenants not to bring, file, or claim, or to cause, assist or permit to be brought,
filed, or claimed, or to otherwise seek to establish liability for any Released Claims against
any Released Entity in any forum whatsoever. The releases provided for in the Teva
Settlement are intended by Released Entitles and the Governmental Entity to be broad and
shall be interpreted so as to give the Released Entities the broadest possible bar against any
liability relating in any way to Released Claims and extend to the full extent of the power of
the Governmental Entity to release claims. The Teva Settlement shall be a complete bar to
any Released Claim.
10.The Governmental Entity hereby takes on all rights and obligations of a Participating
Subdivision or Participating Special District as set forth in the Teva Settlement.
11.In connection with the releases provided for in the Teva Settlement, each Governmental Entity
expressly waives, releases, and forever discharges any and all provisions, rights, and benefits
conferred by any law of any state or territory of the United States or other jurisdiction, or
principle of common law, which is similar, comparable, or equivalent to § 1542 of the
California Civil Code, which reads:
General Release; extent. A general release does not extend to claims
that the creditor or releasing party does not know or suspect to exist in
his or her favor at the time of executing the release that, if known by
him or her, would have materially affected his or her settlement with
the debtor or released party.
A Releasor may hereafter discover facts other than or different from those which it knows,
believes, or assumes to be true with respect to the Released Claims, but each Governmental
Entity hereby expressly waives and fully, finally, and forever settles, releases and discharges,
upon the Effective Date, any and all Released Claims that may exist as of such date but which
Releasors do not know or suspect to exist, whether through ignorance, oversight, error,
negligence or through no fault whatsoever, and which, if known, would materially affect the
Governmental Entities’ decision to participate in the Teva Settlement.
12.Nothing herein is intended to modify in any way the terms of the Teva Settlement, to which
Governmental Entity hereby agrees. To the extent this Election and Release is interpreted
differently from the Teva Settlement in any respect, the Teva Settlement controls.
2
DocuSign Envelope ID: DA8D9ADD-8754-439D-BCCD-33A6405CAF11
I have all necessary power and authorization to execute this Election and Release on behalf of the
Governmental Entity.
Signature:/signer_1_teva_allergan/
Name:/name_1_teva_allergan/
Title:/title_1_teva_allergan/
Date:/date_1_teva_allergan/
3
DocuSign Envelope ID: DA8D9ADD-8754-439D-BCCD-33A6405CAF11
4/12/2023
Kevin Shutty
Commissioner