File No.: ______

RELEASE OF DAMAGES

KNOW ALL MEN by these presents that I/We, ______, [Address], in consideration of the sum of ($ ) dollars now paid to me/us by [COMPANY NAME] (the “Company”), the receipt of which sum is hereby acknowledged, do hereby RELEASE AND FOREVER DISCHARGE the Company, its employees and contractors of and from any and all manner of actions, causes of action, suits, debts, claims, demands and costs whatsoever, and, without limiting the generality of the foregoing, in particular all manner of actions, causes of action, suits, debts, claims and demands arising out of or connected with –

PROJECT DESCRIPTION: LEGAL DESCRIPTION:

TOTAL:

which against the Company and its employees and contractors or any of them, I ever had, now have, or which I, my heirs, executors, administrators or assigns, or any person claiming by, through or under me, hereafter can, shall or may have for or by reason thereof or by reason of any act, matter or thing whatsoever existing up to the present time.

PAYMENT of the said sum of money by the Company to me does not and shall not be deemed to constitute any admission of liability on the part of the Company to me.

IT IS FURTHER UNDERSTOOD AND AGREED that wherever the singular is used throughout this Release the same shall be construed as meaning the plural or a body corporate where the context so requires. SUBJECT TO COMPANY APPROVAL.

ACCEPTED AND AGREED TO this day of A.D. 20 , at the of , in the Province .

Per: Witness [LANDOWNER NAME] Registered Owner

Per: Witness [LANDOWNER NAME] Registered Owner