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0 <br />n <br />TO: <br />DEPARTMENT OF PUBLIC SAFETY <br />SAFETY RESPONSIBILITY <br />O P. 0. BOX 4087, N. AUSTIN STATION <br />AUSTIN, TEXAS <br />A FEE OF $5.00 IS REQUIRED <br />WHEN FILED <br />Accident Case No. S . R. 6155600 <br />INSTALLMENT AGREEMENT <br />As a result of a motor vehicle accident which occurred at La Porte, Harris County Texas, <br />on February 18, 1976 , the undersigned, hereafter known as party of the first <br />part, does hereby agree to effect settlement of claims for damages and/or personal injuries suffered <br />by City of La Porte, a municipal corporation, <br />hereafter known as the party of the second part, on the following terms: <br />The party of the first part agrees to pay the sum of Three Thousand Two Hundred Sixty-two & 84/100 <br />($ 3,262.84 ) to the party of the second part or to his/her personal repre- <br />sentative at the rate of $ 10 0. 0 0 or more per month <br />first payment $ 10 0. 0 0 <br />May 1 , 197 6 . <br />Upon compliance with the provisions of this agreement the party of the second part shall <br />deliver to the party of the first part a complete and unconditional release from all claims <br />O and causes of action he/she now has or hereafter may have against the party of the first <br />part on account of damages and/or personal injuries resulting from the accident referred <br />to. <br />40 <br />41 <br />By the execution and acceptance of this agreement the party of the first part releases <br />the party of the second part from all liability and each agrees that the same may be used <br />by the Texas Department of Public Safety in the administration of the Texas Motor Vehicle <br />Safety -Responsibility Law. <br />STATE OF TEXAS ) Dated April 19, 19 76 <br />ss. <br />COUNTY OF HARRIS <br />( Party of the First Part) TDL $ <br />JOHN WILBUR REEVES <br />JOHN WILBUR REEVES, party of the first part, personally appeared be- <br />fore me, a Notary Public in and for said County, and acknowledged the execution of the above <br />agreement. <br />My commission expires: <br />June 1, 1977. <br />ACCEPTANCE <br />(Notary Public) <br />Harris County, Texas <br />I accept the foregoing agreement and acknowledge that I will execute a release in behalf of the <br />party of the first part upon completion of its terms. <br />STATE OF TEXAS <br />COUNTY OF HARRIS <br />Dated April 19, , 19 76. <br />ss. <br />l� arty of the Second Part) <br />CITY OF LA PORTS, acting herein by CITY OF LA PORTE by I.J.Kibodeaux, Mayor Pro -Tan <br />and thru I.J.Kibodeaux, its Mayor Pro -Tan , party of the second part, personally appeared <br />before me, a Notary Public in and for said County, and acknowledged the acceptance of the above <br />agreement. <br />My commission expires: <br />June 1, 1977 <br />SR-19 <br />(Notary Public) <br />Harris County, Texas <br />